Working at Tudor Manor

Not enough staff some days, down to only two when three needed, so residents wait for help like hoists or buzzers.

One person told us, ‘Some days it’s alright here. Sometimes there’s plenty of staff around and sometimes there’s only 2 staff. Usually there’s 3 staff but sometimes only 2’. A relative told us, ‘There’s definitely not enough staff, [Person] waiting for a chair to arrive. [Person] always has to wait to be hoisted’

Managers missed reporting three incidents to safeguarding authorities and had no checks on strong painkillers.

We did identify 3 missed reportable incidents that had not been reported to safeguarding or the CQC. No audit had taken place for the controlled drugs in the home

Checks by bosses didn't spot problems like low staffing or gaps in daily records like fluid charts.

The manager had audits in place... However, we found concern in the effectiveness of the audits as they had not identified the concerns we found during this assessment... fluid charts had continuous gaps, we saw no action taken