Archived: Tudor Lodge

Updated 6 May 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 6 April 2016 and was unannounced. The inspection team consisted of a single inspector. Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed other information about the service such as notifications about events or incidents that have occurred, which they are required to submit to CQC.

During our inspection the majority of people using the service were unable to share their experiences with us due to their complex communication needs. In order to understand their experiences of using the service we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We were able to speak with one person using the service and a visiting relative. We also spoke with the manager, the quality manager for the organisation and two care support workers. We looked at records which included three people’s care records, four staff files and other records relating to the management of the service.

After the inspection we spoke with three relatives of people living at Tudor Lodge who shared their views and experiences of the service.

Updated 6 May 2016

This inspection took place on 6 April 2016 and was unannounced. At the last inspection in March 2014 we found the service was meeting the regulations we looked at.

Tudor Lodge is a small home which provides care and accommodation for up to six adults. The service specialises in supporting people with learning disabilities. At the time of our inspection there were six people living at the home.

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

At the time of this inspection a new manager had been appointed for the service in February 2016. A new deputy manager was also appointed in December 2015. The new manager had submitted their application to CQC to become the registered manager for the home, which was being processed. Relatives and staff told us, prior to these appointments, the service had not been managed as well as it should have been. Relatives said there had been a lack of continuity and uncertainty as a result of staffing changes particularly with regard to the management of the service. Staff told us during the last two years morale and motivation had been affected by the changes in management.

However, people and staff had positive things to say about the new managers and the quality of their leadership at the home. People said the new managers had made improvements and positive changes at the home. Staff told us they felt better supported and morale and motivation had improved since the new managers were appointed. It was clear from people and staff’s comments they believed leadership of the service had improved but these changes were still quite recent so it was too early to judge at the time of this inspection whether these improvements were sustainable and that consistency in respect of the management of the service could be maintained.

The new managers were improving openness and transparency within the service. People said managers were approachable and they felt well listened to. Staff were encouraged to use communication methods more effectively to ensure people could participate in discussions about how the service could be improved. Staff themselves were provided opportunities to share their views and discuss any issues or concerns they had about work based practices.

Managers carried out regular checks to monitor the safety and quality of the service. They took action to make the necessary changes needed where shortfalls or gaps in the service were identified.

Relatives said people were safe at Tudor Lodge. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk and knew how and when to report their concerns if they suspected someone was at risk of abuse. There were procedures in place for staff to follow to ensure concerns were reported to the appropriate person. They had also received training to ensure people were protected from discriminatory behaviour and practices that could cause them harm.

To keep people safe from injury or harm in the home and community, staff had access to appropriate guidance on how to minimise identified risks to people due to their specific needs. Maintenance and service checks were carried out at the home to ensure the environment and equipment was safe. Staff kept the home free of hazards and obstacles so that people could move safely around.

There were enough suitable staff to care for and support people. The provider had carried out appropriate checks to ensure they were suitable and fit to work at the home. Staff received relevant training to help them in their roles. Staff had a good understanding and awareness of people’s needs and how these should be met. They ensured people’s right to privacy and to be treated with dignity were respected. The way they supported people during the inspection was patient, caring and considerate.

People were supported to keep healthy and well. Staff ensured people were able to promptly access other healthcare services when this was needed. People were encouraged to drink and eat sufficient amounts to meet their needs. Their food and fluid intake was regularly monitored to ensure they were eating and drinking enough. People received their medicines as prescribed. These were stored safely.

People were supported to express their views in a way that suited them. Staff used various methods to ensure people could state their wishes and choices and these were respected. People and their relatives were appropriately supported by staff to make decisions about their care and support needs. Support plans had been developed for each person which reflected their specific needs and preferences for how they were cared for and supported. These provided staff with guidance and the information they needed to ensure people’s needs were met. These were discussed and reviewed with them regularly.

People and their relatives were satisfied with the support people received. People were confident raising any concerns or issues they had with staff. There were arrangements in place to deal with people's complaints, appropriately.

People were encouraged to maintain relationships that were important to them. People were also supported to undertake activities and outings of their choosing. People were encouraged to be as independent as they could be in the home and community. Staff only stepped in when people could not manage tasks safely and without their support. Staff were welcoming to visitors and relatives were free to visit when they wished.

The provider had procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had received training to understand when an application under DoLS should be made and how to submit one. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.