Tudor Lodge

Tudor Lodge is a care home that provides nursing and personal care for up to seven people

within one large adapted building. It provides care and rehabilitation for people with mental health care needs. At the time of our inspection, six people were living at the home.

People’s experience of using this service and what we found

The registered manager and provider did not always ensure their quality assurance checks were consistently strong and effective in reducing risks to people’s health and safety and records were accurate.

The risk of infections were not always effectively reduced by the arrangements in place to clean specific parts of the home environment including shower areas.

Although people were supported to take their medicines the checks undertaken to ensure these were administered as prescribed were not consistently effective to ensure people’s safety was not compromised.

The risks to people’s safety regarding the storage of hazardous items was not always effectively managed with actions taken to reduce the risk of preventable harm.

Staff spoke very affectionately about the people they cared for and supported. People were confident to request support and reassurance from staff when they wanted this and; staff took time to provide this in the ways people preferred.

Staff had received training and developed the skills they needed to care for people, through induction and on-going training. People told us staff knew how to support them and knew what to do if they suspected anyone was at risk of harm including discrimination due to their individual needs.

People's individual needs and requirements were assessed prior to them moving into the home. People had support to eat and drink safely and comfortably. The ethos of the registered manager and staff was to promote people’s independence in all aspects of their life including preparation and cooking of meals.

People had access to other health and social care professionals, so their needs could be monitored and met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff respected people’s rights to make their own decisions about their lives and care. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.

Staff supported people with compassion and understanding. People had support to express their views and opinions, and support was provided with dignity and in private.

The views of people were considered when their care was assessed, planned and reviewed, so people’s preferences were responded to and met. Staff ensured people had opportunities to do things which they enjoyed, which also met their emotional, social and psychological needs. People were supported to keep in touch with others and religious practices that were important to them. People’s wishes for their care at the end of their lives had been planned with them, so their preferences were known and met at this important time.

People knew how to raise any complaints and/or concerns they had and were confident the registered manager and staff would support them to resolve these.

The registered manager promoted an open culture within the service. They were responsive and showed accountability to wanting to make the required improvements to remedy the shortfalls we had identified during our inspection.

We found the service met the requirements for good in three areas and requires improvement in two other areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (inspection report published on 21 January 2015).

Why we inspected

This was a planned inspection based on the service's previous rating.

Enforcement

We have identified breaches in relation to ensuring risks to people's welfare and safety were identified and acted upon as well as ensuring medicine management was in place to keep people safe at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People who lived at the home told us about their experiences of life at the home. One person told us: 'I've been here quite some years. It's like being home. You do your own washing, cleaning and bedroom.' Another person said: 'I suggest things I'd like to do. We have a good quality of life here.'

We found people who lived at the home were safe because the staff were given clear instructions, support and guidance. Every person had an individual plan of care, based on their mental health needs, and other social and health needs.

Our observations during this inspection supported that there was enough staff available to ensure people received the right care, at the right time. We found that minimum staffing levels identified and planned for were met. There was also some flexibility to increase staffing levels when needed that made sure support was tailored to meet people's individual needs and interests.

We found that people had their own rooms which were private and personal to them. One person who lived at the home told us: 'My room is nice and I like it.' There were regular checks being completed to ensure that the premises were safe.

We found that the care, treatment and support people received was well led. People who lived at the home told us that if they were not happy with the care and support they received they would tell the manager or staff. The manager ensured positive outcomes for people were continually developed, reviewed and improved upon when needed.

People were complimentary about the care and support that they received. People told us that the staff, 'Support you with different things. If you have a problem you go to any of the staff, save you worrying about it'. People said, 'I am happy living here'. "The staff are nice and they help me when I get stuck with my jobs'. People felt their individual needs were being met by the service.

We found that people who used the service were protected from the risk of abuse. People who used the service told us they felt, 'Quite safe' at Tudor Lodge. We saw that staff had a kind and caring approach towards people they supported.

People who used the service were asked for their views about their care and treatment and these were acted on. People told us that they had weekly House meetings. People said, 'We talk about things going on in the week. You can air your views; they (the staff) listen and act upon them'. Systems were in place to enable the trust to seek feedback from people to monitor the quality of the service provided.