Inspection on 13/06/05 for Cedar Grange

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 Grange 18/03/09

Cedar Grange 06/02/07

Cedar Grange 17/01/06

Cedar Grange 15/10/04

Cedar Grange 02/07/04

Similar services:

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Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Cedar Grange Whitehill Road Holmfield Halifax HX2 9EU Lead Inspector Lynda Jones Unannounced 13 June 2005 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 Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cedar Grange Address Whitehill Road Holmfield Halifax HX2 9EU 01422 246509 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) Mr Stewart Crabtree and Mrs Susan Crabtree CRH 15 Category(ies) of 15 x Old age (over 65 years) registration, with number of places Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/10/04 Brief Description of the Service: Cedar Grange is a care home providing personal care for 15 older people.The home is located in the Holmfield area of Halifax and can be reached by bus from the town centre. The nearest shops are a short walk away. Accommodation is arranged on two floors. There are eleven single and two double bedrooms. There is a passenger lift to the first floor. There are steps and a ramp to some rooms on the first floor therefore the occupants of these rooms need to be fully ambulant. Three of the bedrooms have en suite toilets. There are separate toilets within reach of all areas of the house. The home has two bathrooms but as only one of these has assisted bathing facilities it tends to be the only one used.The house is surrounded by a large lawned garden, with car parking to the front. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors over a six hour period. Seven residents and two relatives were spoken to. Four members of staff, the area manager and one of the owners were also spoken to. The area manager and owner were present for “feedback” at the end of the inspection. A tour of the premises took place and residents records and staff records were examined. What the service does well: What has improved since the last inspection? The care plans continue to develop at the home. The records are more detailed, they show that the staff are observant and are recording the care that they deliver in good detail. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 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 Grange J52J01_s988_cedar grange_v232535_130605.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 Grange J52J01_s988_cedar grange_v232535_130605.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) Not inspected. EVIDENCE: Cedar Grange J52J01_s988_cedar grange_v232535_130605.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) 7,8,10. The staff communicate with each other well in order to ensure that residents care needs are met. Staff observe what is set out in the care plan and record clear information about the care they provide. EVIDENCE: Three care plans were examined. In each case assessments had been carried out to make sure the home could meet the needs of each person, assessments conducted on behalf of the local authority were also available. Two care plans were detailed and provided some good information about personal preferences and about how people like to spend their time. One plan, in respect of a resident that was admitted on 4/6/05 was incomplete. Inspectors felt that this care plan should have contained more information. The daily records have developed quite well, the staff record their observations and details of the care they have delivered each day. There is evidence of careful monitoring when concerns have been noted about health care issues. There is also evidence that the staff seek advice from other health care workers if they need it and the records show that residents have access to a range of health care services. Details are recorded of the outcomes of all appointments. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 10 A visiting relative said the staff kept her well informed about care issues. Residents said they were well looked after. Cedar Grange J52J01_s988_cedar grange_v232535_130605.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) 13,14 There is a calm, friendly atmosphere at the home. Residents are supported to follow the daily routine that suits them best. EVIDENCE: The care plan contains a detailed checklist about each persons living skills, what they like to do, and how they need to be assisted by staff. Information is available about personal preferences and interests, when people like to get up and go to bed and what people like to do each day. For example, one person likes to go to the shop for a daily paper and staff accompany him so that he can do this. There is evidence in the records to show that people have been out for a walk in the garden with staff and that the staff make time to sit and talk to people. On the day of the inspection a game of dominoes was taking place. Other people were watching TV or reading. Some people choose to spend most of their time in their own rooms and the staff respect this. Cedar Grange J52J01_s988_cedar grange_v232535_130605.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) 18 Residents are not at immediate risk but further training on adult protection issues will ensure that residents are properly protected. EVIDENCE: The staff have an understanding of the need to make sure that the people living at the home are properly cared for and protected, but they have not been offered any formal training on adult protection issues. Following the last inspection in October 2004 the home owners were required to make arrangements for staff to be provided with adult protection training. This has not been carried out. The home has the dates of training that is being offered in autumn by the Adult Protection Coordinator for Calderdale and arrangements must to be made for people to attend. Cedar Grange J52J01_s988_cedar grange_v232535_130605.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) 19,20,21,22,23,24,25,26. There is no evidence of any plans to decorate and refurbish the home to ensure that it is well maintained and comfortable throughout. There are not enough bathrooms with assisted facilities to meet the needs of residents. EVIDENCE: The homes domestic works hard to keep the home clean and tidy. However, the owners need to question whether domestic cover on only three days a week is sufficient. On the other days, valuable care staff time is being used to carry our domestic tasks. (See staffing section of this report). The decoration in some parts of the home needs attention. In some rooms the paint work is chipped and wallpaper is coming away from the wall, some ceilings and plastering need attention. It would be useful if someone carried out an audit of all parts of the house to check which areas need attention. In addition, residents should be asked whether the lighting levels throughout the home are suitable for them. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 14 Splined key locks need to be removed from doors. All toilet and bathroom locks should be checked to make sure they are suitable and in working order. There is only one useable bathroom in the house. The second bathroom does not have an assisted bath and cannot be used by anyone living there. This bathroom is unpleasant and has not been decorated for many years. Requirements have been made in previous reports for the owners to provide details showing how this situation will be addressed but they have not replied to CSCI. One of the owners has said that this will be remedied when the home is extended, but no further details have been provided. In the meantime, this bathroom should be made fit for use. The National Minimum Standards state that there should be at least one assisted bath for eight residents. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 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 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) 27,29,30. The procedures for recruiting staff are not thorough, leaving residents at risk of being cared for by unsuitable people. EVIDENCE: The staff files of all staff working in the home were checked. There were no CRB checks for three members of staff, inspectors were told these had been applied for but no response had been received. It was not possible to verify this from the information on the files. A new manager had been appointed and started work on the day of this inspection. No CRB had been obtained in respect of this individual and there was no evidence that a POVA first check had been obtained. This is unacceptable. There was no evidence that a standard CRB check had been obtained in respect of the person carrying out domestic duties. The number of staffing hours allocated to domestic/ catering duties are below those agreed with the previous regulatory authority. Valuable care staff hours are being used to cover some of these duties. The owners should review this situation. One person who was recruited from overseas had been working in the home until recently. All documentation about this person related to her being given a permit to work in a home in another part of the country. There was nothing in Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 16 place to show how she had been recruited and how long she had worked at Cedar Grange. There was no evidence of a contract of employment for this person. The records for two other staff who are currently living on the premises do not indicate that they are working at Cedar Grange. Documents in their staff files show the names of two other homes owned by the proprietor of Cedar Grange. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 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 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) 38 Progress has been made to improve fire safety in the home. Infection control procedures are not always being followed. EVIDENCE: There are still some radiators that need radiator guards fitting. The person with responsibility for maintenance in the home said that the work recommended in the Fire Safety Officers report has now been completed. Arrangements will be made to visit the home with the Fire Safety Officer to confirm this. There are concerns about the lack of provision of separate cooking facilities for staff who are living on the premises. As they are using the main kitchen in the house, the owner must ensure that there is no risk of cross contamination and that food hygiene standards are strictly observed. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 18 Toilets need to be checked to make sure that liquid soap and paper towels are available for handwashing. This was not the case on the day of the inspection. Water temperatures need to be monitored carefully. Inspectors noted that the temperatures in parts of the house were in excess of 43 degrees C. The home has been without a registered manager since 2001, although it has been ably managed recently by an “acting manager” who is now the deputy. A new manager has recently been recruited and she started work at the home on the day of this inspection. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 1 3 1 1 3 3 1 1 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 x x x x x x x 1 Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 20 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. 3. Standard 18 19 20 Regulation 13 23 23 Requirement Arrangements must be made to provide adult protection training for all staff All parts of the home must be kept reasonably decorated. Lighting in communal areas and bedrooms must be checked to ensure that it is sufficiently bright for all residents. Bathroom and toilets must be fitted with suitable working locks. A second bathing facility must be provided. Timescale for action 31 July 2005 30 September 2005 17 July 2005 17 July 2005 4. 5. 6. 21 21 29 13 23 19 7. 8. 38 38 13 23 30 September 2005 All staff must have the necessary With effect checks completed before they from 13 start work at the home. There June 2005 must be two written references, one of which must be from the last employer. CRB checks must be obtained and the Protection of Vulnerable Adult list must be checked. To ensure that residents are not 31 July put at risk, all radiators must be 2005 guarded The registered person must With effect ensure that hygiene and safety from 13 measures are strictly adhered to June 2005 J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 21 Cedar Grange in the kitchen. Consultation should take place with Local Authority Environmental Services officers on this matter. 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 26 Good Practice Recommendations The arrangements for domestic cover should be reviewed. Cedar Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 22 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Grange J52J01_s988_cedar grange_v232535_130605.doc Version 1.30 Page 23 - 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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