Inspection on 20/07/05 for Cedar House

This inspection was carried out on 20th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cedar House 17/04/07

Cedar House 05/12/05

Cedar House 08/12/04

Cedar House 22/06/04

Cedar House 18/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Cedar House 249 Station Road Rothley Leicestershire LE7 7LD Lead Inspector Keith Williamson Unannounced 20th July 2005 at 9.00am 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 House Version 1.10 Page 3 SERVICE INFORMATION Name of service Cedar House Address 249 Station Road Rothley Leicestershire LE7 7LD 0116 2303066 0116 2375520 None Mr John Lowe 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) Vacant Care Home 20 Category(ies) of OP Old Age 20 registration, with number of places Cedar House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 08/12/2004 Brief Description of the Service: Cedar House is situated in a rural setting, on the border of Rothely, and is a short walk from the Great Central Railway station. The home is a tastefully extended and converted house, and is registered to accommodate a maximum of 20 older persons. All of the bedrooms provide single “en-suite” accommodation; seven of which include bathing facilities as. The home has one “double” bedroom, but this is presently reserved for couples, and also provides an “en-suite” facility. There are a number of lounges, and 2 dining rooms, in various areas of the ground floor of the home. There is a large secluded and private rear garden with appropriate seating and cover for service users use, and large car park to the front of the home. There are no shops in the immidiate vicinity, and a bus service is available to leicester. Cedar House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day, commenced at 8.45 am and was completed in four hours by one inspector. An opportunity was taken to view the care plans and other records in detail. Three residents were spoken with on this visit; a sample of the comments made from those residents and the eighteen comment cards returned to the inspector prior to the inspection are enclosed in this report. Two staff were also interviewed. Two comment cards arrived later than the majority and the issues highlighted shall be explored on the next inspection of this service later in 2005/06. The registered person and acting manager assisted with the inspection, spending time with the inspector discussing the management of the home. This is the first inspection visit to this home with the current acting manager, and overall the inspector recognised the home, continues to function very well and provides a homely and secure environment for residents’ and staff. What the service does well: The registered person provides a homely and comfortable atmosphere for the residents. Clear guidance is given to staff members regarding keeping residents’ care records up to date. Residents spoken with indicated that they feel safe residing in the home and that they are well taken care of. A tour of the premises took place, which indicated that the premises are maintained to a very high standard creating a homely environment for residents. The registered providers are committed to raising and maintaining good standards of care for this service based on the outcome of the inspection. Residents and staff spoke positively about the approach to managing the home indicating that it creates an open and inclusive atmosphere. There is an excellent relationship between the resident and staff group. Cedar House Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar House Version 1.10 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 House Version 1.10 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) 1, 2, 3 & 6. The admission process is good. There is detailed information about the type of services provided in the home, which is given to prospective residents and their relatives. The assessment process is detailed and effective. The entire staff team are very committed to delivering good quality care. EVIDENCE: The Statement of Purpose and Service User Guide were viewed; residents could not confirm to the Inspector that these documents were supplied prior to moving into the home. Resident assessments are completed prior to their admission, and care plans compiled from the information supplied. Contracts between the resident and the home are in place, and were placed appropriately in files. The home does not provide accommodation under Standard 6. Cedar House Version 1.10 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, 9, 10 & 11. Residents’ care plans are well written but require to have more detail to supply staff with clear instructions about the tasks they must carry out to meet residents’ care needs, which includes residents’ having access to health care provisions. The medication procedure works does and now fully protects residents in the home. EVIDENCE: On the inspection of two residents’ care plans these indicated that all aspects of personal and health care needs are being met, however the detail in the plans could be increased and the individual resident abilities recognised. Both of the residents passed comment on knowledge of their care plan. Residents and their relatives commented on the care in the home, a sample stating, “my mother in law is very well cared for”, “I only have praise for all the staff, who do such wonderful work in caring for all their residents” and I commend the staff for their level of care and interest. Cedar House Version 1.10 Page 10 Evidence is in place to confirm contact with community health professionals. The daily care records were inspected and these appear to be filled in appropriately. The medication system was seen to be administered appropriately, and there is an overall improvement from the last inspection. Observations made indicated that residents’ privacy is maintained for example knocking on residents’ bedroom doors before entering their rooms, which was confirmed by verbal statements made by a resident. On viewing individual files, no mention of the residents final wishes were noted in the plans of care, it is recommended this be amended and information be entered accordingly for new residents entering the service. Cedar House Version 1.10 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) 12, 13, 14 & 15. Giving residents’ choices over their daily lifestyles and providing a wellbalanced meal is managed very well for residents residing in the home. EVIDENCE: A varied programme of activities is offered to residents, a sample programme being viewed by the inspector, a resident commented that she was “taken out regularly” intimating walks in the grounds and trips from the home. Personal choice is offered throughout the home, and evidence is in place to suggest the homes practices flexible promoting resident’s individuality and independence. Comment passed by residents indicated that the home was very accommodating to visitors, the residents’ knowing of no restrictions placed on visiting. Comments by a residents relative stated, “residents should be encouraged and helped to take more exercise” The menu system offers a well-balanced dietary choice. Comments from the residents indicated that the breakfast (when served on trays in the bedroom) “very well liked” and “I like my breakfast in my room”, other comments from the Service User and relative comment cards indicated the food was of a good quality and was well liked. Cedar House Version 1.10 Page 12 An alternative to the main meal is not always on offer, the acting manager indicating residents have an alternative meal on offer, and though this was confirmed independently by the cook; a comment was passed that alternative meals were not widely on offer, this could be explored appropriately with residents and or relatives. Cedar House Version 1.10 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 standard(s) 16 & 18. Complaints and adult protection procedures are in place for the protection of residents in the home in the event of a complaint or suspicion of abuse. EVIDENCE: The complaints procedure is publicly displayed in the foyer of the home, as well as in the Statement of Purpose and Service User Guide, which makes clear the process of making a complaint. Residents stated they felt “at home” and “secure” in the home. Detailed examination of the adult protection policy indicated that sufficient information is contained in the document for staff members’ guidance on how to prevent elder abuse in the home. The majority of the staff have undertaken a course on dealing with abuse in the home. Two staff members spoken to displayed good verbal knowledge concerning the protection of vulnerable adults in their care. Evidence of advocates and advocacy information is publicly displayed on a notice board in the foyer of the home. Cedar House Version 1.10 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 standard(s) 19, 20, 21 & 26. The premises are maintained to a very high standard with strong emphasis on residents’ comfort. There is sufficient communal space including adequate numbers of toilet and bathing facilities. The home is clean and pleasant in appearance. EVIDENCE: An inspection of the flooring, fixtures and fittings in the home indicated that the registered provider make good effort in maintaining the home to a good standard, however comment was passed to the inspector with regard to the automatic closing corridor fire door, which is permanently closed. The registered person and acting manager confirmed that this repair was being dealt with and the repairer was awaiting specific parts to complete the job. The chairs that were mentioned in the last report have been replaced. Residents spoke positively about the upkeep of the home commenting, they had their room cleaned regularly, evidence of which was in place with the staff on duty. Cedar House Version 1.10 Page 15 The bathroom and toilet facilities were inspected and found to be sufficient in numbers based on the number of residents residing in the home. An inspection of the premises found it to be very clean and hygienic in appearance. Cedar House Version 1.10 Page 16 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 number of staff employed to work in the home is sufficient in meeting residents’ assessed care needs; and the recruitment process is sufficient to ensure resident safety in the home. EVIDENCE: The staffing rota was examined and a physical count indicated that there was adequate numbers of care staff on duty. The staffing rota was viewed and discussion held with the acting manager indicated that there is appropriate skill mix of staff employed to work in the home. Residents’ spoken to indicated that there are staff members available when needed, and the staff were “very good and treat us like family”; and I am looked after well here”. Other comments passed indicated “the evening staff are overworked, because they have to wash up etc their caring time is restricted” and too often the cleaning staff are required to do care and the cleaning is not always sufficient. Of the staff files viewed all had the appropriate pre-employment checks in place prior to staff commencing in their post. Evidence of staff training and an organised training programme is in place, with a large group of staff awaiting final confirmation of passing their NVQ level 2. Cedar House Version 1.10 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) 36, 37 & 38. The management approach does not promote effective care practice in the home for residents’ care and protection. EVIDENCE: Staff are not appropriately supervised with no sessions being planned or targeted toward individual resident discussion, or staff knowledge of the policies and procedures of the home. Two residents’ care records were inspected. All care records seen are kept up to date and in order in accordance with the Data Protection Act 1998 and the Care Homes Regulations 2001. Observations made indicated that periodic tests were performed to the water gas and electrical services on a regular basis. Cedar House Version 1.10 Page 18 Two staff members spoken to indicated that the home appear to be adhering to safe work practices for example the practice of safe moving and handling techniques. Cedar House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 x x x x 3 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 Standard No 16 17 18 Score 3 x 3 x x x x x 2 3 3 Cedar House Version 1.10 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 36 Regulation 18(1) a Requirement The registered person must arrange formal staff supervision to commence on a planned and regular basis. The original timescale of 8th February 2005 was not met. Timescale for action To commence by 20th August 2005. 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. 2. 3. 4. Refer to Standard 7 7 9 14 Good Practice Recommendations It is recommended that more detail is entered into the plans of care, with detail information on the assistance each resident requires. It is recommended that a “front sheet” is entered into the care plan so reviews are recorded instead of re-writing the full plan of care. It is recommended the medication process become a regular part of staff supervision in the home. It is recommended that the meal and menu system be one of the topics discussed at service user meetings and be part of the quality assurance questionnaires circulated to service users and their relatives. It is recommended that new care staff have a copy of their completed induction and foundation training on file for the management’s reference and use on future inspections. Version 1.10 Page 21 5. 30 Cedar House 6. 33 It is recommended that an anonymous resident and relative questionnaire be circulated to all connected with the home, and the results be published in line with this standard. Cedar House Version 1.10 Page 22 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX 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 House Version 1.10 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. 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!