Archived: Tudor Lodge

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.

We found that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. This was because staff received appropriate training, professional development, supervision and appraisal.

We reviewed four care files and saw evidence that a comprehensive assessment of people's needs was carried out before they began to use the service. We reviewed the records of care provided and saw that care and treatment was planned and delivered in line with people's individual care plan. The assessments included input from people using the service, their relatives and other significant people in their lives. A person using the service told us, "I like it here. The staff are nice." A relative told us, " x is settled there. I think the staff are doing a good job."

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We reviewed four staff files and found that there were effective recruitment procedures in place and appropriate checks were carried out before staff began work. However, we were concerned that staff were not supported by the provider to deliver care safely and to an appropriate standard, through relevant training, professional development, supervision and appraisal.

People who use the service told us that they were happy and that the accommodation and that the staff were nice. Most of the people who use the services were unable to speak to us due to their communication needs. However we did speak with family members. People made generally positive comments about Tudor Lodge and said that they had always felt listened to and had been made to feel welcome by the staff. People were aware of the complaints process and of the annual surveys which were sent out by the provider.

You can see our judgements on the front page of this report.