Inspection on 17/05/05 for Cedar Court

This inspection was carried out on 17th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cedar Court 10/12/09

Cedar Court 09/11/09

Cedar Court 15/10/09

Cedar Court 18/12/07

Cedar Court 02/04/07

Cedar Court 11/04/06

Cedar Court 22/09/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Cedar Court 37 New Road Whittlesey Cambridgeshire PE17 1SU Lead Inspector Lesley Richardson Announced 17 May 2005 @ 10:00 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 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 I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cedar Court Address 37 New Road Whittlesey Cambs PE7 1SU 01733 350320 01733 205930 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cedar Court Care Ltd Rosemary Zirker Care Home with Nursing 25 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Physical disability (1) Physical disability over 65 years of age (24) Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named female with physical disabilities under 65 years of age (PD) for the duration of her residency only. 2. 24 older people (OP) for the duration of Condition 1. Date of last inspection 10th September 2004 Brief Description of the Service: Cedar Court is a single storey purpose-built home that provides personal and nursing care and support for up to 25 people over the age of 65 years. The building is situated in the market town of Whittlesey and is within reach of shops, pubs and other local amenities. Accommodation comprises 21 single bedrooms, all but two of which have en-suite facilities, and 2 double rooms, which also have en-suite facilities. There are a total of three day/quiet rooms and the home has bathing and toilet facilities, which are provided with aids to enable the needs of the residents to be met. The home has transport available to service users, including two wheelchair accessible vehicles, for visits into the community. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and was carried out as an unannounced inspection on 17th May 2005. Two hours was spent examining records and documents and three hours was spent looking around the building and spending time with service users and staff. Four people who live at the home, three of the staff on duty and one visitor were spoken to during the inspection. A new registered provider has been registered since the last inspection. What the service does well: What has improved since the last inspection? What they could do better: 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 Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 6 contacting your local CSCI office. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 8 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 standard(s) 3 and 4 A pre-admission assessment of prospective service users and staff training ensures the home is able to meet service users needs. EVIDENCE: Two of the three service user files seen during the inspection contained a preadmission assessment, although one contained very basic details only. The third file contained a copy of the social services assessment completed prior to that service users admission and additional information from the care home the service user had been transferred from. Transfer letters had been obtained from hospitals following periods of admission to ensure additional needs were known. Service users or their representatives are able to document having seen care plans and provide comments in a form specially designed for the purpose. Staff members said they attended mandatory training in health and safety issues during their induction to the home or at college. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 9 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 standard(s) 7, 8 and 10 Although systems are in place for referring service users to health care professionals, supporting documentation is not always available to ensure personal, health and social care needs are met. Personal care is offered in such a way as to promote and protect service users’ privacy and dignity. EVIDENCE: Individual care plans are available to ensure personal and health care needs are identified and planned for. However, on a care plan for one service user it was difficult to ascertain the need identified, as two different needs were written. This may lead to appropriate care not being received by that service user. Care plans were reviewed, although not all on a monthly basis and some had not been re-written when care needs changed or discontinued if no longer required. Service users care records showed the access each service user had to health care professionals. Risk assessments were completed and reviewed regularly, but the recommendation to refer to one health care professional had not been followed through. Although the presence of one particular care plan may have explained the lack of action, there was no specific explanation for the service user not being referred. Daily records had been made but not all care given Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 10 was written in detail; for example, one service user requiring all aspects of care assistance had little information about mouth care given, except that dentures had been cleaned. Service users are happy with the way carers approach them, saying they are waited on hand and foot. They are well dressed and care is taken with their appearance. Staff members also gave good accounts of ways to ensure service users’ privacy and dignity is maintained. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 11 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 standard(s) 12 and 13 Social activities provide stimulation and interest for people living in the home, and visits from relatives and friends ensure continued social contact. But, as service users are not consulted about their interests, individual preferences may not be catered for. EVIDENCE: Service users and staff members said activities are arranged by the home, but not everyday. Service users were looking forward to an organist scheduled to visit the day of the inspection. Trips out of the home are arranged for the summer months. Service users social and life history information is collected and one staff member said information is passed on to staff verbally. Of the three service user files seen, life history information had been poorly completed and only one social history identified the service users interests. None of the files contained care plans to show how service users social needs would be met. Service users are able to have visits from family at any time of the day and files showed family visiting routines. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 12 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 standard(s) 16 and 17 The home had a satisfactory complaints system with evidence that service users were able to confidently raise concerns. Systems are in place to enable service user to maintain their civil rights. EVIDENCE: Service users said they would have no qualms about raising concerns or making a complaint, although they had no complaints at all. Staff members were able to identify the appropriate action to take if a complaint was made to them. Staff members said service users who wanted them had been issued with voting cards or postal votes. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 13 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 standard(s) 19 and 26 The standard of the environment within this home is good, providing service users with an attractive and homely place to live. EVIDENCE: The home is well decorated and maintained, all areas are accessible and safe for service users, with open communal spaces. It was clean, tidy and all areas were free from offensive odours, including the sluice areas. The laundry is placed well away from the kitchen and dining areas. This area and the sluice areas all have separate hand washing facilities to ensure infection control. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Vetting and recruitment practices do not ensure that all appropriate checks are being carried out, potentially leaving service users at risk. Staffing numbers and staff training opportunities were sufficient to meet the needs of service users. EVIDENCE: On the day of inspection the home was adequately staffed; there was one registered nurse and five care staff throughout the day. The staff file of the most recently employed care worker was seen and indicated that the home had undertaken all the necessary checks to ensure protection of service users. However, the employment history did not contain full dates and possible gaps in employment were not explained in the interview notes. It was not clear from one of the references obtained exactly who the reference was from or in what capacity the referee had known the applicant. Staff members said they attended mandatory training in health and safety issues during their induction to the home or at college. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 32 The home is run in an open manner, thereby enabling it to be run in the best interests of the service users. Staff morale is good, resulting in a workforce that works positively with service users to improve their quality of life. EVIDENCE: The home changed ownership on 8th April 2005 and a new provider company was registered with the Commission. The responsible individual within the company is a registered nurse, with experience as a provider of another registered care home. Staff members said there has been little, if any, change at the home and the transition has gone very smoothly. They feel supported by the previous owners, who have remained at the home to assist with this process, and the new owners who staff said were very approachable. The registered manager has continued in post and this has also contributed to the stable transition of ownership. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 16 Open containers of washing powder and fabric softener had been left on top of one of the washing machines. This poses a health and safety risk to service users as the laundry door is kept open by an automatic door closure system. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 x x x x x 2 Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 18 YES Are there any outstanding requirements from the last inspection? 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. 2. Standard 7 12 Regulation 15(2)(b), (c) 16(2)(m) Requirement Care plans must be updated to show how the home intends to meet changed needs. Service users must be consulted about their social interests and arrangements made to enable them to engage in activities. The home must obtain a full employment history and a satisfactory written explanation of any gaps in employment. All parts of the home to which service users have access must be free from hazards to their safety. Timescale for action 31st July 2005 31st July 2005 30th June 2005 30th June 2005 3. 29 19(4)(b) (i) 13(4)(a) 4. 38 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. 2. Refer to Standard 7 8 Good Practice Recommendations All entries made in service users care records should be dated, with full day/month/year format, and signed by the author of each entry for audit purposes. The home should document the reason for non-referral to a health care professional if there has been recommendation to do so. I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 19 Cedar Court 3. 29 References should be clear as to the capacity in which the referee knows the applicant. Cedar Court I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 20 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 I53 I03 S63735 CEDAR COURT v227229 170505 STAGE 4.doc Version 1.30 Page 21 - 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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