This inspection took place on 12 December 2017 and was unannounced

The Tudors is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Tudors is registered to provide personal care and accommodation to up to 21 people. The home is an older style building with accommodation for people arranged over two floors. The second floor can be accessed by stair lifts. The home specialises in the care of older people. At the time of the inspection there were 13 people living at the home.

Following the last inspection in October 2016 we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; Safe, Effective and Well led, to at least good.

At the last inspection we found that improvements were needed in the recording of medicines administration, staff training and ensuring people’s legal rights were respected. At this inspection we found that improvements had been made in all these areas.

At the last inspection we also found that improvements were needed to make sure the service was well led and there were systems in place to effectively monitor the quality of care provided to people. At this inspection we found that improvements had been made but further improvements were needed in this area.

Records maintained, including risk assessments and internal audits, were not robust. They did not give full information about who would be responsible for actions or how control measures identified in risk assessments would be reviewed to promote people’s independence. The poor quality of the records could potentially place people at risk because staff may not have all the information required to safely and effectively support people.

There was a registered manager 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 said that the registered manager and the provider were very approachable and listened to their views and concerns.

People felt involved in decisions about their care and told us they made choices about their day to day lives. However records seen did not always show how people had been involved in planning or reviewing their care needs.

Staff said they felt well supported and it was a ‘Happy’ place to work. This helped to create a warm and homely environment for people. One visitor described the home as being like a family.

People were cared for by staff who were kind and caring. Throughout the day we saw staff showed kindness and patience when supporting people. People were supported with personal care in a way that respected their privacy and dignity.

The provider had systems in place to help to minimise the risks of abuse to people and people felt safe at the home. One person said, “I do feel safe here. Everyone is nice and they make sure it’s all locked up at night. It gives you peace of mind.”

People told us they would be comfortable to make a complaint if they had any concerns about their care. One person said, “I would just talk to [staff member’s name] they’d sort out anything.”

Further information is in the detailed findings below

The inspection took place on 12 October 2016 and was unannounced. This was the first inspection of the home since the home was re-registered when new providers took over ownership of the home in October 2014.

The Tudors is registered to provide accommodation with personal care for up to 21 older people. The service does not provide nursing care. At the time of this inspection there were 20 people living there (including two people who were in hospital). There was a registered manager in place. 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 told us, and we saw evidence of many improvements to the building, services and care since the provider took over the home. Further improvements to the environment were planned. However we identified some further areas where actions were needed in their management of medicines, staff training, assessment of people’s capacity to make decisions, and notification of incidents, accidents and deaths. The providers and registered manager carried out a range of quality monitoring checks on a weekly and monthly basis. However, further improvements were needed to the quality monitoring processes to ensure all legal requirements were met.

While medicines were generally stored and administered safely there were some areas where improvements were needed. Tablets were stored, administered and recorded safely. However, there were gaps in the records of creams and lotions and this meant there was a risk some creams had not been administered regularly in accordance with the prescriber’s instructions. Medicines that required refrigeration were not stored securely.

There was a warm and friendly atmosphere in the home. People praised the care and services they received. One person said “Everyone is very kind to you. Very thoughtful.” A relative told us “I am quite happy with the care they give to (person’s name). I think we can say (person’s name) is very happy.” The staff were patient, kind and friendly.

There were sufficient staff to meet people’s needs. We asked a person if they thought there were enough staff and they replied “I think so. If you want any help someone will come and help you.” A member of staff told us “There are enough staff. Everyone knows what they have to do. Nobody rushes.” However, staff training needs had not been closely monitored to ensure staff had received essential training and updates to enable them to meet people’s needs effectively. Risks of abuse were minimised because the provider checked all new staff and made sure they knew how to recognise and report abuse.

People were confident their health needs were met effectively. Regular checks were carried out to enable staff to pick up and act on any signs of potential illness quickly. Where concerns were noted the staff contacted the person’s GP or health professionals promptly for advice or treatment.

People were offered meals and drinks in accordance with their dietary needs and preferences. People told us they enjoyed the meals. For example, one person “The food is good wholesome food.”

People received care that met their assessed needs from staff who had sufficient information about how they wished to be supported. Before a person moved into the home an assessment of their needs was carried out. This information was used to draw up a plan of their care. People told us they were satisfied with the care they received.

People had opportunities to take part in a range of activities that met their individual needs. Group activities included games, arts and crafts, parties, visiting entertainers. People had been consulted in resident’s meetings about the activities they wanted staff to arrange. They had been on various o