Inspection on 14/05/09 for Cedar House

This inspection was carried out on 14th May 2009.

CQC found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cedar House 23/02/10

Cedar House 27/11/09

Cedar House 29/05/08

Cedar House 11/01/07

Cedar House 09/05/06

Cedar House 14/09/05

Cedar House 24/05/05

Cedar House 04/11/04

Cedar House 06/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Key inspection report CARE HOME ADULTS 18-65 Cedar House Cedar House 47 Smethurst Street Middleton Manchester M24 2BA Lead Inspector Bernard Tracey Unannounced Inspection 14th May 2009 08:10 Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar House Address Cedar House 47 Smethurst Street Middleton Manchester M24 2BA 0161 6553553 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) Mrs Ann Merabi Ms Valerie Hewitt Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 16 Date of last inspection 29th May 2008 Brief Description of the Service: Cedar House is a care home providing personal care for 16 adults, who have been diagnosed with a mental disorder. Three places are registered for residents over the age of 65 years. The home provides 16 single bedrooms, a lounge, conservatory, dining room, communal toilets and bathing facilities. Cedar House is located at the end of a residential street, approximately two miles from the town centre of Middleton. A number of small local shops, post office and pubs are near by. The home has a car park for residents and visitors. A grassed area is provided to the rear of the house and small garden areas to the front. The most recent Commission for Social Care Inspection (CSCI) report is available in the office. The home makes charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody Hairdressing Magazines and Newspapers Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 5 toiletries, activities, clothing and transport. Fees charged by the home in May 2009 are as follows: £328.00 to £380.00p per week. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 stars. This means the people who use this service experience Poor quality outcomes. The last key inspection on this service was completed on the 29th May 2008. We also undertook a random visit to the service on the 30th October 2009 to follow up the progress the manager was making with the requirements made at the inspection in May. We (the Care Quality Commission) undertook this key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. This visit was just one part of the inspection. We also looked at other information we had about the home. The manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, these comments have been included in the report. We sent our questionnaires out to people who live in the home, and staff in order to find out their views. Other information we had received since our last major inspection at the home was also reviewed. We spent eleven hours at the home over two days. During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We have received three complaints about the service from Social Services, which are still under investigation. The contents were discussed with the manager. An Expert by Experience was also used at this inspection. This is a person who, because of their shared vision of using services and ways of communicating, visit a service with us to help us get a picture of what it is like to live in and use a service. The expert stayed with us for part of the first day and spoke to the people living here to get their views about what it was like. We have included some of the things residents told the expert in the body of this report. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: Records of medicines received into the home, given to people and disposed of must be clear, accurate and complete so that all medicines can be fully accounted for. We told them that medicines must be given to people as prescribed because receiving medicines at the wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing. The home’s social activities programme needs to include activities that meet individual needs so they would have something to keep them stimulated and occupied during the day. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 8 We found there was a serious failure by the manager to adequately carry out the necessary pre employment checks of new staff beginning work in the home. Staff must not be allowed to start work before all the right checks have been completed and the manager is sure they are safe to work with vulnerable people. The registered provider must ensure that she fulfils her responsibility as a an employer, in that, staff working at the home are provided with adequate statements of wages earned and deductions taken from their wages. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their needs assessed prior to admission thereby having reassurance that the staff team can meet their needs. EVIDENCE: We looked at the files for 3 people. Assessments were in place for all 3. The manager told us that new residents are admitted following an assessment undertaken by a member of staff, usually by the registered manager. When the home is contacted the initial reasons for the referral are established and a pre admission assessment is then arranged. Prospective residents are invited to view the facilities and meet both residents and staff before making a decision to move into the home on a trial basis. Adequate time and opportunity to make a decision regarding the placement is afforded the individual and this opportunity enables them to discuss how the home can meet the person’s individual requirements. Clear and detailed information concerning trial visits and the length of the ‘settling in’ period is included in the Statement of Purpose and is confirmed in the information we were given in the Annual Quality Assurance Audit (AQAA). Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 11 All of the residents confirmed this to be the case in their experience, and this was also confirmed in discussion with a fairly new resident. One service user described coming to the home as “the best move I’ve ever made”. Where possible, the resident’s representative visits the home to assess the facilities and have the opportunity to meet with the staff to discuss the way their needs of their relatives’ will be met. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by the staff to make decisions and choices in their lives. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 13 EVIDENCE: Any potential restrictions on choice, freedom, services or facilities that become part of the resident’s daily life, had been discussed and agreed with the resident during assessment and recorded in the care plan. One resident spoken with confirmed that she had been given “good information about how the home is run before coming here.” The care plans set out how the current and anticipated needs are to be met. There is evidence that the resident, together with family, friends or advocate, is involved in the drawing up of the plan. Wherever possible, residents are encouraged to manage their own finances, but where the home does manage the finances for individuals, records are maintained and a recognised tool for audit is incorporated in the monthly review of finance. The Expert By Experience who accompanied us on for part of this inspection spoke to residents who felt that that the home could take a more encouraging and pro-active approach to providing opportunities for service users to pursue their interests and try out new things, and where possible to build links with the community, with support as appropriate. In a group discussion with three residents, all agreed that staff cared very well for the residents and they felt they were consulted in regard to how the home was run. Observations made during the inspection indicated that staff had developed a good rapport with residents and there was a calm and relaxed atmosphere throughout the home. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12,13,15,16 &17 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has made progress in implementing a varied individual activities programme, but further development needs to take place so that residents feel they are supported in pursuing personal interests and hobbies. EVIDENCE: Staff members were seen to support residents in the activities of daily living, which in the case of some individuals is presently fully meeting their needs, but arrangements must be put in place to enable residents to take up opportunities in relation to education and training activities. A programme of meaningful activities, agreed with the individual resident, implemented and supported by the care staff is a recommendation of this report. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 15 There has been considerable progress in addressing the general routines of daily living, through a structured programme, but further development of individual activities and educational opportunities needs to be addressed. Care staff support service users in accessing local facilities for leisure and shopping, according to the assessed needs of the individual. Staff support residents in ensuring access to public transport as well as the organised trips to places of interest and enjoyment, suggested by the residents. Residents are encouraged to participate in the political process through the opportunity to vote in local and general elections. Members of the care staff maintain residents’ right to privacy, dignity and respect. Staff members were observed to obtain permission prior to entering the individual’s personal accommodation and used the service users preferred form of address. Freedom of movement for an individual is identified within the care plan and agreed with the individual following the assessment of risk. Residents told us that they were actively supported to keep in touch with their families and friends. One resident said he preferred not to maintain contact with his family and the staff had respected his wishes. Residents informed us that the food is always served in adequate portions. Special diets are catered for; one resident a Muslim, said his dietary requirements were respected and he was able to go with a staff member to buy his food from a local provider. A discussion with the cook confirmed that she obtained halal meat but also purchased ready -made meals from a local supplier of halal foods. The cook has recently booked a place for further training in conjunction with the Environmental Health department. Staff helped residents who required assistance to eat and drink, in a sensitive and dignified way. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of residents are met, with the exception of a shortfall in the administration of medication, which potentially compromises the well being of residents. EVIDENCE: Relationships between staff and residents seemed warm, friendly, caring and respectful. Staff treated residents with courtesy and supported them to make choices. Residents felt staff listened to them and treated them well. One resident said, “living here is very good”, another that “it is a good home, I like it”. Individual care plans are in place for each resident. The three care plans examined were well written, but with little evidence of resident involvement in formulation of the plan and the review of care. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 17 Staff are on hand to provide personal care and support when needed and as agreed with the resident. This is dependent on individual needs. In the main, residents are prompted in maintaining their own personal care and appearance. Residents are registered with a local medical practice. For all other healthcare needs, residents are supported in accessing relevant community facilities, such as community psychiatric nurses, dentists and opticians. Where necessary, referrals would be made to specialist medical services. Where a resident would require support, a member of staff would escort them to any outside appointments. Prompt and appropriate specialist healthcare advice had been sought when residents had become unwell, particularly for those with more complex health problems. Care staff provide residents with information regarding general healthcare and specific issues relating to their lifestyles and needs. None of the current residents manage their own medicines, although a policy is in place should they wish to and have been suitably assessed. Medication is given out at intervals by staff, and residents spoken with knew the times they took there medication, in particular when they needed to come back to the home if they were out. The medication sheets showed a small number of gaps indicating that residents had not received their medication. The manager said that on one occasion she was sure it was an oversight, but the gaps tended to be when the night staff were administering medication. This needs to be addressed by the manager. It was also noted that the time of administration of a medicine for one person had been changed but since this occurred the medicine had not been administered at the new time. All hand written entries should be signed by two staff members to avoid any mistakes being made. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service know who to complain to and feel that they will be listened to. EVIDENCE: Residents spoken with all said they knew how to make a complaint and whom they would need to speak to. A log is kept of complaints raised, which shows how the manager has investigated the complaint and what its outcome was. The manager told us in the information we asked her for that she usually tries to resolve complaints in 24 hours. A clear, detailed formal complaints procedure, displayed in the home and provided to each resident, supported the home’s open culture, where residents were encouraged to express their views, either informally or in regular residents’ meetings. Residents felt staff listened to them and were clear who to talk to if they were unhappy or had any concerns. One resident said, “If I had anything to complain about but I would speak to one of the staff.” No resident expressed any concerns about their safety in the home or how they were being cared for. Staff understood the importance of listening to residents’ concerns and how to respond to any issues that were raised. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 19 The protection of the residents is being compromised by the failure of the Registered Manager to carry out pre employment checks on new starters. The Social Services Department has told us of three Safeguarding alerts. These are still being investigated by the Social Workers. Evidence was seen that training in the Safeguarding of Adults had been booked for all of the staff in June 2009. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of investment in the home does not provide a comfortable, safe environment for residents to live in. EVIDENCE: During our visit we discussed with the manager and owner representative the progress they believed had made since our last inspection. They told us that they had decorated and where necessary provided new carpets, fittings and furniture to the majority of the bedrooms. Three bedrooms, presently vacant, require refurbishment. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 21 The requirements made to ensure that the lounge and conservatory decoration was finished have been accomplished to a satisfactory standard. New carpets and redecoration of the stairwells have taken place. In the dining room the UPVC window frames were deeply stained (with nicotine), as was the ceiling of this area. The window blinds were broken. These issues still have to be addressed satisfactorily. During our visit we asked that flooring be provided to the dining room, as there was only bare concrete when we arrived. This was mainly completed during our visit though the edging had still to be fixed. We asked that the tiles on kitchen walls were cleaned and re grouted and that the filler be replaced behind the sinks and work surfaces. The cupboards need cleaning both inside and out and the ceiling needed a coat of paint. Apart from and area of grouting and painting the ceiling the work was carried out during the period of our visit. The laundry room required new plaster behind the sink and the whole room needed cleaning and re painting. Satisfactory arrangements for a designated smoking area must be made as presently the dining room is providing this facility. The visitor who accompanied us on our visit to the home commented: “The entrance to the home was through a conservatory entrance, this is being used as a dining room and smoking room. I would not personally be keen to eat in a room, which is also a smoking room, even though I am a smoker myself. It also does not feel very welcoming to visitors to have to walk through a smoking area to get into the home. If I lived at the home, I would not like to eat in an area where people were coming in and out. I thought that the conservatory area could be usefully extended around the side of the building to create 3 separate areas rather than the existing 2; 1 for the entrance, 1 for smoking and 1 for dining.” Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 & 35 People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements in place do not promote or protect residents from unsuitable staff being employed EVIDENCE: Random inspection of the staff files showed that not all the required recruitment checks had been made prior to employment. None of the three care assistants recently employed by the manager had all of the information required under Schedule 2 of the Care Home Regulation 2001. A further seven staff employed by the manager did not have a staff file and none of the information previously stated had been sought. In order to protect residents, staff should not be employed before all relevant checks have been made, including two references, and CRB. The manager must ensure that all staff personnel files are audited to ensure they contain all of the relevant checks, prior to individuals commencing work in the home. The manager must also ensure that staff currently working in the home have all of the necessary documentation as described in Schedule 2. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 23 Some staff training has been scheduled for June that includes First Aid Food Hygiene and Safeguarding Adults. These courses are being provided by an outside Agency but the manager may wish to consider the Rochdale MBC courses that are available free of charge and cover all of the mandatory training required in care homes. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 & 43 People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lack of organisation and poor management of the home potentially compromises the quality of the care delivered to the residents. EVIDENCE: The manager runs the home in an open and inclusive manner, which supports the interests of residents, however, the poor financial management and investment in the business by the provider is potentially compromising the health and welfare of residents and placing people at risk. The manager has day-to-day control and fulfils her duties well in respect of providing a good service to residents but by poor recruitment practices the manager does not Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 25 promote and protect residents from unsuitable staff being employed and is putting residents at risk. The manager has not recommenced the Registered Manager’s Award to complete the remaining units that are outstanding. We were assured that she would do so when the training provider was paid for the outstanding invoices. We checked with the trainer and they confirmed that no invoices are outstanding and therefore it is expected that the manager now finish her management training. Residents’ meetings take place, which allows the residents to let the manager know what they think about the service. A selection of safety certificates were examined during our visit and all were found to be current. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 2 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 1 X 2 X X 1 X Version 5.2 Page 27 Cedar House DS0000041209.V375423.R01.S.doc No 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. Standard YA34 Regulation Schedule 2 (3) Regulation 19(4) (c) Requirement Staff employed at the home must be suitably checked (POVA 1st, CRB, references) before they commence work at the home to ensure that the manager is confident that residents are not put at risk. Medication must be given as prescribed or a clear reason for the non-administration clearly documented in the MAR so that the residents and the manager can be confident medication is being given as prescribed. Timescale for action 30/07/09 2. YA20 13 30/07/09 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 YA20 Good Practice Recommendations All handwritten medicines records should be an exact copy of the pharmacist’s dispensing label, which should be double-checked and countersigned to help prevent mistakes. The manager should complete the Registered Manager’s DS0000041209.V375423.R01.S.doc Version 5.2 Page 28 2. YA37 Cedar House Award so that the service can benefit from a well-trained manager. 3. YA43 Staff should be issued with a personalised ‘wage slip’ summarising their pay and what deductions have been made. A P60 should be issued to all staff at the end of each tax year. The premises must be kept in a good state of repair at all times, so that residents live in a safe and comfortable environment. To give people who use the service interest and stimulation, they should be asked about the activities they would like to take part in and be provided with opportunities to partake in these, both inside and outside the home. A quality assurance and monitoring system should be set up so that the owner and manager can measure outcomes for the people living at the home. 50 of the care staff group should be trained to NVQ level 2 standard. 4 5. YA24 YA14 6. 7. YA39 YA32 Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 29 Care Quality Commission Care Quality Commission Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Cedar House DS0000041209.V375423.R01.S.doc Version 5.2 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!