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Archived: Tudor Lodge Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 August 2016

The inspection was unannounced and took place on 14 & 15 June 2016. Tudor Lodge is a care home which provides care and support for up to 44 older people with mental health needs. There were 38 people living at the service at the time of our inspection. People have their own bedrooms; some have ensuites; bedrooms are located over the basement, ground, first and second floors. A shaft lift provides access to all floors and a number of stair lifts are installed to help people access mezzanine areas of the premises. The service is in a central location in the town of Folkestone and has limited off street parking.

This service was last inspected on 3 December 2014 under previous methodology and at that time the provider was found to have addressed previous noncompliance and no breaches of regulations were identified.

There was a registered manager in post. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they were happy living at the service. People’s relatives spoke positively about the quality and delivery of care provided by staff to their family members, but expressed concerns that staffing levels meant staff could not always give people the time they needed; staff said they felt rushed all the time. We observed that for the needs and dependency of the people being supported there were not enough staff available at some busier times of the day and also during the night, when a number of people were up. Recruitment procedures and checks of new staff were made but this needed improvement to ensure these were carried out thoroughly and in line with regulatory requirements.

The risk assessment framework used needed expanding to ensure all potential risks people may be subject to were assessed and measures implemented to reduce risk of harm occurring.

Care plans were individualised but did not always reflect in depth strategies used to manage behaviour or support in respect of specific health conditions. Quality audits were in place but not always carried out robustly or evidenced clearly actions taken to provide assurance that the service was meeting standards. The Care Quality Commission was not routinely informed as required of deaths of people at the service.

Professionals we spoke with during and after the inspection spoke positively about the improved communication with them from staff and good working relationships that the registered manager was developing with them.

Visual checks that fire extinguishers and emergency lighting was in working order were not routinely undertaken each month. Staff were not attending the minimum number of fire drills annually and had not trained in the use of some evacuation methods contained in people’s personal evacuation plans.

People enjoyed the activities provided for them and although they were consulted through meetings and questionnaires about what else they might want to do, the type of activities available were not suitable for everyone and we have recommended the registered manager sources appropriate training for the activities organiser to make activity sessions more appropriate to the needs of people.

Staff received supervision and appraisal of their work performance. They had opportunities to meet and felt able to raise issues individually or within staff meetings, staff said communication was good and they felt part of a team and enjoyed their work but did not always feel their views were valued or listened to by some of their line managers.

There was a high level of accidents occurring. Staff took appropriate action to support people when accidents occurred and sought medical advice if necessary, the manager analysed these for trends but we have suggested additional a

Inspection areas

Safe

Requires improvement

Updated 10 August 2016

The service was not consistently safe

Medicine practice was inconsistent and needed improvement. Recruitment processes did not meet the requirements of the regulation. Staffing levels were insufficient to meet the dependency needs of people in the service. Not all risks people could experience were routinely assessed.

There was a high level of accidents occurring but staff took appropriate action to support people. We have suggested the provider seek competent advice in regard to staff fire drills and individual evacuation plans.

Staff knew how to protect people from abuse. The premises were clean and well maintained and servicing checks were in place.

Effective

Good

Updated 10 August 2016

The service was effective

Staff received regular supervision of their practice. New staff were required to complete induction in line with the new Care Certificate. All staff completed training to give them the right knowledge and skills to understand people’s needs and support them safely.

People ate a varied diet that took account of their preferences. People’s health needs were monitored and they were supported to access healthcare appointments.

People were supported in accordance with the Mental Capacity Act 2005 (MCA) they were consulted about their care and support needs.

Caring

Good

Updated 10 August 2016

The service was caring

People were treated with kindness, patience and respect. People were given opportunities to express their views.

People’s privacy was respected. Staff supported people to maintain links with their relatives and representatives.

People were encouraged to personalise their won space and bring possessions. Relatives felt they were kept informed and always made welcome.

Responsive

Requires improvement

Updated 10 August 2016

The service was not always responsive

The pre-admission assessment of new people needed improvements, omissions in care plans could place people at risk of not receiving the right support.

People had opportunities to participate in activities that they had been consulted about and in accordance with their care plan; they could choose to participate in or not.

People and relatives told us they felt comfortable raising issues with staff and were confident these would be addressed.

Well-led

Requires improvement

Updated 10 August 2016

The service was not consistently well led

The Care Quality Commission was not consistently notified of deaths that occurred. Audits for the assessment and monitoring of service quality were not completed robustly and needed improvement.

The culture of the home had improved but further work was needed to ensure staff felt listened to, valued and supported. People and relatives were asked for their views these were analysed and informed service development but would benefit from being shared.

Staff said there was good team work and they enjoyed their work. They said communication was good. Policies and procedures were kept updated. Staff said they were given opportunities to express their views at regular staff meetings.