Inspection on 02/04/07 for Cedar Court

This inspection was carried out on 2nd April 2007.

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 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 Key Unannounced Inspection 2nd April 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.V335133.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.V335133.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 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.V335133.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 11th April 2006 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. Service users have access to a garden and patio area at the front of the building. Weekly fees range between £509 and £560 depending on the source of funding. Service users pay individually for newspapers, private chiropody and hairdressing. Basic toiletries are provided. The home does not have an email address or web site currently. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on the 2 APRIL 2007 and was unannounced. The inspector spoke with five residents and interviewed the manager and three members of staff. A tour of the home and kitchen was undertaken, and a range of documents was viewed. 12 completed comment cards from residents and their relatives, requesting feedback about the service, were also received. What the service does well: What has improved since the last inspection? What they could do better: All residents, whether privately of local authority funded, must receive a contract so that they are fully aware of the terms and conditions of their stay at the home. This should include the room to be occupied, the fees payable and by whom, additional services to be paid for over and above those included in the fees, and periods of notice. Activities at the home should be reviewed so that all residents, especially those who are partially sighted, can be included. This is vital to ensure that all residents have the opportunity for stimulation and social interaction All staff must receive regular supervision so that they their working practices can be discussed and their training needs identified. This is a requirement out standing from the previous inspection and failure to comply may result in legal action being taken against the home. Water temperatures around the home must not be allowed to get hotter than the recommended temperature of 43 degrees, otherwise residents are at risk Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 6 of scalding themselves. The kitchen’s fridges must be adequately defrosted to ensure that they function efficiently and the quality of the food that residents eat is not impaired. Finally, the registered person must inform the Commission for Social Care Inspection in writing of any incident that seriously affects the well being of a resident at 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. The summary of this inspection report can be made available in other formats on request. Cedar Court DS0000063735.V335133.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.V335133.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 adequate. Information is available about the home to help residents decide if it is where they want to live. However not all residents receive a contract and therefore do not know the terms and conditions of their stay there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a statement of purpose and service user guide that give good information about the home and the services it offers. These are available in each resident’s bedroom. 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. One resident commented ‘ Anand (the manager) visited me and told me what was what and then I visited the home that very Saturday’. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 9 Some residents, however, had not been issued with a written contract. Without this residents cannot know the terms and conditions of their stay at the home. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 10 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’ health needs are closely monitored and they have access to health professionals. 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. The care plans had been signed by those residents who were able, and had been reviewed monthly. Residents’ weights, blood pressure and pulse are monitored regularly, and their risk of pressures sores is also assessed. There were good guidelines for staff in one residents’ plan about his challenging behaviour. All residents spoken to confirmed that they see health professionals regularly. One commented ‘whenever I’m ill they get the doctor in straight away’. This resident reported that he recently saw the dietician and is now taking fortified foods in response to staff’s concern about his weight loss. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 11 The home’s medication storage areas and a sample of medication records was viewed and found to be in good order, however staff should record the date when they open a bottle of liquid medication. One resident looks after some of his medication himself, and his ability to do this had been properly assessed. Most residents stated that staff do respect their privacy but two reported as part of the home’s quality assurance questionnaires, that staff don’t always knock before they before enter their bedrooms. Kitchen staff refer to residents who require help with eating as ‘the feeders’. Use of this language is inappropriate. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 12 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, 13,15 Quality in this outcome area is adequate. Residents are able to keep in contact with family and friends, and some are able to undertake social activity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents reported that there were some activities. There is a musical entertainer who visits weekly and a monthly church service. Staff regularly play a range of games with residents. Despite this however, one relative commented ‘I feel my mother doesn’t receive enough stimulation in the form of activities so stays brooding in her room too much’. Two residents told the inspector they never joined in any of the activities as they were partially sighted, and therefore couldn’t participate. One commented ‘I can’t see the skittles so how can I play’ More should be done to find suitable activities for these residents. All residents reported that their families and friends visit, and that they are made to feel welcome at the home. Most residents reported that they enjoyed the food provided at the home, and there was plenty available. One resident stated that he would like an occasional shandy or wine with his meal, and another stated she would like Yorkshire pudding with a roast dinner. Lunch on the day of inspection consisted of quiche, chips and peas or roast beef and broccoli. A brief tour of the kitchen was undertaken and all foodstuffs were stored correctly, and fridge, freezer Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 13 and food temperatures were recorded daily. However one freezer was badly frosted up and should be defrosted to ensure it works efficiently. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 14 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. Residents have access to a complaints procedure and staff receiving training in adult protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although most residents spoken to were unaware of the home’s formal complaints procedure, they did state they would complain if unhappy about anything. The home has policies on abuse and whistle blowing (2007) that, although basic, were satisfactory. Records viewed showed that staff had attended formal training in adult protection and those interviewed showed a reasonable knowledge of the different types of abuse that can be suffered by a vulnerable adult, and of reporting procedures. There has been one recent allegation of abuse at the home. The manager acted quickly and suspended the member of staff concerned, and informed all relevant adult protection agencies. The matter is currently being investigated. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 15 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): 19,21,26 Quality in this outcome area is good. Residents live in a safe and wellmaintained home with aids and adaptations in place to meet their needs. 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. Residents spoken to stated they liked their bedrooms. One gentleman commented ‘the staff moved all the furniture around in the room, so now it completely suits me’. There are additional bathrooms and toilets. Aids and adaptations are provided throughout the home. The home was found to be clean and fresh throughout on the day of inspection, and there is a domestic staff team employed. The laundry facilities meet the needs of the service with one washing machine having a thermal disinfection cycle. Hand washing facilities are available throughout the home and staff are provided with protective aprons and gloves to minimise the risk of cross infection. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 16 One relative stated in a questionnaire that there was often an unpleasant smell around the home’s laundry and sluice. Both these areas were checked on the day of the inspection and were found to be free from any strong odours. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 17 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. Residents receive care from well-trained staff, who have been properly vetted before being employed at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are a minimum of four staff on duty between 8am and 2.30pm and three staff on duty between 2.30 pm and 9pm to support 25 residents. Two waking staff are on duty throughout the night. Scrutiny of the duty rota showed these levels to be maintained. Residents spoken to reported that staff were available when they needed them; and staff reported that the home was rarely short staffed. During the inspection it was noted that the residents’ call bell was responded to quickly when it was rung. The files of two recently employed staff members were checked and each contained two references and appropriate CRB/POVA checks. 75 of staff hold an NVQ level 2 or equivalent and training files viewed showed that staff had undertaken a range of training specific to the needs of older people. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 18 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): 31,32,33,36,38 Quality in this outcome area is adequate. The home is managed in a satisfactory way. Residents opinions are sought on the quality of the service they receive This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff interviewed reported the management team to be approachable and easy to talk to, although also stated that they sometimes lacked ‘follow through’ when acting upon their suggestions. There are regular staff meetings that were described as ‘useful’ and where staff felt they could raise issues concerning them. However, one member of staff reported that she had never received any formal supervision, despite having worked at the home for over 18 months. Another reported that she had only received her first ever supervision the previous week. Supervision records checked confirmed this. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 19 The home does seek feedback from its residents on the quality of the service they receive. The inspector was shown completed questionnaires that had been sent to residents and their visitors concerning the quality of staff, staffing levels, cleanliness meals and activities. Most respondents rated the home positively. 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, gas safety and hoist servicing) and were found to be in good order. A report by the environmental health officer (8/09/06) indicated four minor concerns with the home’s kitchen. It was of concern to note that records frequently showed that water from the home’s taps exceeded the recommended temperature of 43 degrees, in some cases by as much as 25 degrees. Little had been done to address this problem and the maintenance officer was unaware of the recommended temperature, or how to rectify the problem. Unless a safe water temperature is maintained, residents are at risk of scolding themselves. The manager did inform the CSCI verbally of a serious adult protection incident at the home, however this was not then followed up in writing as required by the regulations. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 20 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 1 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 x N/A 2 x 2 Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 21 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 OP2 Regulation 5(b)(c) Requirement Each resident must be issued with a contract that clearly states the terms and conditions of their stay at the home. The date on which a bottle containing liquid medication is opened must be recorded. All staff must receive regular supervision, so that their working practices are reviewed . Timescale for action 01/05/07 2. 3. OP9 OP36 13 (2) 18(2) 10/04/07 01/05/07 4. OP38 37 5 OP38 13 (4) Timescale of 30/01/07 not met. The CSCI must be notified in 03/04/07 writing of any incident that seriously affects the well being of any resident. Water temperatures around the 03/04/07 home must be maintained at 43 degrees, otherwise residents are at risk of being scolded Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 22 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 OP12 Good Practice Recommendations Suitable activities for those residents with sight and hearing impairments should be provided. Cedar Court DS0000063735.V335133.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office 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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