Inspection on 11/10/06 for Cedar Court

This inspection was carried out on 11th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cedar Court 05/01/06

Cedar Court 23/06/05

Cedar Court 03/02/05

Cedar Court 08/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Cedar Court Lensbury Way Abbey Wood London SE2 9TA Lead Inspector Maria Kinson Key Unannounced Inspection 11th October 2006 09:50 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Court Address Lensbury Way Abbey Wood London SE2 9TA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8311 1163 020 8311 1193 cedarcourt@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited Mrs Kim Madeline Brown Care Home 47 Category(ies) of Dementia - over 65 years of age (47) registration, with number of places Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: Cedar Court is a purpose built home, which was originally registered in 1996. In 1997 the home was taken over by Southern Cross Healthcare Ltd and was registered for 47 mentally infirm people. At that time, 10 places provided nursing care. On the 4 March 1999, the registration was changed and the home now provides 47 residential places for older people with dementia. The home is located a short distance from Abbey Wood station, bus routes and shops. It has 41 single and 3 double bedrooms. The home is on two floors and has a sitting room and dining room on each floor. There are additional communal rooms on each floor. From the ground floor residents have access to the garden, which is enclosed. On the ground floor there are offices, a laundry, kitchen and storage rooms. The fees charged by the home range from £372.02 - £620 per week. Residents are responsible for any additional charges such as hairdressing, toiletries, outings and personal clothing. This information was supplied to the commission on 18.09.06. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 11.10.06, between 09:50 am–18:00 pm and on 12.10.06, between 12:00 midday - 14:00 pm. The inspector spoke with residents, staff and one visitor and observed staff assisting residents with various activities throughout the day. Two sets of care records were examined and the management of medication was assessed. All of the communal areas and a selection of bedrooms were examined. On day two of the inspection health and safety, quality assurance and staff records were assessed. Comment cards requesting feedback about the service were sent to a random selection of relatives and health care professionals. Sixteen cards were returned to the commission - two from health care professionals, eleven from relatives and three from care managers or placement officers. What the service does well: This home provides a consistently good standard of care for older people with dementia. Feedback from residents, relatives and healthcare professionals was good. Prospective residents were able to spend time in the home prior to making a decision to move in, and written information about the service was provided. Staff worked in partnership with other care professionals to ensure that residents’ healthcare needs were met. Professionals who had visited the home said they were “impressed by the range of activities provided for residents and the very friendly/supportive rapport between staff and residents”, and “this home provides a very good service for service users”. Medication was stored and managed in a safe and secure manner. There was a warm and welcoming atmosphere in the home. All parts of the home were clean, tidy and odour free. The building was well maintained and health and safety issues were addressed promptly. Feedback from relatives was good. Relatives were satisfied with the visiting arrangements and said they were kept informed about important issues. One relative said, “ I cannot fault the staff they are very helpful and care for all the people in the home. They are all very dedicated. I trust them implicitly”. Staff worked hard to provide meaningful and interesting activities for residents. Residents were supported to remain alert and active and develop new friendships in the home and community. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 6 Although many of the residents living in the home were not able to provide detailed feedback about the home or say how they were feeling, most residents looked relaxed and happy and there were clear indications that residents psychological needs were being met. One resident said, “we are very lucky, there are no temperamental nurses here”. Other residents said they were pleased with their rooms and enjoyed the food provided. Staff encouraged residents to make choices and make their wishes known. The home has a stable team of competent and committed staff. Residents received support from staff that were familiar with their preferences, strengths and needs. Staff communicated effectively and took an interest in residents’ health and wellbeing. Staff were supported to develop their existing skills and knowledge and attain relevant qualifications. There were good systems in place to monitor and improve the quality of care provided in the home and safeguard residents’ money. This home was well managed. The atmosphere in the home was open and supportive. What has improved since the last inspection? What they could do better: Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 7 The quality of care provided in the home was good and almost all of the standards assessed were met or exceeded. The requirement and recommendations identified during the previous inspection had been addressed and one new requirement was made as a result of this inspection. The manager must introduce a system for supervising staff that do not have a full criminal record disclosure. The arrangements for supervising new staff must provide adequate protection for residents. Care plans were good overall but often lacked specific information about residents’ preferred routine and individual needs. Although care plans were reviewed regularly it was not always clear in the records whether the care plan was meeting the residents’ needs. Staff should ensure that residents are consulted about sharing a bedroom before they move into the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4. Standard 6 does not apply to this standard. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff ensured that up to date information about the service was made available to prospective residents and their representatives. Staff obtained information about residents’ needs and preferences before they moved into the home. This assisted staff to meet residents needs. The staff working in this home carried out their work in a manner that promotes good health and wellbeing for residents with dementia. EVIDENCE: A variety of useful information was provided in the reception area for visitors to read. Two documents that care homes must make available to residents and their representatives; a Statement of Purpose and Service User Guide, were displayed. Information included in these documents was reviewed and updated at regular intervals. The Service User Guide was also available on cassette tape. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 10 Prospective residents were invited to spend a day in the home to see if they liked the facilities. This visit also provided an opportunity for staff to assess the resident’s needs. The manager assessed the resident in their own home or in hospital if they were too frail to visit or if other professionals thought that visiting the home would disorientate the resident. Information about residents care needs, personal preferences and usual routine was recorded and kept in the residents file. Information was also obtained from other professionals and the residents funding authority. This home is registered to care for people with dementia. Staff working in the home demonstrated an excellent understanding of the needs of people with dementia and treated all residents, irrespective of their level of understanding or ability to communicate, with respect and understanding. The atmosphere in the home was warm and relaxed. Staff did not correct or question residents when they spoke about situations that were unlikely to be true. When residents became anxious because they thought their children were in danger or their mother and father had not visited, staff acknowledged their fears and tried to reassure the person. Residents were encouraged to make decisions for themselves, choose the food they preferred and speak up if they did not like something. Staff encouraged residents to carry out every day tasks such as helping them to post a letter, dusting and laying the tables. Staff did not expect all residents to behave in the same manner; residents were treated as unique individuals with different needs, preferences and skills. Staff spent time talking with and listening to residents and had a good understanding of residents’ life history and background. Staff knew what jobs residents had done, whether they had any children or pets and what mattered to them. Staff used their imagination and common sense. Two members of staff had collected personal items such as clothing, photographs and ornaments from a resident’s home because the resident did not have any relatives. When a residents remaining relative was ill staff arranged to take the resident to the hospital to visit her family member and when the Chiropodist was not able to visit staff took residents to a local clinic. If residents were hungry staff cooked or prepared them a meal or snack, regardless what time of day or night it was. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ physical and psychological needs were identified and addressed by staff. The home had good systems in place to ensure that residents received their medicines in a timely manner. The relationship between carers and residents was good. Staff demonstrated excellent communication skills and carried out their work with due regard to residents’ privacy and dignity. EVIDENCE: The records for two residents were assessed. Both of the files seen included an assessment of needs, a care plan and a variety of other assessments that were relevant to the care of older people. Discussions with staff and residents confirmed that the information recorded in care plans reflected residents’ needs, was accurate and up to date. Although the standard of care planning was good overall some areas for improvement were identified. Some of the care plans seen for different residents included very similar information about the residents personal hygiene needs and little detail about the residents’ Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 12 individual preferences or preferred routines. There was misunderstanding amongst some staff about how they should evaluate care plans. For instance some staff had recorded the care they provided for the resident or the care that the resident required on the monthly evaluation form. It was not always evident on the evaluation form if staff had assessed whether the care plan was meeting the residents needs. See recommendation 1. A new system had recently been introduced to prompt staff to review and update care plans regularly. This arrangement seemed to be working well. Staff received regular support from a GP and other professionals such as a community psychiatric nurse, district nurses, the dietician and diabetic nurses. Feedback about the home was obtained from five health and social care professionals that were in regular contact with the home. All of the professionals that responded said that staff communicated clearly, demonstrated a good understanding of residents needs and were satisfied with the care provided in the home. Medication was well organised. There were systems in place to record medication received in the home, medication administered by staff and medication that was returned to the pharmacy. Medication was stored appropriately but the temperature in the clinical room was slightly above the temperature recommended for the storage of medication. Staff said that plans were in place to install an air conditioning unit. Records were well maintained and complete. The staff member administering medication wore a red tabard that advised relatives and visitors that they should not be disturbed whilst they were administering medication. Residents were provided with good support to take their medication and an explanation about what the medication was for if requested. One resident was prescribed, but had not received, medication that would usually be administered by a trained nurse. Staff were advised about the circumstances in which they would be permitted to undertake this task. Staff communicated effectively with residents and were able to interpret messages that lay behind some residents words or behaviour. Staff addressed residents by their name and adapted their approach when talking to residents with different needs. Residents were supported to choose their own clothing and accessories where possible. Personal care was undertaken in the privacy of the resident’s room or in the bathroom. Some members of staff had recently attended training about the Liverpool Care Pathway. This model is an excellent tool for staff to use when caring for residents that are terminally ill. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff arranged a structured programme of activities and outings and residents were encouraged to engage in everyday tasks. Residents were able to maintain contact with their family and form new friendships in the home. Residents were consulted about decisions relating to their care and were encouraged to make their wishes known to staff. EVIDENCE: Two senior carers were responsible for arranging a regular programme of activities and outings and for ensuring that the activities listed took place. The range of activities provided was varied and included both group and one to one activities. In addition staff sometimes arranged local outings because the weather was good or because a resident said they wanted to go to the shops or for a walk. During the course of this inspection a group of residents made cakes, one resident went to the shops with a staff member, some residents attended a church service and some residents were dancing in the lounge. Records indicted that some residents had been to Howletts Zoo, a local theatre, pub lunch, visit to a local school fete and Age Concern dances and quizzes in recent months. The home hosted an annual summer fete and other social vents such as a Halloween and Christmas party was planned. In house Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 14 activities had included arts and crafts sessions, aromatherapy, foot spas and card games. A number of social care professionals commented about the homes activity programme “I have been impressed by the range of activities provided for residents and the very friendly/supportive rapport between staff and residents”, “this home provides a very good service for service users. The residents are taken out for visits when the weather is fine”. Eleven relatives provided written information about their observations during visits to the home and about their family members experiences. All of the relatives said they were made to feel welcome when visiting the home, that they were kept informed about important matters and were consulted if there relative was not able to make decisions for themselves. All of the relatives that sent written information to the commission or spoke to the inspector during the inspection were satisfied with the overall care provided in the home. “ I cannot fault the staff they are very helpful and care for all the people in the home. They are all very dedicated. I trust them implicitly”. My relative is “well cared for”. Staff encouraged residents to make choices. Residents who chose not to attend the church service or who did not want to take part in activities were not pressurised to do so. Although staff knew how residents liked their tea or coffee some residents were heard instructing staff about how they preferred their drink and were happy to speak up if it was not to their satisfaction. The menu was displayed in the home. Lunch was observed in the first floor dining room. Residents were asked what they wanted to eat from the menu and were offered alternatives if they did not like the menu options. Staff encouraged residents to eat and support was provided for those residents that could not feed themselves. A food and fluid chart was maintained for one resident who had a poor appetite. Staff checked the residents weight every two weeks. One resident said “we have good food here” and other residents spoken with said they enjoyed the meals provided. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a comprehensive complaints and adult protection procedure. Complaints and concerns were investigated promptly. EVIDENCE: The complaints procedure was displayed in the reception area and most relatives said they were aware of the procedure to follow if they had any concerns about the home. A complaints file was kept in the office and all complaints were recorded and reported to head office. The home had received one complaint since the last inspection about communication issues. The complaint was investigated promptly and although some of the issues were difficult to prove the manager upheld the complaint and apologised to the complainant. The home had a ‘Protection of Vulnerable Adults’ and ‘Prevention of Abuse’ procedure. Both procedures were issued in January 2006. The procedure provides clear guidance for the manager and staff about what they should do and who must be notified about allegations of abuse. Staff that the inspector spoke with were aware of the need to report allegations of abuse or misconduct to senior staff. A training update for staff about abuse was provided in September 2006. Since the last inspection the home had not referred any staff to the POVA list but two members of staff were dismissed for failing to follow company procedure. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An extensive redecoration programme was in progress. All parts of the home were clean and comfortable. There was little evidence that one of the residents in a double room had chosen to share a room. EVIDENCE: Work to improve the visual appearance of the home was in progress. Most of the communal bath, shower rooms and toilets had been redecorated and refurbished. New furniture and entertainment systems were purchased for the dining and activity rooms and some of the bedroom furniture such as beds, wardrobes, chairs and chests of drawers were replaced. The home was warm, and welcoming. Further work was planned to complete the programme of work and personalise residents’ bedroom doors. There were ridges in some bedroom carpets. The manager said that she was aware of this issue and would arrange for the carpets to be stretched or replaced. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 17 All parts of the home visited were clean tidy and odour free. Clinical waste was stored appropriately and hand- washing facilities were satisfactory. One of the residents in a double room said that she was “not used to being in with anyone else” but “I think I am getting used to it now”. The resident’s history stated that she had not married and had lived a very private life. The records indicated that the resident had made staff aware that she did not wish to share a room when she first moved into the home. See recommendation 2. There were no dividing curtains in the room. The curtains were collected from the laundry and replaced during the inspection. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff working in this home had a good understanding of the needs of people with dementia. The homes recruitment procedure was good overall but adequate arrangements were not in place to supervise staff that were awaiting a full criminal record check. Prompt action was taken to address this issue. Staff were supported to undertake relevant training. EVIDENCE: The staff team comprised of a full time manager, administrator, team leaders, senior care assistants, care assistants and ancillary staff. The duty roster for the period 01/10/06 – 21/10/06 was examined. Although there had been some changes to the staff team since the last inspection, staffing levels were stable and residents continued to receive care from permanent staff that were familiar with their needs. Most residents were familiar with the manager and staff team and addressed them personally. The atmosphere in the home was friendly and welcoming. Sixty eight percent of care staff working in the home had attained a vocational qualification in care at level two or above. This exceeds the standard set by the Department of Health. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 19 Three staff recruitment files were examined. All of the files included an application form, two written references, proof of identity and a recent photograph of the employee. A full criminal record disclosure had not been received for one member of staff who was working unsupervised. This issue was discussed with the manager. The manager arranged for the staff member to work alongside a colleague from another home until the criminal record was obtained. See requirement 1. Staff that had started working in the home since the last inspection were satisfied with the support they had received during the induction period and said that senior staff were approachable and helpful. Individual training records were maintained for each member of staff and training needs were identified during supervision. Since the last inspection some staff had attended accident, food hygiene, fire safety, moving and handling, dementia awareness, infection control and principles of care training sessions. A training plan had been developed to meet staff training needs and to ensure that staff were able to meet residents’ needs. An induction workbook had been developed for new staff. The workbook provided evidence that staff had received training and understood the basic principles of care. Although the records indicated that new staff had received a copy of the induction workbook it was not possible to assess progress as staff retained the workbook. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home was well organised and run. The manager of the home was committed to the provision of good quality dementia care. There were good systems in place to monitor the quality of care and ensure the safety of residents and staff. Appropriate action was taken to safeguard residents’ personal money. EVIDENCE: The manager was assessed as a suitably experienced and qualified person to manage a care home for older people. The manager had completed training relevant to this post and is currently undertaking the Registered Managers Award. The home was well organised. Records were easy to locate and were up to date and accurate. Staff had a good understanding of their role and responsibilities and there was good team working. Staff said they were Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 21 consulted and advised about changes within the company and home and received good support from the manager who also assisted with resident care if staff were busy. The manager was observed advising a work experience student about the most effective manner to approach and talk to residents. The home had systems in place for monitoring the quality of care provided in the home. The nominated person visited the home regularly to talk with residents and staff and the reports compiled as a result of these visits were sent to the manager and the commission. The manager carried out regular medication; pressure sore, accident and financial audits. The Operations Manager checked the results. If concerns were identified the manager was required to complete an action plan to confirm how and when the issues identified would be addressed. The administrator was able to store personal money or valuable items for residents. Good systems were in place to record any money deposited with staff, used to pay bills such as hairdressing and chiropody or removed from the residents account for them to spend during outings. The administrator signed all entries and receipts were retained for items purchased on the resident’s behalf. Health and safety and fire records were sampled. All of the records seen were satisfactory. The fire risk assessments had been reviewed and staff had started to address some of the recommendations made by the assessor. The accident records for a two-month period were viewed. There were two accidents in October and five in September 2006. Most of the accidents recorded were falls or superficial skin injuries. Accidents were monitored to identify patterns and trends and where possible staff considered what they could do to avoid the resident falling or sustaining an injury again. The company had recently introduced a new accident form. The new form provided little space for staff to record witnesses, the circumstances or the position that the resident was found in. The inspector discussed this issue with staff from the commission that liaises with providers. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 2 X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 Requirement The Registered Person must ensure that staff with a POVA first check, who are awaiting a full CRB disclosure, do not work unsupervised. (A record should be maintained in the staff members file about the arrangements that have been made to supervise the employee) Timescale for action 27/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The Registered Person should ensure that: • Care plans include specific information about residents preferences, skills, strengths and needs • Staff use the evaluation sheet to assess whether the care plan is effective The Registered Person should ensure that residents that have made a positive choice to share occupy double rooms. This decision should be discussed with the DS0000006786.V306501.R01.S.doc Version 5.2 Page 24 2. OP23 Cedar Court resident and their representative during the pre admission assessment and recorded. The individuals currently residing in shared room should be offered a single room when a vacancy occurs. Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cedar Court DS0000006786.V306501.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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