Tudor Manor

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Peoples needs and rights were supported. Peoples care and treatment was effective due to their health, care, well-being, and communication needs being assessed with them. Peoples care plans were kept up to date with any assessments completed in a timely manner. Staff were aware of people’s preferences and respected these in a person-centred way. People were aware of their rights around care and treatment. Staff have good knowledge of the mental capacity act, including capacity and consent. Staff were aware of how to support someone with fluctuating capacity.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Mostly people were confident that their needs were understood by the staff team. However, 1 person told us, ‘I think staff forget I am blind’. Relatives and people told us how they were involved in their care plan and reviews took place with them involved.

Staff told us they used an electronic system which they can access at any time, this held peoples care plans and risk assessments. Staff told us care plans and risk assessments were not always updated with new information. Staff had good knowledge of how to support people’s needs, and what action to take if the person’s needs appeared to have changed.

Staff had access to documents on how to support people. Where people’s needs changed, these care planning documents were not always updated so staff understood people’s changes in needs. For example, where a district nurse had come out to assess a person’s pressure area and advised a new regime of care, this was not always found updated in peoples care plans and risk assessments. People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people, to have a clear understanding of the person’s needs.

People told us they were comfortable with the care they were receiving and felt their needs were being met. People had good relationships with staff, 1 person told us, “They treat me well. “[Person] is outstanding”. One relative told us, “All the staff are good and caring, they support [Person] to go to town when they wish to”.

Staff always had a mobile device on them whilst providing care to people. This meant they had access to keep records up to date. However, we found records were not consistently completed for people. For example, where a person was at risk of constipation and bowl monitoring was required, this was not always completed and bowel charts had numerous consistent gaps. This meant people were at risk of not receiving the correct health intervention to ensure they maintained healthy and not become unwell. We raised this concern during the inspection, the manager and provider implemented a daily audit of bowl charts to mitigate the risk.

We found the electronic system, which was used to record peoples care, difficult to look back on charts completed for people, such as the recording of fluids, repositioning and bowel monitoring records. This did not provide assurance around the monitoring of people’s health needs. The system did not provide an alert system when a person had not had enough fluids for the day as per guidelines found in their care plan. Training was provided to staff in recording information and use of the electronic care planning system. Paper records were in place for medicines administration during this site visit.

People were happy with the care they received during this site visit. People found the staff and management team were friendly and listened to them.

The management told us how they involved all staff in regular team meetings to gain feedback and have staff voices heard. The staff team had completed mandatory training, and we saw a training plan which had training sourced from the local authority. The management team discussed at team meetings people’s needs and any changes that required a further assessment, this meant staff and managers worked in partnership. The provider had a process when assessing people to move into the home, this included gaining advice and information from other health professionals as part of the pre assessment.

Stakeholders attended the service and provided feedback of how the home had processes in place to ensure people were kept safe. This included when people moved from the service or had a hospital admission. Stakeholders told us how referrals were sent in a timely manner and where additional information was required the provider would respond in a timely way.

There was a policy and procedure to follow when assessing people to move in and out of the home. As the home has had an embargo where nobody could move in or out without the authorisation of the care quality commission, we could not review evidence of how this process was followed. The provider and manager told us the process and showed records that were used. For example, a pre assessment form, this covered people’s personal characteristics and diagnosis of needs.

People we spoke with told us they were happy with food and meal choices provided. One person told us, ‘Food here its nice, home cooked food’. People told us they were provided choice and if they wanted something that was not on the menu, they could request this. We saw a ward walkaround took place weekly with the local general practitioner. GP. If there was a concern around a person’s nutrition or weight, this would be discussed during the ward visit or if urgent the general practitioner (GP) would be contacted.

Staff told us they received training on nutrition and how healthy options are to be offered to people. Management was aware of people that required monitoring and told us, staff would always inform them if there was a concern around nutritional needs.

People who had moved into the service were provided with a local authority assessment and care plan. The provider also completed their own pre assessment of people’s needs. The provider also developed care plans and risk assessments following this.

There were plans in place to ensure people achieve positive outcomes. We saw how people were positively interacting in activities. For example, 1 person had not played a musical item in many years and the activities coordinator had introduced this back into their activity. Some people’s preferences were not met, for example, where a person preferred female 1:1 company, this was not in place for them. We raised this with the provider and manager who told us they would look into where they can have a female carer spend 1:1 time with the person through the week.

Staff were aware of the outcomes for people and understood how these outcomes would improve their lives. The activities coordinator was very focused on sourcing activities for people to be involved in. The provider and manager were very engaged in meeting the needs of people and individual interests.

Staff researched and spent time to get to know people and look at the outcomes they wished to achieve. Management and staff would include relatives or friends when finding out the persons interests. Outcomes in place for people were meaningful to them. For example, where a person was a member of the local church, the home invited the church into the home. They would also come with the choir and sing for people.

People and relatives were aware of consent to care. We saw where people lacked capacity to consent to their care then a lasting power of attorney was in place.

Staff were not clear on why an assessment of people’s mental capacity would be completed and how to raise concerns if they felt a person’s capacity may be declining or in need of reassessing. We raised this during the inspection, the provider and manager evidenced on a training plan that staff were booked on face to face training coming up. However, staff had previously completed mental capacity training. Therefore, this not provide us assurance around the quality of training provided and compliance checks that were in place. The manager told us the process to assess people’s mental capacity and how to apply for deprivation of liberty safeguards (DoLS) authorisations.

We saw Local authority assessments included mental capacity assessments which provided an outcome to all stakeholders involved in the person’s care as to whether the person had mental capacity or not. The manager had a Deprivation of liberty (DoLS) tracker in place to help them identify who required DoLS and at what stage of the application this was currently at. The manager emailed the local authority regularly to gather updates on applications made. During this assessment no person had a DoLS in place with conditions.