Inspection on 18/12/07 for Cedar Court

This inspection was carried out on 18th December 2007.

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 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 02/04/07

Cedar Court 11/04/06

Cedar Court 22/09/05

Cedar Court 17/05/05

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 PE7 1SU Lead Inspector Janie Buchanan Unannounced Inspection 18th December 2007 10:00 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 DS0000063735.V357086.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 DS0000063735.V357086.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Court Address 37 New Road Whittlesey Cambridgeshire PE7 1SU 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) 01733 350320 01733 205930 cedarcourtcare@btinternet.com Cedar Court Care Limited Anund Oogorah Care Home 25 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (24), of places Physical disability (1), Physical disability over 65 years of age (24) Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 1 named female with physical disabilities under 65 years of age (PD) for the duration of her residency only 24 older people (OP) for the duration of condition 1 The maximum number of places not to exceed 25 The 3 places registered for DE(E) will have their mental health nursing care needs met by the community psychiatric service 2nd April 2007 Date of last inspection 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. It is owned by Cedar Court Care Ltd 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. Residents have access to a garden and patio area at the front of the building. Weekly fees are £560. Residents pay additionally for newspapers, private chiropody and hairdressing. Basic toiletries are provided. A copy of the most recent CSCI report is available in each resident’s bedroom. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For this inspection we (CSCI) looked at all the information that we have received, or asked for, since the last key inspection. This included: • the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • surveys returned to us by people using the service, staff at the home and from other people with an interest in the service. We received a total of 35 of these surveys: this was an excellent response. • what the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. We visited the home and talked to four residents, three members of staff and the manager. We also undertook a brief tour and viewed a number of documents and proecdures. Three requirements and two recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? All residents, whether privately of local authority funded, now receive a contract so that they are fully aware of the terms and conditions of their stay at the home, and the fees payable. All care staff now hold an NVQ level 2 in care which means residents receive their care from well qualified and knowledgeable staff. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 6 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. Information is available about the home to help prospective residents choose if it is where they want to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a statement of purpose and resident guide that give good information about the home and the services it offers. These are available in each resident’s bedroom, along with a copy of the most recent CSCI inspection report. Each resident is issued with a contract that states the terms and conditions of their stay at the home. Residents’ needs are assessed before they are admitted to the home, and there was good pre-admission information available on the files viewed for two recently admitted residents. Residents are able to visit the home to assess its facilities. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Residents receive health and personal care based upon their needs This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents’ care plans were checked. The information they contained was detailed and up to date. Residents’ needs in a number of areas were clearly identified, as was the intervention required to meet them. There was also additional information about residents’ likes and dislikes, hobbies and interests, and also a little about their personal history. However there was little evidence that residents actively participate in drawing up and reviewing their care, and their plans are not easily accessible to them. Residents’ weights, blood pressure and pulse are monitored regularly, and their risk of pressures sores is also assessed. There was evidence in the plans that residents see a range of health care professionals. One resident told us: ‘I am very prone to chest infections and the nurse always takes action as soon as possible, requesting a doctor to visit so that I can have treatment to relieve it’. However one relative felt that staff needed better training in handling hearing aids as when she visits, her mother’s hearing aid is not switched on, or has Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 10 been placed in her ear incorrectly, therefore preventing her mother from hearing their conversation. The home’s medication storage area and a sample of medication records and was viewed and found to be in good order, with medication administered accurately recorded and accounted for. Residents spoken to confirmed that staff were courteous, respectful and communicated well with them. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. Residents have access to some activities and mealtimes are enjoyable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents who completed the survey told us that there were activities arranged by the home that they could take part in. Five residents recently attended a nearby school’s Christmas play and the local girls’ brigade visited the home to sing Christmas carols. However one resident commented ‘I would like a few more trips out’; another: ‘I am concerned that there won’t be as many activities, entertainment or outings as the member of staff who was very good at organising these has left. Staff also voiced concerns that the frequency activities might suffer in absence of this member of staff. Relatives told us that the home helps residents stay in touch with them, and that they are made to feel welcome. They are encouraged to take part in the daily life of the home and a recent buffet and Christmas party had been arranged for them and the residents. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 12 Lunch on the day we visited consisted of steak pie or Chinese chicken. Residents spoken to told us they enjoyed the food at the home. However one relative commented: ‘our relative has her meals in her room. Being the last stop if there are any hold ups on the way, the food has occasionally cooled off. Containers to keep the food hot would be an improvement’ Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. Staff listen and act upon concerns residents or their relatives raise. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Relatives and residents told us their concerns are responded to. One commented: ‘I’ve never been shown a formal complaints procedure but on the few issues we have been concerned about, we have written to the manager and the issues have been addressed. Lesser issues we have tackled verbally and they have been dealt with well’. Another wrote: ‘occasionally we have made suggestions and our comments were taken on board and any appropriate actions taken’. The complaints procedure is not well advertised around the home. There is a copy in the main entrance but its print is too small for residents to read it easily. Staff receive training in protecting vulnerable adults so that they are aware of the different types of abuse and reporting procedures. There has been one adult protection concern in the last year concerning pressure care of one resident at the home. This is still under investigation. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,26 Quality in this outcome area is good. Residents live in a comfortable and wellmaintained home with a range of indoor and outdoor space available to them This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is purpose built to meet the needs of older people. All but 3 bedrooms have en-suite facilities and 2 have their own shower. There are additional bathrooms and toilets and aids and adaptations are provided throughout the home. The home was found to be clean and fresh throughout on the day we visited, and there is a domestic staff team employed. There is additional communal space available and an attractive courtyard garden for residents to enjoy the fresh air and sun. Hand washing facilities are available throughout the home and staff are provided with protective aprons and gloves to minimise the risk of cross infection. One member of staff showed particularly good knowledge of the additional measures in place for a resident who has MRSA. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Care staff have the right skills and experience to look after residents properly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many positive comments were received about the staff from residents and their relatives including: ‘the staff are very good’ and ‘the management and staff work hard to make the place a real home for residents’; ‘my elderly relative is so well looked after at Cedar Court’. The reliance on agency staff to cover vacant shifts has reduced considerably and a number of new permanent staff have been recruited. There are four members of staff on each morning and three members of staff on in the evening to meet the needs of up to 25 residents. Two staff cover the night shift. Staff told us that staffing levels were usually OK but that morning time could be very busy and they often felt rushed. One resident told us: ‘I sometimes have to wait a long time for help off the commode. It feels as though I’m left sitting for ages and it hurts my stump’ The files of two recently employed staff members were checked and each contained two references and appropriate CRB/POVA checks. However the references for one employee both came from the same organisation, despite this member of staff having worked in a number of care homes previously. Training for staff is generally very good, with them undertaking a range of training including nutrition and older people, continence promotion, falls and Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 16 dementia care. All care staff hold an NVQ level 2 in care: this is to be commended. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is good. Residents live in a home that is well managed and where staff feel supported. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home is a registered nurse and has many years experience in both owning and managing residential care homes for older people. Staff described their morale as good and told us they enjoyed working at the home. They reported that the management team were approachable and offered good support. Staff do receive formal supervision of their working practices but not as often as recommended by the national minimum standards: supervision records showed that one member of staff had only received two supervisions in a period of 10 months, and another only one in the last year. The home does seek feedback from its residents on the quality of the service they receive. 11 completed questionnaires that had been sent to residents and Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 18 their visitors concerning the quality of staff, staffing levels, cleanliness, meals and activities were viewed. Most respondents rated the home positively. The home also undertakes an annual (March 2007) quality audit of its service covering the environment and facilities, resident care and organisation and management. The home does not handle any residents’ personal finances, or hold any money on their behalf. A number of records in relation to health and safety were viewed, (including portable appliance testing, fire alarm tests, water temperatures and hoist servicing) and were found to be in good order. However it was of concern that one member of night staff had not received any training in first aid since November 2001. Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 19 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 3 3 x 3 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x N/A 2 x 3 Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15 (2) Requirement Timescale for action 01/03/08 2 3. OP29 OP36 Residents must be actively involved in drawing up and reviewing their care plans so that their views are sought in how they would like to be cared for. 7,9,19 sch Two appropriate references must 2 be obtained for any prospective member of staff at the home. 18(2) All staff must receive regular supervision, so that their working practices are reviewed. Timescale of 01/05/07 not met. 01/02/08 01/03/08 Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 21 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 OP16 Good Practice Recommendations The home’s complaints procedure should be made more easily available to residents so that they are fully aware of what they have to do if they want to raise concerns. All night staff must receive training in first aid so that they can respond appropriately in the event of a medical emergency 2 OP38 Cedar Court DS0000063735.V357086.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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