Care Home: Tudor Manor Nursing Home

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What the care home does well The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognize the needs of the people they support. Observation of practice and discussion with staff members confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of the people in their care. We spoke to people about their experiences living in the home and were told they were being well cared for by a group of staff who are friendly and kind. They told us they received the care and support they need, the staff are available when they need them, they listen and act on what they say and they get the medical care they need. One person said, "I am very happy with my care. The staff are very kind and friendly and attentive when you need them. I am very settled and wouldn`t want to go anywhere else. The food is good, we get plenty of choices and the portions are more than enough. Activities organised every day to keep us occupied. What more could you ask for". Visiting arrangements at the home are informal and family and friends of people who live there are encouraged to maintain contact. Relatives and friends were observed visiting the home throughout the day and were made welcome by the staff on duty. The home has good quality assurance systems in place and provides people with the opportunity to comment on the service being provided. The relative of one person said, "The home shows consideration not only to the people who live there but also their relatives. They hold regular meetings at which we are kept informed and allowed to question any problems we have". Staffing levels were sufficient for the number of people being accommodated. The staff were observed throughout the visit having enough time to deliver care and support without being hurried. People spoken to said the staff were very quick to respond to requests for assistance. Staff employed at the home have been well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed the people they support are treated with respect and dignity. The home has been decorated and furnished to a good standard to ensure the comfort of people who live there. When we visited an ongoing refurbishment programme was in place with improvements being made to both the interior and exterior of the building. The people we spoke to told us they were happy with the standard of accommodation provided. What has improved since the last inspection? This is the homes first key inspection since the recent change of ownership took place. What the care home could do better: There has been no requirements or recommendations made of the home during this inspection. The manager and her staff are providing a service, which people are happy with and feedback throughout the inspection process was positive about the home and the staff who work for them. However, the manager of the home understands there is always room for improvement and they must continue to work hard to ensure the standards presently being provided continue to be met. During completion of the Annual Quality Assurance Assessment form the manager has identified some areas where she thinks the service being provided can be improved. These include continuing with the extensive refurbisment programme to generally improve the environment year after year. They also recognize the need to provide more in house training for staff at all levels and bolster staffing levels by recruiting more bank staff to cover staff leave and sickness. Key inspection report Care homes for older people Name: Address: Tudor Manor Nursing Home Clifton Drive Blackpool Lancs FY4 1NP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Wesley Cornwell     Date: 2 4 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Tudor Manor Nursing Home Clifton Drive Blackpool Lancs FY4 1NP 01253408771 01253347728 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Modelfuture Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Physical disability - Code PD. The maximum number of service users who can be accommodated is: 50 Date of last inspection Brief description of the care home Tudor Manor care home is registered to accommodate 50 people who require residential and nursing care. People who are assessed as requiring nursing care are generally accommodated on the ground floor where qualified nurses are on duty. People requiring residential care are located on the first floor. The home is purpose built and the accommodation comprises of 46 single rooms and 2 double rooms. EnCare Homes for Older People Page 4 of 25 Over 65 50 0 0 50 Brief description of the care home suite facilities are available in 40 rooms. Lounge and dining room areas are located on both floors. A passenger lift enables people to have access to the rooms situated on the first floor. Various aids are provided around the home to assist the people in their daily routines. The home is situated in the South Shore area of Blackpool, close to the promenade and the Pleasure Beach theme park. A varied programme of entertainment is in place with professional entertainers regualrly visiting the home. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the service that people can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is available from the manager to help people make an informed choice about whether to move into the home. The range of fees charged by the home are three hundred and three pounds to five hundred and forty seven pounds covering all aspects of care, food and accommodation. Additional charges are made for chiropody and hairdressing. The manager provided this information on 24th November 2009. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit was undertaken as part of the homes first key inspection since the recent change of ownership took place. The visit commenced at 9.30am and took place over 6 hours. Prior to the visit the manager of the home completed an Annual Quality Assurance Assessment form (AQAA) providing detailed information about the service they are providing. The AQAA is a self assessment and data set, which providers are asked to complete each year and is one of the main ways that we obtain information about how they are meeting outcomes for people they support. A number of people living in the home were contacted prior to the visit and their views about the service being provided have been included in the report. In addition we spoke to three people who live in the home, four staff members one visitor and the manager and home owner. Staff, care, maintenance and financial records were examined and a full tour of the premises was undertaken with the manager. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: There has been no requirements or recommendations made of the home during this inspection. The manager and her staff are providing a service, which people are happy Care Homes for Older People Page 7 of 25 with and feedback throughout the inspection process was positive about the home and the staff who work for them. However, the manager of the home understands there is always room for improvement and they must continue to work hard to ensure the standards presently being provided continue to be met. During completion of the Annual Quality Assurance Assessment form the manager has identified some areas where she thinks the service being provided can be improved. These include continuing with the extensive refurbisment programme to generally improve the environment year after year. They also recognize the need to provide more in house training for staff at all levels and bolster staffing levels by recruiting more bank staff to cover staff leave and sickness. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of people were met. Evidence: We looked at the care plan records of two people and found they had full assessment information in place including their religious/cultural and relationship needs. The assessment had identified the nutritional needs of the people and risk assessment information advising staff members of the action to be taken to minimize identified risks and hazards. The staff member responsible for the preparation of meals told us they are provided with information about people with special dietary needs and these are accommodated. The people we spoke to said they were very happy with the care being provided and told us their needs were being met. One person said, I am very satisfied with my care and have no grumbles. I dont think I could be looked after better anywhere, I Care Homes for Older People Page 10 of 25 Evidence: am very happy. This home doesnt provide intermediate care. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously and peoples welfare is closely monitored and were met. Evidence: Individual records are kept for each person with a plan of care setting out the action that is to be taken by support staff to ensure all aspects of health, personal and social care needs of the people living at the home were being met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed regularly and updated to reflect any changes needs and these were being actioned as required. We looked at the records of two people and these described their healthcare needs. Discussion with the manager and staff members confirmed they were fully aware of the healthcare needs of people living in the home and these are monitored and their care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. Daily entries made on the care plans confirmed staff members were following the instructions of healthcare professionals Care Homes for Older People Page 12 of 25 Evidence: and an appropriate level of care was being provided. People with nutritional problems were having their weight recorded on their admission and this was being closely monitored and appropriate action take where necessary. One person who became unwell during the visit received prompt assistance from two staff members and medical attention was immediatley sought. People who were being cared for in bed had been provided with a special mattress that was suitable for the relief of pressure and prevention of pressure sores. People being nursed in bed looked comfortable and well carered for and were observed receiving their care from attentive staff. We spoke to people about the care they were receiving and were told they liked living at the home and were being well treated. One person said, The staff are very polite and respectful. I am very happy with my care and dont feel I could be looked after better anywhere. I like to spend time in my room and find my privacy is respected by the staff. The medication practices we observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received accredited training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Evidence: We spoke to people about the routines in the home and they told us they were flexible and they were able to make their own decisions about how to live their lives. One person said, I love it here. You can choose what you want to do. I prefer to stay in my room as I enjoy my own company. People spoken to told us they were happy with arrangements in place for receiving their visitors. Relatives and friends were observed visiting throughout the day and seen to be made welcome by the staff team. The staff member responsible for the preparation of meals was able to confirm they had information about people with special diets and personal preferences and told us these were being accommodated. Menus were observed and found to be providing meals that were varied and nutritious. We spoke to people about the meals provided by the home and they told us these were enjoyable and they got plenty to eat. Meal times were served in a relaxed and unhurried manner. Staff members were observed Care Homes for Older People Page 14 of 25 Evidence: being very attentive to the needs of people who needed assistance. The people we spoke to told us they were happy with the arrangements in place for social activities. These were varied and arranged individually and in groups. One person commented, Plenty going on for those who want to take part. No time to get bored. Most people handle their own financial affairs or these are handled by their relatives/representatives. Records being kept in respect of people unable to handle their own finances were being well maintained ensuring the interests of people were being safeguarded. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The home has a detailed complaints procedure, which is issued to all people on their admission. The complaints procedure was on display around the home for the attention of the people who live there and their visitors. People spoken to told us they knew how to make a complaint if they were unhappy. All said they were happy and had no reason to make a complaint. One complaint which had been received by the Commission prior to this inspection and referred to the home to investigate had been investigated thoroughly and appropriately. The home has a procedure in place for dealing with allegations of abuse. The staff members spoken to had received training in the protection of vulnerable adults and showed a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff members spoken to said they wouldnt hesitate to report any concerns they had about care practices to ensure people living at the home are protected from potential harm or abuse. At the time of this visit the Care Quality Commission had not received any safeguarding referrals about staff working at the home. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, homely, clean and safe environment Evidence: The home has been well maintained and decorated for the comfort of the people living there. The people we spoke to told us they were happy with the standard of accommodation provided and said they felt at home. Since the change of ownership of the home work has been ongoing with the first floor being redecorated and refurbished. New fire doors have been fitted throughout the building and a new call bell system purchased. The downstairs lounge and dining have been re carpeted and refitted and external building work completed. A complete refit of the kitchen has also been undertaken. The manager told us the refurbishment of the home is ongoing and there are plans for further improvements throughout the home. The people we spoke to told us they were very happy with the improvements being made. A tour of the building confirmed bedrooms had personalized with people being encouraged to bring their own belongings on their admission into the home The People we spoke to were happy with their rooms and said they had the choice of spending time on their own or in the lounge areas. Care Homes for Older People Page 17 of 25 Evidence: Hot water temperatures were checked throughout the home and found to be delivering water at a safe temperature in line with health and safety guidelines. It was observed during the visit the home was clean and hygienic ensuring a pleasant environment in which to live. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient to meet the needs of people living at the home. Evidence: Staffing levels were sufficient for the number of people living in the home. The people we spoke to during the visit told us they were happy with their care and said they were well treated by the staff. They told us the staff were available when they needed them and they were treated with kindness and patience. One person said, The staff are lovely, always available when you want them. I like to stay in my room and if I press my bell when I need something they come quite quickly. You have to be patient sometimes because they are kept busy but they always come with a smile on their faces. They are very friendly and pleasant and I am very happy living here. The staff members we spoke to showed a good understanding of their role and responsibilities and felt they worked well as team to ensure the individual and collective needs of the people in their care were being met. People visiting the home told us they had no concerns about the care being provided and said their relatives were being well treated. Records show all staff members have access to a structured training and development programme ensuring the people in their care are being supported by a well trained and competent staff team. In addition 50 of staff members have achieved National Care Homes for Older People Page 19 of 25 Evidence: Vocational Qualifications (NVQ) ensuring people are in the safe hands of qualified and competent staff. Examination of staff records confirmed the home has thorough and robust systems in place for recruiting staff members ensuring the protection of people living there. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and ensures the health and safety of staff and people living there are promoted and protected. Evidence: The home is presently without a manager who is registered with the Commission. The owner of the home said he has recently appointed a manager who is qualified, competent, experienced and who he hopes will run the home for the benefit of the people who live there. He stated that he would submit a manager application for registration to the Commission once all her clearances had been completed and a satisfactory probation period has been completed. The home is presently being run by a registered manager on secondment from another Southern Cross home. We spoke to people about the management arrangements in place and were told they were happy with these. They told us the home was being well run. People living in the home and their visitors were very positive when we spoke to them about the service being provided. We were told the Care Homes for Older People Page 21 of 25 Evidence: manager was friendly, approachable helpful and professional. Through discussion and observation of records we were able to establish she undertakes periodic training to ensure her knowledge and skills are updated and the home continues to be run well and for benefit of the people in her care. This included attending training with the local authority about the Mental Capacity Act deprivation of liberty safeguards which had provided guidance for providers on their duties and responsibilities to apply for authorisation if they felt it was in the best interests to deprive someone in her care of their liberty. The people we spoke to confirmed they had choice of movement, were able to make their own decisions about their lifestyle and their civil rights were being safeguarded. The manager has in place quality assurance systems to gather the views of the people in her care about the service being provided and keep people informed about events being organised by the home. The people we spoke to told us they are consulted about changes taking place within the home and they are kept fully informed about events being organised by the home. A self assessment form that the Commission had asked the manager to complete before this visit took place was completed to a good standard. The manager told us how outcomes for people in her care were being achieved and areas she had identified for future development. She also informed us about the training her staff were receiving and how this was helping with their development. Financial records were well maintained and up to date ensuring the interests of people are safeguarded. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation providing a safe environment for people to live. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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