Inspection on 25/06/09 for Cedar Lodge

This is the latest available inspection report for this service, carried out on 25th June 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cedar Lodge 21/10/05

Cedar Lodge 19/05/05

Cedar Lodge 12/11/04

Cedar Lodge 22/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cedar Lodge Devon Court 109 Devon Drive Brimington Chesterfield S43 1DX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nancy Bradley     Date: 2 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Cedar Lodge Devon Court 109 Devon Drive Brimington Chesterfield S43 1DX (01246)477047 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Ann Gibbins,Dr Edward Marcion Ranjit De Saram,Mr Norman Turner care home 10 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 10 The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home Cedar Court provides personal care and support for up to ten younger adults with learning disabilities. The service aims to promote normal living, autonomy and choice for service users in accordance with their individual risk assessed needs. This is provided by way of planned care, which is subject to regular review. The home is purpose built and is situated within a residential area in the grounds of a registered care complex. It is located to the north-eastern outskirts of Chesterfield, on a direct bus route and relatively close to local shops and amenities. The Registered Manager has the support of a team of care and hotel services staff, together with external Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home administrative and management support. The home provides single room accommodation with a choice of lounge/dining space. There are communal bathing and toilet facilities, with four bedrooms providing an en suite facility. Remaining bedrooms have a wash hand basin provided. The home is decorated and furnished to a high standard and service users own bedrooms are personalised. There is access to a garden area to the rear of the home with seating for service users and car parking space is provided to the front of the home. Fees for this home are individually assessed. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection and took place over a total of five hours. We spoke with the registered manager, care staff and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the last key inspection. This included the following: The Annual Quality Assurance Assessment (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well Care Homes for Adults (18-65 years) Page 6 of 27 outcomes are being met for people using the service. It also gives us some numerical information about the home. Two people living at the home were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the person. Additionally, time was spent in preparation for the visit, looking at the service history and the previous inspection report. Records were examined relating to the people living there and the general running of the home. There were ten people living at the home on the day of the visit, the home has no vacancies We sent out ten Have Your Say questionnaires to people living at the home and have received six back. Completed surveys indicated the people living at the home were very happy there, were supported by the staff on a daily basis and liked living at Cedar Lodge. Care staff had assisted the people in completing the questionnaires. Completed questionnaires from relatives were very positive about the home and indicated they were happy with the care their relatives received and the home. We received four staff questionnaires which indicated they were happy working at the home. We received a warm, friendly and enthusiastic welcome from the people living at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that peoples needs are fully assessed and met prior to admission. This ensures that peoples holistic needs are appropriately met. Evidence: The majority of the people who are admitted to the home have their needs assessed by social workers or through the care management system. The single assessment then forms part of the planned care people receive. Also the home undertakes their own individual comprehensive needs assessments. This was in accordance with a recognised care model and provides a person centred record of individual needs, including identified strengths and needs, long-term goals, and evaluation. Care management review the care needs on an annual base. Family and carers interests were also recorded. There have been no new admissions to the home since the last site visit. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a care planning and review system in place, which ensures that peoples individual needs are met. Evidence: During the visit care plans of two people who live at the home were seen. The registered manager had compiled the care plan and evidence was seen of care plans being reviewed on a monthly and six monthly bases. All of the people case-tracked had a comprehensive care plan, which was in accordance with their assessed need and formulated within a risk assessment framework. All care plans were very detailed and comprehensive including peoples individual lifestyle preferences and choices; the interventions prescribed by outside healthcare professionals were appropriate. Daily records are also maintained on each person. The home has moved into person centred planning and people living at the home were being involved in their planning and work developing their care plans. The person Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: centred planning runs alongside the more formal care planning system in operation. The care records include peoples goals, achievements and aspirations. As discussed with the registered manager, person centred planning needs to develop further with peoples life history being included and daily recording in the care plan if they wish. During the visit care staff were observed discussing with people, choices and arrangements for daily living. Detailed risk assessments were in place and these included actions to be taken by staff. Discussed with the registered manager about what information should be kept on people records and included in their care plans. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were arrangements in place to enable people to maintain and develop appropriate relationships and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. Evidence: During the site visit we spoke with people from the home and care staff about the activities they were engaged in and the arrangements for these. The care records of all people provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and outside in the community. The peoples personal goals, choices and preferences were identified and there were properly recorded risk assessments in place for each person in relation to the activities Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: they were engaged in. People at the home lead an active daily life with planned activities and trips out, following discussions at house meetings. Photographs were on display showing how people have spent their time. Activities are tailored to the individual needs and abilities of the people living at the home. A record of peoples individual activities is kept by them and included as part of their person centred care plan. People have access to the Derbyshire Advocacy service should they wish or need the service. Information on peoples records indicated that contact with family and friends were appropriate and that were they played an important part in their lives, the home maintains good contact with them. Restrictions in contact were clearly recorded and were with peoples agreement. Examination of the menus showed the home is providing a healthy, well-balanced and nutritious diet. The home maintains a record of peoples weight. The people are given a choice if they do not like the options on the menu. The care staff were observed checking with people as to their likes and dislikes. Menus are displayed in Makaton format so people can fully understand the meal options available. During the site visit we joined the people for lunch. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and beliefs Evidence: During the visit it was clear that the peoples privacy and dignity is respected, and where people need supervision during personal care this is recorded in their care plan. From records examined and from discussions with staff, people health and personal needs were being met . People were generally healthy and records showed that staff promptly contacted the appropriated medical services. All people attended services within the community including optician, podiatry, and dentist. People at the home receive regular health check from centre at Ash-green. Cedar Lodge has implemented the My Health Care booklet. This is a record of all medical appointments and health details. Each person completes this and can take it with them to appointments. This is a scheme supported by the National Health Service and the Co Operative for people with additional needs. The AQAA indicates the home wishes develop peoples confidence when attending medical appointments this is one way in which this may be Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: achieved. The home operates and monitors all medication. None of the people are able to administer their own medication. All staff have received training on medication administering procedures. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. All medication is recorded on MAR sheets. The list of staff approved to administer medication had a number of staff names crossed out. These were staff who had left the home. The AQAA indicates that medication is provided by Boots the Chemists, and they regularly undertake medication audits. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements in place to safeguard peoples welfare, which enables their concerns and complaints to be listened to and acted upon. Evidence: The home has a complaints procedure, which is included in the service users guide which all of the people living at the home have a copy of. The complaints procedure is also displayed throughout the home. The home has developed a format which is accessible to people and they are made aware of how to make a complaint and who they can complain to. Records seen indicated that no complaints had been made about the home since the previous site visit. The Care Quality Commission has not received any concerns about this home. The home also keeps a record of compliments from family and friends. The policy did not show the current details from the Care Quality Commission The procedure informs the complainants that they are able to contact the Commission for Social Care Inspection at any stage of the complaints process if they wish to do so. The home operates an open surgery where people can speak with staff in confidence if they have any complaints or concerns which they wish to raise. The complaints record is signed off after each Registered Provider regulation 26 visit. Discussions with the care staff and records examined indicate that there has been no reported incident or allegations under the safeguarding of adults procedure since the last site visit. The registered manager indicated that several staff are still to undertake Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: training on safeguarding adults. The home has about seventy percent of its staff trained. The home operates in accordance with Derbyshire County Council Social Services policy on Safeguarding of Adults. The safegurding policy did not show the contact details for the local social services office or call Derbyshire. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A homely, comfortable and personalised environment was provided that suited the needs and lifestyle of those residents accommodated. Evidence: We carried out a full tour of the home, accompanied by the registered manager staff and people who live at the home. All communal areas were inspected together with staff facilities. Peoples bedrooms were inspected with their agreement and all rooms had been decorated and furnished to their personal choice and all were personalised. The home was clean, well maintained, well furnished, equipped and well lit and heated. There is a central kitchen and separate laundry and staff facilities. There are no outstanding maintenance issues with an on going programme of refurbishment and decoration in place. During the visit we were able to see which areas had been redecorated and several people living the home showing us their bedrooms which had been done. Several people have keys to their room if they wish. A conservatory is being built at the back of the home. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has robust recruitment procedures and practices in place which ensure the safety and protect the service users. People living at he home are well supported by an effective staff team who are appropriately trained. Evidence: The home operates a key-worker system and the staff spoken with during the visit were aware of the individual needs of the people they care for. Records examined during the site visit indicate that there is ninety five percent of the staff who have attained a National Vocational Qualification at level 2 or above. The home has a recruitment and selection policy in place. Several staff records were examined and generally these were well presented. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a probationary period. However the companys application form does not indicate that a full employment history is required. The form is not requesting the days date, month and year. This was discussed with the registered manager. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: Copies of staff qualifications were on file. There have been several staff changes since the last site visit. Staff spoken with during the visit stated there were good training and development opportunities. The AQAA and the homes training records confirmed the training undertaken over the last twelve months together with future training requirements. The AQAA indicates staff are yet to receive training on the Mental Capacity Act. All staff have a Personal Development Plan. The home has a staff supervision policy place. There was evidence in staff records to show that staff appraisals were being undertaken and staff had received supervision. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to ensure that people have a voice and their views are listened to and acted upon. Evidence: The Registered Manager has a Registered Managers Award, NVQ Level 4 in care and management and has a relevant job description. Discussions and completed staff questionnaires stated the manager was approachable and supportive and open to discussion. All of the staff indicated they felt supported by the manager and there is good team support. The home has developed a system for auditing quality and monitoring all services provided by the home. The Registered Manager provided copies of the most resent audits undertaken by the home. These confirmed that the necessary service aspects of the home had been audited. The Regulation 26 visits are under taken by the Registered Managers for the homes within the Elm Care Group these were seen and found to be satisfactory. The registered manager compiles an annual report and Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: reviews the team objectives on a regular basis. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to us by way of the AQAA. The Registered Manager had completed the AQAA to satisfactory standard and within the required timescale. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 18 All applicants must provide a 31/07/2009 full employment history. This is to ensure people are supported and protected by he homes recruitment procedures. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Following examination of records, historical and miscellaneous information on peoples records should be archived. A new update sheet of staff approved to administer medication should be compiled. The complaints policy should include the current contact details for the Care Quality Commission. The contact details for Call Derbyshire should be included in the Safeguarding policy. All staff should receive up to date training on safeguarding vulnerable adults. All staff should receive training on the Mental Capacity Act Page 25 of 27 2 3 4 5 6 20 22 23 23 34 Care Homes for Adults (18-65 years) and Depravation of Liberty Safeguarding (DOLS). 7 35 All staff should receive training on the Mental Capacity Act and Depravation of Liberty Safeguarding (DOLS). Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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