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Inspection on 20/02/06 for Cedar Falls Nursing Home

Also see our care home review for Cedar Falls Nursing Home for more information

This inspection was carried out on 20th February 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Cedar Falls provides a very clean and comfortable, homely environment which is maintained to a high standard both in and outside the home. The home is run by a registered and experienced manager and a stable staff group. Relatives comments included; `It`s like a first class hotel, when my time comes I`ll definitely move in here`, `there is always lovely food every day`, and `I`m very happy how they look after my mum`. Nutritious food is provided for residents who are offered plenty of choice, one resident said, `I`m trying to finish my meal because I enjoyed it so much`. Staff spoken to were happy in their work, one saying,` I enjoy my job and like getting to know new residents and meeting new people`.

What has improved since the last inspection?

The training plan has been developed and supported by a mentoring scheme by the in house trainer. The home is well maintained with an ongoing programme of routine improvements.

What the care home could do better:

The organisation, the manager and staff in the home are striving towards meeting and exceeding the National Minimum Standards. One requirement was left at this inspection, requiring staff to ensure that they record that medication is given and if not, why not.

CARE HOMES FOR OLDER PEOPLE Cedar Falls Nursing Home Little London Road Spalding Lincs PE11 2UA Lead Inspector Jean Cope Unannounced Inspection 20th February 2006 09:30 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 Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cedar Falls Nursing Home Address Little London Road Spalding Lincs PE11 2UA 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) 01775 713233 01775 766062 Tanglewood (Lincolnshire) Limited Mrs S Woods Care Home 93 Category(ies) of Old age, not falling within any other category registration, with number (93), Physical disability (12) of places Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Physical Disability (PD) Registration Category will apply only to the bungalows. Bungalows accommodating service users with a physical disability must be single occupancy. Bungalows accommodating service users with a physical disability must have environmental adaptations and equipment provided, according to individual assessed needs. 1st November 2005 Date of last inspection Brief Description of the Service: Cedar Falls Care Home is situated in the market town of Spalding, which provides a wide range of amenities including shops, pubs etc. It is part of the Tanglewood Healthcare Group, which operates five care homes in Lincolnshire. The home comprises a two storey main building, with a lift to the first floor, and 12 bungalows situated in the grounds. The home is registered for 69 older people in the main building, and 24 in the bungalows, although the bungalows are single occupancy at present. All bedrooms are single occupancy with the majority having en-suite facilities. The home is decorated and furnished to a high standard, and has 9 quiet sitting areas. The extensive gardens are laid to lawns and flower- beds, with outdoor seating provided. The bungalows were also registered to accommodate up to 12 people with physical disabilities earlier in the year. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place with the assistance of the manager, Shirley Woods. One inspector undertook the inspection over a five and a half hour period. The inspector toured the building, spoke with two members of the care team and the manager, three visiting relatives and several residents living in the care home. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care that they receive through the checking of their records, discussion with them, the care staff and observation of care practices. What the service does well: What has improved since the last inspection? The training plan has been developed and supported by a mentoring scheme by the in house trainer. The home is well maintained with an ongoing programme of routine improvements. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 the following standard(s): 3 Residents moving into the home can be sure that the manager is sure that the service offered in the home can meet their needs. EVIDENCE: The manager assesses all new residents and keeps written records of their needs. This can be undertaken in a hospital setting, their own homes or in another care home. The information is gathered from the resident, their relatives or friends and any health or social care professionals involved in their care. The home does not provide a service for intermediate care. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 the following standard(s): 9 There are systems in place to ensure that medications are kept and disposed of appropriately, however, more care must be taken to ensure that staff sign to say that residents have received their medications. EVIDENCE: If a resident wishes to look after and take their own medication, they can do so. A risk assessment, often involving the resident’s family is undertaken to ensure that appropriate support is offered where necessary. Qualified nurses give medications for residents who require nursing care directly from the original containers. Those residents receiving personal care are given medications by senior staff who have received in house training on the management of medications. These medications come to the home when they have been pre-packed by the home’s pharmacist into monitored dosage systems. In addition to the in house training, senior staff have enrolled on a distance learning course on the safe handling of medications. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 10 The home has a system for ordering, storing and disposing of medications, however, some medication administration sheets had not been signed to indicate whether the residents had received their medications or not. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 the following standard(s): 12 and 15 The provision of activities is taken seriously. Residents are offered plenty of choice and provided with a nutritious diet. EVIDENCE: An activity co-ordinator is employed by the home to work full-time. A monthly newsletter is published which advertises forthcoming activities. These are also advertised on notice boards, in the reception area and other communal areas. Activities provided in the home include slide shows, clothing shops, knitting sessions, coffee mornings and trips out. Some residents had enjoyed a trip out to an evening show in the local town. The activity co-ordinator also brings in any shopping that residents require, and in better weather, takes residents out to shop. There are regular visits from the hairdresser and chiropodist. Church services are held on a weekly basis by rotating church personnel. The home offers several choices of breakfast menu, two choices at midday and at tea time. The menu is rotated on a four weekly basis. A record is kept of residents’ individual dietary preferences and specialist diets. Specialist equipment such as plate guards and adapted cutlery are available so that residents are able to continue to feed themselves for as long as possible. Staff were seen feeding residents in the dining room and were engaging in conversation with them and speaking kindly to them. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 12 Induction training includes aspects of dietary needs, such as how to assist residents who required specialist diets and thickened fluids. Staff involve the Speech and Language Therapist when necessary and said that she was very supportive. There was plenty of food in the kitchen, with fresh vegetables delivered twice a week. Residents are also able to have a salad or fresh fruit if they wish. The group chef for the organisation gave a good account of providing a nutritious diet for residents, which took into account health eating. The Environmental Health Officer recently visited the home and left no recommendations. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not inspected. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 23 The home provides a safe, homely and comfortable environment for residents who are able to bring their personal belongings with them if they wish. EVIDENCE: The home was clean and was maintained to a very high standard. There are plenty of communal and quiet sitting areas where residents can meet together or with their relatives, which are bright and airy. Two smoking lounges are also provided, one on each floor. There are eight bathrooms in the home; two of the bathrooms provide assisted baths, with a third being accessible to use a hoist in. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 There is a stable, well trained staff group who provide consistency of care for residents. EVIDENCE: The manager ensures that the rotas she devises take into consideration the skill mix of staff on duty. Attempts are made to provide a fixed rota for staff, but changes due to holidays and sickness sometimes have to be made. Induction is provided over a two day period by the home’s in-house trainer, who is also a qualified teacher, and an instructor in moving and handling techniques. Eight hours of her time each week is committed to staff training and she supports new members of staff through a mentoring scheme. Her training timetable is flexible to be able to incorporate evening and night staff members of the team. Training, such as moving and handling, health and safety and fire training is repeated for staff on an annual basis. Members of staff spoken with had been recruited safely. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 16 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, 35 and 38 The health and welfare of residents and staff is taken seriously. EVIDENCE: The manager of the home is registered with the Commission and has successfully completed her Registered Manager’s Award. There are secure arrangements for keeping residents’ valuables in the home and any monetary transactions are recorded, signed for and receipts are retained. The fire alarm was sounded accidentally on the morning of the inspection. The manager used this opportunity to ensure that fire drill procedures were carried out efficiently. Electrical equipment and fire extinguishers had been serviced appropriately. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 17 Some beds have bedsides attached to them to reduce the risk of residents falling out of bed. The manager has purchased bed wedges which are placed between the mattress and the bedsides to make them safer and reduce the risk of residents becoming trapped in them. Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 18 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 X X 3 X X X STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 19 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 OP9 Regulation 13(2) Requirement Staff must sign medication administration sheets to indicate that residents have received their medication, and if not, to use the coding system explaining why not. Timescale for action 20/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cedar Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Falls Nursing Home DS0000002636.V284847.R01.S.doc Version 5.1 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. 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