Tudor House Nursing Home provides accommodation and nursing care for up to 37 older people. It is a purpose built care home that offers accommodation to people on three floors. There were 35 people using the service at the time of our inspection.

At the last inspection in May 2016, the service was rated Good.

At this inspection we found the service remained Good.

The service demonstrated they continued to meet the regulations and fundamental standards.

The home had 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 using the service were positive about the care and support provided. They said staff treated them in a kind and caring manner.

Feedback about staffing levels was however mixed and the registered manager acknowledged there had been staffing shortfalls earlier in 2017 following some experienced staff leaving the employment of the service. New staff had now been recruited and the staffing ratios were now restored to previous levels. Staff spoken with and records seen confirmed this.

Staff had received training around safeguarding vulnerable people and knew what action to take if they had or received a concern. They were confident that any concerns raised would be taken seriously by the registered manager and acted upon.

Staff were positive about the service provided and felt confident in the quality of care given to people using the service. Staff felt able to speak to the registered manager or other senior staff to raise any issues or concerns.

People were supported effectively to have their health needs met. We saw that people’s prescribed medicines were being stored securely and managed safely.

Some people using the service said they enjoyed the food provided to them whilst others said they would welcome more variety in the menus offered.

The staff attended regular training which gave them the knowledge and skills to support people effectively. The service understood and complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff understood the importance of gaining people’s consent before assisting people.

An experienced registered manager was in post who knew the service well. There were systems in place to help ensure the safety and quality of the service provided.

Further information is in the detailed findings below

We carried out an unannounced comprehensive inspection of this service in December 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Tudor House Nursing Home on our website at www.cqc.org.uk.

We found improvements had been made so that the service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). We saw that staff had received further training in the MCA and DoLS since our December 2014 inspection.

Where people no longer had the capacity to consent to aspects of their care, we found that the registered manager and staff worked in people’s best interests. Assessments were completed to document the decision making process with involved family and medical professionals consulted as appropriate.

This unannounced inspection was carried out by the lead inspector for the service. We spoke with ten people using the service, three visiting relatives or friends, two members of staff and the manager during our visit. We also looked at the care files for four people currently living at Tudor House Nursing Home.

People using the service told us "I think it's excellent", "I could not ask for more" and "Marvellous, I'm very happy". One person said "I could not have fallen into a better place, one of the best things I've done". Relatives or friends commented "Very good, I think it's one of the best" and "My relative is looking much better since they came here". We asked people about the care they received. The individuals we spoke with said that the care staff treated them well and they felt safe. Their feedback included "The nurses are marvellous", "The carers are very nice", "Very caring staff" and "I like the people here, we are lucky to have them".

At the last inspection on 17th January 2014, we asked the provider to take action to make improvements to the assessment and care planning processes. We found that this action had been completed.

At our previous inspection of Tudor House we identified that action needed to be taken by the service provider to improve care planning and support provided to people who used the service. We also found that improvements were required to do with the training, support and development of it's staff. During our follow up visit we found that appropriate action had been taken by the provider to address concerns to do with staff training and supervision however planned improvements to do with needs assessment and care planning still needed to be implemented.

The manager told us that home’s policy to do with staff training and staff supervision had been revised since the last inspection and new practice implemented. We were told by the manager that staff now received individual supervision bi-monthly and have attended appropriate training. Staff told us that they now received improved supervision and improved access to training. We saw evidence that demonstrated that staff had been on appropriate and relevant training since the last inspection.

People who used the service told us that they liked to be called residents.

During this inspection we spoke with six people who used the service, two relatives and four members of staff. Residents who we spoke with said that they were able to choose what they wanted to do with regards to their personal care and support as well as with their activities and trips out. One resident told us, “I don’t like going to bed too early so I don’t…….. I like to get up later after 9.00am and staff are OK with that”. Another resident told us that they can go out when they want to and they told us “I feel like it’s my home and I have choices about what I want to do”.

The feedback received from relatives and visitors was positive, one person said, “I have no suggestions, I hope that the high standards can be maintained”. Another person said, “They are doing well in the quality of care for individuals, very loving towards service users”. Somebody else said, “The care is excellent”.

People told us that they liked the food and that they felt safe and well cared for in this home.

During the inspection we talked with five people using the service, two relatives and five members of staff to obtain their views about the service.

People said they received a good standard of care. We also observed that people looked well cared for. One person said “they [staff] keep you clean”. One relative said “I have never come and found [my family member] unhappy”.

Staff asked people about their choices and respected these. We saw that people could choose how they spent their day and make choices about their meals and activities to take part in. There were arrangements in place to promote people’s involvement in the community. Relatives confirmed that staff promoted people’s privacy and dignity.

People’s care records however showed that their needs were not always comprehensively assessed and reviewed to ensure these appropriately addressed all of their needs. Care plans were also not always updated and risk assessments were not reviewed at periodic intervals to ensure these appropriately reflected people’s needs and the care they required. Daily records kept about the care people received were also not always completed accurately to fully describe the care people received.

People received support with their healthcare needs and were referred to the GP and other healthcare professionals according to their needs. The management of medicines was however not always effective to ensure people were protected against risks associated with medicines.

The people who use this service told us that they like to be called residents.

Overall, we have found that Tudor House meets the essential standards but to maintain this we have suggested that some improvements are made. Please see main report for this information.

Tudor House Nursing Home provides accommodation and nursing care for up to 37 older people. It is a purpose built care home that offers accommodation to people on three floors. There were 35 people using the service at the time of our inspection.

At the last inspection in May 2016, the service was rated Good.

At this inspection we found the service remained Good.

The service demonstrated they continued to meet the regulations and fundamental standards.

The home had 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 using the service were positive about the care and support provided. They said staff treated them in a kind and caring manner.

Feedback about staffing levels was however mixed and the registered manager acknowledged there had been staffing shortfalls earlier in 2017 following some experienced staff leaving the employment of the service. New staff had now been recruited and the staffing ratios were now restored to previous levels. Staff spoken with and records seen confirmed this.

Staff had received training around safeguarding vulnerable people and knew what action to take if they had or received a concern. They were confident that any concerns raised would be taken seriously by the registered manager and acted upon.

Staff were positive about the service provided and felt confident in the quality of care given to people using the service. Staff felt able to speak to the registered manager or other senior staff to raise any issues or concerns.

People were supported effectively to have their health needs met. We saw that people’s prescribed medicines were being stored securely and managed safely.

Some people using the service said they enjoyed the food provided to them whilst others said they would welcome more variety in the menus offered.

The staff attended regular training which gave them the knowledge and skills to support people effectively. The service understood and complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff understood the importance of gaining people’s consent before assisting people.

An experienced registered manager was in post who knew the service well. There were systems in place to help ensure the safety and quality of the service provided.

Further information is in the detailed findings below