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Inspection carried out on 11 June 2018

During a routine inspection

This inspection took place on the 11 and 19 June 2018. The first day of this inspection was unannounced with a second day of inspection which was announced.

Tudor House is a family run residential care home which provides accommodation for up to 24 older people living with dementia who required nursing or personal care. At the time of this inspection 14 people lived at the service. Tudor House is a well maintained detached building in a residential area of Bognor Regis, located a short distance from the seafront and town centre. There is a dining room, large communal lounge and conservatory which leads out into an accessible and pleasant garden area.

At our last inspection on 12 January 2016 we rated the service as Good in all key question areas of Safe, Effective, Caring, Responsive and Well-led. At this inspection we found the information supported the rating of Good with the key question of Responsive which had improved to a rating of Outstanding for the exceptional effort that the management and staff team made towards providing a wide range of exceptionally personalised activities that engaged and stimulated people who were living with dementia. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were supported by a proactive management team and caring staff. A wide range of excellent, stimulating activities were organised by the management of the service to support those people who were living with dementia. These activities were very beneficial to people and evidently provided positive experiences for relatives as well as people alike. We observed people engaged very positively with the wide range of activities provided. External experts were sourced by the management team to provide creative art based activities for those who lived with dementia. Wonderful, personalised experiences were facilitated for people to share with their loved ones by the service staff, which had very positive outcomes for people.

People’s needs were met by a sufficient number of staff who were well trained to meet people’s individual and diverse needs and preferences. People who may have had difficulty communicating or who required one to one support to eat their meals were supported by patient staff who took the time to listen and care for them. Staff were trained appropriately and supported by the management team with regular supervisions to review their performance in their roles.

Risks to people were assessed and minimised appropriately and medicines were managed safely. Infection control measures were in place to reduce the risks of infection. Staff understood their roles and responsibilities and people were safeguarded from abuse, with appropriate policies and procedures in place.

Access to healthcare was provided when people required this and the management team had developed positive relationships with health and social care professionals to continue to develop the service and to maintain their knowledge of current best practice initiatives.

Professionals and relatives of those who lived at this home were very supportive and complimentary about the service provided at Tudor House for people who lived with dementia.

The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) were understood by the management team and staff. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Further information is in the detailed findings below

Inspection carried out on 12 January 2016

During a routine inspection

The inspection took place on 12 January 2016 and was unannounced. Tudor House is a family run business and is registered to provide nursing care and accommodation for up to 24 people living with dementia and other health needs. At the time of our inspection 19 people were living at the home. The provider was in the process of refurbishing the home and was not planning to admit any new people until all the maintenance and redecoration work had been completed. Tudor House is a large detached property in a built-up area of Bognor Regis. It is close to the town centre and seafront. There is a communal sitting room with an adjacent conservatory area and a separate dining room, with access to the garden. Some bedrooms have en-suite facilities.

A registered manager was in post. A registered manager is a person who has 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 were protected from avoidable harm and abuse. Staff were trained to recognise the signs of potential abuse and knew what action to take if they had any concerns. Risks to people were identified, assessed and managed appropriately. Accidents and incidents were reported and people’s risk assessments and care plans were reviewed following any incident. Premises and equipment were managed safely and the provider was updating and redecorating the home. Staffing levels were sufficient and duty rotas confirmed the number of staff on duty was consistent. Safe recruitment practices were in place. People’s medicines were managed safely.

Staff were trained in a range of areas and provided effective care to people. They received regular supervision and had annual appraisals. New staff shadowed experienced staff and followed the Care Certificate, a universally recognised qualification. Staff meetings were held four times a year and records confirmed this. Staff were trained to understand their responsibilities under the Mental Capacity Act 2005 and associated legislation and put this into practice. People were supported to have sufficient food and drink and to maintain a healthy lifestyle. They had access to a range of healthcare professionals and services.

People were looked after by kind, caring and friendly staff who knew them well. People and their relatives spoke highly of the care they received and of the staff. People were involved in planning their care as much as they were able and were supported to make decisions. Care plans contained detailed personal histories, which enabled staff to form positive relationships with people. People were treated with dignity and respect.

Care plans contained comprehensive information about people and guidance to staff on how they wished to be cared for. Care plans and risk assessments were reviewed monthly. The provider was in the process of upgrading the care plans and were moving to an online, computerised system. Activities were structured and planned in line with people’s choices; there were outings into the community every week. Complaints were responded to and managed appropriately in line with the provider’s policy.

People were asked for their feedback about the service and had the opportunity to attend residents’ meetings to discuss matters of importance to them. Relatives were also asked for their views about the home and positive comments had been recorded. Staff felt that the home was well led and that the management team was approachable. A range of robust audit systems enabled the provider to monitor the quality of the service overall.