Care Home: Tudor Rose

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What the care home does well There was a warm and welcoming atmosphere in the home. Residents were very relaxed and good interaction was observed between staff and residents. Staff encouraged the residents to be as independent as possible and the policy of the home was that it was the residents` home and they were responsible for making decisions about how it was to be run. Residents were involved in the planning of their care and their goals. Staff supported the residents well assisting them to achieve their goals, which for two residents included working in the community with children. All of the residents attend courses of their choice at local colleges and participate in a wide range of activities both in the home and the community. The health care needs of the residents were met with advice sought as necessary from the GPs and other health professionals such as speech and language therapists and psychologists. Staff said that they liked working at the home and they received the training they required to fully support the residents. The registered manager runs the home well and in the best interests of the residents. Residents said that they liked living at the home and relatives said that they were always made to feel welcome and that communication with staff was good. What has improved since the last inspection? At the last inspection some records regarding the recruitment of a staff member were not available as they were held in the organisations head office. Those records were available at the home for this inspection. What the care home could do better: The registered manager is continually working to improve the quality of care provided at the home. No requirements were made at this inspection. CARE HOME ADULTS 18-65 Tudor Rose 23 Borovere Lane Alton Hampshire GU34 1PB Lead Inspector Marilyn Lewis Unannounced Inspection 7 February 2008 10:00 th Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tudor Rose Address 23 Borovere Lane Alton Hampshire GU34 1PB 01420 544118 01420 544140 annievolt@yahoo.com, or emartin@iliace.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Iliace Ltd Ms Ann-Marie Glass Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2006 Brief Description of the Service: Tudor Rose is registered to provide care and accommodation for four adults with learning disabilities between the ages of 18 and 65. The accommodation is provided in a large detached house situated in a residential area, approximately half a mile from Alton town centre. The home has a large lounge, a dining room and kitchen and each service user has a single bedroom, two of which have en-suite facilities. There is an enclosed garden to the rear of the home which service users are able to access. The residents who are all female, have lived at the home since it opened in 2004. The residents are supported to take part in the running of the home and to participate in employment and educational opportunities. The home is managed by ILIACE Ltd, an organisation which has a number of similar services in Hampshire. Fees at the time of this report ranged from £1442 to £1470.88 per week. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use the service experience good quality outcomes. Information provided by the home including their Annual Quality Assurance Assessment (AQAA) and information obtained during an unannounced visit to the home was taken into account when completing this report. The unannounced visit to the home took place on the 7th February 2008. The inspector met with three of the four residents, two support workers and the registered manager. Records were seen including care plans and risk assessments and records for staff training, complaints, accidents and fire safety. What the service does well: There was a warm and welcoming atmosphere in the home. Residents were very relaxed and good interaction was observed between staff and residents. Staff encouraged the residents to be as independent as possible and the policy of the home was that it was the residents’ home and they were responsible for making decisions about how it was to be run. Residents were involved in the planning of their care and their goals. Staff supported the residents well assisting them to achieve their goals, which for two residents included working in the community with children. All of the residents attend courses of their choice at local colleges and participate in a wide range of activities both in the home and the community. The health care needs of the residents were met with advice sought as necessary from the GPs and other health professionals such as speech and language therapists and psychologists. Staff said that they liked working at the home and they received the training they required to fully support the residents. The registered manager runs the home well and in the best interests of the residents. Residents said that they liked living at the home and relatives said that they were always made to feel welcome and that communication with staff was good. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information and systems are in place to ensure potential residents have the information they need to make a decision about living at the home. No one will be admitted to the home without an assessment to ensure their care needs and aspirations can be met. EVIDENCE: The four residents have lived at the home since it opened in 2004 so there were no recent preadmission assessments to assess. However the home has clear procedures in place should this change. The registered manager was aware of the procedures including the need to visit the potential resident to assess their care needs and to provide the opportunity for visits to the home by the person, to assist them in making a decision about moving there. The registered manager said that the permanent residents would be very involved in the decision regarding the person moving into their home. The home has information available on the services offered at the home, which would be given to a prospective resident and their family. The registered manager said that the information was currently in normal print but would be provided in the most suitable format for the person requiring it when their needs were known. Residents and staff use the Makaton sign language system to assist with communication and the Service User Guides provided for the residents are Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 9 printed with Makaton signs to assist them with reading and understanding the document. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are very involved in their care planning and are supported to make decisions and take risks as part of an independent lifestyle. EVIDENCE: AQAA information indicated that residents were involved in their care planning, which included monthly review meetings with their key worker. The information stated that residents were able to choose the support worker they wished to act as their key worker. A resident spoke very enthusiastically about planning her care. The resident confirmed that she had chosen her key worker and said that her key worker discussed her care plans with her often. The resident said that she agreed her care plans reflected her wishes, saying ‘I do what I want to do’. The resident had personal goals that included working with children and attending church services. The documents seen showed that staff had contacted local schools to Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 11 discuss the possibility of the resident helping there and the process for obtaining a CRB check prior to her starting work at the school. The care plans seen also provided information on the likes and dislikes of the residents such as preferring to bath instead of shower and details such as which shampoo was to be used. Guidelines were included for staff on the triggers, which could cause challenging behaviour and the actions to be taken if this occurred to minimise the risks to the resident and other people in the home. A resident showing the inspector around the home pointed out the morning routine that was displayed on her bedroom door. She said that it told staff what she liked to do in the morning such as what time she liked to get up and also what she could do for herself and what she needed assistance with. It was evident during the visit that residents were being supported to make their own decisions and to take part in all aspects of life at the home. Makaton signs and symbols were displayed around the home such as on the kitchen cupboard doors to assist the residents to be independent. One of the residents made a drink for the inspector and as she made the drink she read out the pictures on the doors and containers she was using. Risk assessments were included in the care plans including those for daily tasks such as bathing and for activities in the community including vulnerability. Risk assessments were also available for the environment including the use of non- slip mats under chopping boards. The registered manager said that during a resident meeting residents had asked to be able to run their own bath. The temperature of the hot water was regulated and risk assessments were completed for each resident. Relatives of the residents were asked for their opinions regarding this issue and records seen indicated that all agreed to their relative being responsible for their own bath. Risk assessments for residents who may have a seizure, included guidance for staff regarding staying close to the bathroom but not in the room unless needed. The residents spoken with were aware of the procedures to follow should the fire alarm sound. Care plans and risk assessments had been reviewed frequently. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are well supported by staff, enabling them to participate in a wide range of daily and social activities of their choice. EVIDENCE: A resident talked about the visits she made to a local school to help the children with art. She said that she enjoyed the visits and spoke enthusiastically of the next visit. Another resident was helping at another school at the time of the visit. Both residents had said that they would like to work with children in their goal planning and the registered manager had contacted local schools to discuss the possibilities of this taking place. Both residents had Criminal Records Bureau checks completed before being able to visit the schools. A support worker who accompanied one of the residents to the school said that the placement was working well and the resident was really enjoying the visits. Another of the resident’s works at a shop in the town again arranged following person centred planning meetings. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 13 The registered manager said that arrangements were being made for the fourth resident to undertake administration duties, her choice, in the home and in other homes in the area. All of the residents attend courses at a local college, which included creative activities and computer skills. One resident said that she enjoyed going to church and to social occasions such as coffee mornings with the church group. The registered manager said that all the residents went to church and also to a group where they were able to do sign singing. The registered manager said that a meeting had been held to discuss where the residents would like to go for their holiday. Last year they had chosen to go to a holiday camp that was within easy travelling distance. This year they had decided they would like to go to Wales and the registered manager had found a holiday cottage that was suitable and residents agreed this was where they wanted to go. One of the residents talked about the holiday with the inspector and showed the brochure of the holiday cottage. The organisation pays for one holiday each year for the residents who are required to pay for additional trips and spending money when there. All the residents have passes for use on the local transport and they also use the local ‘can go’ bus service and the trains for trips out. The home has a people carrier type vehicle for residents’ use and when this is not available residents may walk into the local town and get a taxi back. Records seen indicated that residents went out frequently to college and work experience and also into the community for personal shopping, the library and food shopping. Trips into Winchester, Guildford and Southampton were recorded in the residents care plans. The registered manager said these were used to build independence skills. The residents also attended a nightclub that held a special event for people with learning disabilities once a month and parties were held for special occasions such as Halloween. The residents all had timetables for social and daily activities and one said that she knew she would be going out with her support worker that afternoon. Two support workers spoken with said that there were enough staff on duty at any one time to allow the residents to participate in the activities of their choice. A letter seen indicated that the registered manager was aware of the need to protect the residents from any discrimination when out in the community. The residents had not been made to feel welcome at one establishment and the registered manager had taken steps to address the issue on behalf of the residents. Residents said that they visited or received visits from family members and friends. Records in one care plan showed that the resident was supported to use a computer to contact her relatives and the registered manager said that a Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 14 telephone with three connections was available for a resident who was unable to speak over the phone but could listen and use sign language to reply which a staff member then translated for the family member. A resident showed the inspector the menus for the week displayed in the kitchen. The resident said that she liked the food provided and that she was able to choose what she wished to eat. Residents helped to prepare the meals and lay tables. The resident showing the inspector the menus said that it was her day to help with lunch, which was going to be omelettes. The registered manager said that the menus were discussed with the residents on a weekly basis prior to shopping for the groceries. One resident who had difficulty eating had been referred to a speech and language therapist for advice. The parents of the resident were involved and were due to discuss options for the future to help the resident with their nutritional intake. A special menu had been developed in agreement with the resident who was aware of what foods she should and should not eat and the risks to her health should she choose to eat foods not included in the diet. Resident’s weights were being monitored and recorded weekly and records seen indicated that advice was sought from the GP if there was any concern regarding weight gain or loss. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health care needs are being met and they are protected by staff adhering to the home’s clear procedures for dealing with medicines. EVIDENCE: A resident said that they were able to receive their personal care in the manner they preferred. Care plans contained the wishes of the residents including details such as how much they could do for themselves. For example one resident said that she was able to brush her own hair but needed assistance to style it. As previously reported staff had changed the system of running water for a bath following requests from the residents. Records seen indicated that residents’ health care needs were being met. Visits to the GP and dentist were recorded and also attendance at outpatient departments. Advice had been sought from a speech and language therapist for the resident with difficulty eating and following visits from the community learning disability team psychologist the challenging behaviour presented for a short time by one resident had stopped. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 16 The health records seen had been updated on a day- to- day basis as necessary indicating that the changing health care needs of the residents were being met. The home has clear procedures for dealing with medication. None of the residents were currently self- administering their own medication. However procedures were available for self administration of medication should this change. Records seen had been completed appropriately and medication was stored securely. When a medicine prescribed as ‘when needed’ was given, the reason for its use was documented. No controlled drugs were currently in use. Records were kept of medication taken from the home when visits were made to the family home. Staff said that they had received training in the administration of medication and records seen confirmed this. Up to date information on the medication administered was available for staff. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that any complaints will be dealt with quickly and they are protected by staff awareness of the need to protect vulnerable adults. EVIDENCE: A Makaton version of the home’s complaints procedures was displayed on the residents’ information board. One of the residents said that she would talk with the registered manager if she were unhappy about anything. A support worker said that residents were asked if they had any complaints during group meetings and in one to one meetings with their key worker and records seen confirmed this. AQAA information states that two complaints had been received by the home in the last year. Both complaints had been investigated quickly. The home has clear procedures for the prevention of abuse and the registered manager and a support worker asked were both aware of the procedures to follow should abuse be suspected. All staff had received training in the protection of vulnerable adults and records seen indicated that adult protection was discussed during staff meetings and supervision. The registered manager said that she had requested a Makaton course regarding adult protection, to assist residents in understanding what to do should they have concerns regarding abuse and was awaiting confirmation of the course. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 18 The registered manager said that the parents of the residents managed their financial affairs. Residents have cash cards, which they are supported to use at cash points. Records are kept of any money withdrawn and parents check this against bank statements. A small amount of money was held for three of the residents in the homes’ safe with the fourth resident holding her own personal money. Records seen for the three residents matched the money held. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tudor Rose provides a clean and homely environment for all who live and visit there. EVIDENCE: Tudor Rose is a detached property situated in a residential area of Alton. Parking is available to the front of the property and also on the road. Visitors to the home are asked to sign the visitor record book for health and safety reasons such as a fire alarm. The home looked clean, cheerful and homely. Residents are accommodated in single rooms, two of which have en-suite facilities. The other two residents share a bathroom and there are separate toilets. Three of the residents were at home at the time of the visit and they invited the inspector to view their rooms. The rooms looked clean and contained many personal items such as televisions, books, soft toys, pictures and photographs. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 20 One of the residents said that she had chosen the colours for her room and all said that they liked their rooms. Residents have access to all areas of the home including the large lounge, separate dining room which is also used for activities, the domestic style kitchen and laundry room. The door to the office was also kept open unless a one to one meeting was taking place. A resident pointed out the Makton signs displayed around the home saying that they ‘help me’. One of the residents has a monitor in her room to alert staff of any epilepsy seizures. Records seen confirmed that the resident had agreed which type of monitor was to be used. Residents said that they were involved in the cleaning of the home and records seen indicated that a rota system was in place so that each resident took a turn at the home tasks. During the visit it was evident that the residents were encouraged and supported to manage the home as theirs and not the organisations. An enclosed garden is at the rear of the property. One area of the garden has been developed as a vegetable garden where residents grow their own vegetables. The registered manager said that surplus vegetables had been given to neighbours who in turn gave them some of their vegetables. Records and certificates seen indicated that regular maintenance checks were undertaken on the property. Staff said that protective clothing such as disposable gloves and aprons were readily available for them and they had received training in the control of infection. Records seen confirmed training had taken place. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who receive regular supervision and the training required to do their jobs well. Systems are in place to ensure that robust procedures would be used for the recruitment of new staff to protect the safety of the residents. EVIDENCE: The home employs six support workers plus the registered manager. Two support workers are on duty for the 7.30am to 3pm and 2.30pm to 10pm shifts and one support worker ‘sleeps in’ from10pm until 7.30am. Two support workers and a resident spoken with said that are enough staff on duty to meet the residents’ needs. The registered manager said that staffing levels are flexible to allow for social activities and records seen confirmed this. Staff on duty were aware of who was to take responsibility for the running of the home when the registered manager was not on duty as this was identified on the rota. The registered manger said that on the occasions when agency staff are needed, the same agencies are used and staff who have worked at the home before are employed. The agencies supply the home with information Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 22 regarding the training and experience of the agency staff and also confirmation that Criminal Records Bureau (CRB) checks have been completed. Five of the six support workers hold or are working towards NVQ level 2 or 3 in care and the registered manager holds level 4. Two support workers said that training opportunities were very good and records seen confirmed that all staff have received training in health and safety including moving and handling, fire safety, infection control, first aid and food hygiene. Staff had also attended training in topics related to the service group including epilepsy, communication awareness and Makaton. The registered manger said that no new staff members had been recruited since the last inspection. Records seen for one staff member at the last inspection had not contained all the information required as it was still at the organisations’ head office. The information was seen to now be in the staff member’s records. Procedures seen and discussion with the registered manager indicated that robust procedures would be used for the recruitment of staff including Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks undertaken before the person started work at the home to protect the safety of the residents. The two support workers spoken with said that they received regular supervision and an annual appraisal from the registered manager. Records seen confirmed this. The registered manager said that she received supervision and support from her area manager during monthly meetings. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the residents. EVIDENCE: The registered manager, Ms Ann- Marie Glass, has managed the home since March 2005. Ms Glass holds a degree in Education and Biological Studies and the Registered Managers Award and is awaiting certification for NVQ level 4 in health and social care. She has worked as a manager of another home for eight years prior to taking up her post at the Tudor Rose. The registered manager was overseeing another care home situated close to the Tudor Rose while the registered manager there was on leave. Staff said that they were able to contact the registered manager if needed and she was able to return to the home quickly as she did for the inspection. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 24 The two support workers spoken with said that they received very good support from the registered manager and both said that they ‘really liked working at the home’. During the visit residents chatted easily with the registered manager who said that her office door was always open and residents and staff were welcome to talk to her at any time. Letters and records seen indicated that there was good communication with relatives. The home had undertaken quality monitoring regularly with the most recent information obtained during December 2007 for residents and in January 2008 for relatives. The information indicated that the residents and their relatives were very satisfied with the quality of care being provided. Relatives said that they were made to feel welcome when they visited, were invited to review meetings and the care given was of a high standard. One of the relatives commented that the home had a ‘very welcoming homely atmosphere’. Residents said that they liked living at the home; they were given choice and were very involved in the running of the home. An area manager for the organisation visited the home monthly to undertake quality assurance monitoring. Records seen indicated that all aspects of the management of the home were assessed during these visits. During the visit staff were observed encouraging the residents to make their own decisions about all aspects of life at the home. One of the residents said that it was ‘my home’. All the residents looked relaxed and moved freely around the home and there was very good interaction between residents and staff. AQAA information stated that the care provided had improved in the last year as all staff had received training to level 8 in the use of Makaton. During the visit it was observed that the ability of all staff to be able to communicate with the residents in Makaton signing assisted the residents in talking and making themselves understood easily. Staff had received training in health and safety issues and information on health and safety was available in the home. The kitchen and laundry room looked clean and in good condition. Hazardous substances such as cleaning fluids were stored safely. Fire records seen indicated that checks were made on fire safety equipment as needed and staff and residents attended fire drills. Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 x LIFESTYLES Standard No Score 11 3 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 3 x Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tudor Rose DS0000062129.V356962.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone, Kent ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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