Inspection on 29/05/08 for Cedar House

This inspection was carried out on 29th May 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 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 14/05/09

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 27/09/2008.

CARE HOME ADULTS 18-65 Cedar House Cedar House 47 Smethurst Street Middleton Manchester M24 2BA Lead Inspector Bernard Tracey Unannounced Inspection 29th May 2008 08:15 Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 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 House DS0000041209.V363628.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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 DS0000041209.V363628.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), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (3) Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum number of 16 service users to include 16 service users in the category of MD (Mental disorder) and up to 3 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age) within the total number of 16. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 1st November 2007 2. Date of last inspection 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 toiletries, activities, clothing and transport. Fees charged by the home provided in January 2007 are as follows: £249.00 to £374.00p per week. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We (the Commission of Social Care Inspection) undertook a 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. 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. This helps us to see if the manager of the home sees the service the same way we do, and the same way the residents do. Overall, we felt this form was completed honestly and that time and effort had been put into completing it. Before the inspection we sent comments cards to the residents and staff asking them what they thought about the care provided. We received four from residents, and one from a visiting professional. We spent six and a half hours at the home. 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 also examined files that contained records about staff training. We spent time speaking to six residents, as well as speaking to three staff, including the manager. The owner and her son were present for some of the time. The Commission for Social Care Inspection (CSCI) has not received any complaints about the service since the last key inspection. No safeguarding investigations have taken place either. What the service does well: The service has an established and experienced manager and staff group who meet the needs of the residents well. They are well liked by the residents and comments such as “the staff here are all very nice” and “the manager really knows her job” were made. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 6 Prior to admission the manager assesses residents’ health and social care needs. The assessment information is then used to form the basis for a plan of care. Care files seen were organised, easy to read and provided good detail with regard to individual care needs. Through discussion and observation it was evident that residents were treated respectfully and the home ensures that residents’ views are sought and acted upon. Residents feel they are well looked after by caring and committed staff. Comments from the residents included: “the home was a very good place to live”, another: “it is a good home, I like it”, whilst another resident said staff were “kind, helpful and polite”. All of the residents were looking forward to a forthcoming holiday in Skegness. What has improved since the last inspection? What they could do better: The personal accommodation for residents remains poor. We identified with the owner the work that is required to bring the communal and personal accommodation up to an acceptable standard. Replacement carpets in the lounge, conservatory and reception areas have not been laid within the timescale agreed at our last visit. A commitment to replace these carpets by 30th June 2008 was made by the registered provider. The reduction of a staff member between the hours of 10am and 6pm has had an effect on the residents’ opportunities to access leisure and personal pursuits during the day. A social worker who returned a comment card said “My client is happy at Cedar House but rarely goes out. I feel he would benefit from being taken out for walks”. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 7 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 and that staff receive a P60 at the end of the tax year. The fees payable for the service should be entered in the contracts given to service users. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 8 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.V363628.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken, thereby ensuring that the home can meet the assessed needs. EVIDENCE: There have been no admissions to the home since our last visit. We looked at the files of three residents who had lived in the home for some time. Assessments were in place for all of them. The manager told us that, as previously reported, 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. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 10 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). All of the questionnaires returned by the residents confirmed this to be the case in their experience. Because of the nature of the client group admitted to the home, it is also seen as appropriate that, where possible, the resident’s representative visits the home to assess the facilities and has the opportunity to meet with the staff to discuss the way their needs of their relative will be met. Each file we looked at contained a copy of the home’s contract. The resident and the manager had signed each, but none contained details of the fees payable and this remains outstanding from our last visit to the home. Emergency admissions are avoided as far as possible. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents are supported by the staff to make decisions and choices in their lives. EVIDENCE: We looked at three care files; all had up to date care plans, with personalised and detailed information about their goals, both short and long term, and care needs. Resident involvement was clearly reflected – signed by the resident. All three said they knew about the care plan and felt the staff, particularly Val, kept it up to date with current issues. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 12 The manager develops a care plan based on the assessments made prior to admission to the home. There is evidence within the care plans, and in discussion with the residents, that any potential restrictions on choice, freedom, services or facilities, likely to become part of the residents’ daily life, had been discussed and agreed with the individual during assessment. Any changes in status are agreed with the resident and their representatives and recorded within the care plan. Residents were encouraged to take positive risks as part of an ordinary, independent lifestyle. Comprehensive risk assessments were in place, with clear, up to date guidance regarding how to reduce and manage any potential risks. Residents we spoke to said they felt they received good care and support from the staff and received assistance as needed, with staff accompanying them to activities or the GP’s or anything else they needed assistance with. This was also confirmed in the surveys that were returned from residents. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Opportunities for integration into community life and leisure activities need to be further expanded so that residents can develop their skills and live more independent and fulfilling lifestyles. The dietary needs of the residents are well catered for with a balanced and varied selection of food available that meets the residents’ preferences, tastes and choices. EVIDENCE: Staff are 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 sufficient care staff with records kept, is a requirement of this report. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 14 Care staff support residents in accessing local facilities for leisure and shopping, according to the assessed needs of the individual. One resident works in a local cafe and has gained a NVQ in hospitality, as well as being supported in gaining a qualification in Mental Health Awareness. Care staff offer support to residents in ensuring access to public transport, as well as the organised trips to places of interest and enjoyment, including an annual holiday, 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 user’s preferred form of address. Residents informed us that the food is always served in adequate portions. Special diets are catered for. Comments received included: “Carol a brilliant cook. All the meals are really nice” “Plenty to eat and more if you want it” “Tasty and delicious grub” Other residents with special dietary needs, such as fat free or diabetic, were also catered for. Staff helped residents who required assistance to eat and drink, in a sensitive and dignified way. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The residents’ physical and emotional health needs are being met, promoting good health and responsive individual care. EVIDENCE: Care plans looked at showed that personal care and health care need to be detailed for people. Where appropriate, residents are accompanied for health checks. Each resident has a single bedroom and is able to ensure they have privacy in attending to personal care. The care plans also cover support with mental health issues and how these are to be addressed. One resident said “I always receive the care and support I need, and there is always someone to turn to. The staff do listen to what I say, and they are always available. I always receive the medical support I need” and this comment was supported by residents through the surveys we received. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 16 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 home was a “very good” place to live, another that “it is a good home, I like it”, whilst another resident said staff were “kind, helpful and polite”. Both male and female staff worked at the home. The staff team were knowledgeable about and very sensitive to each resident’s individual personal support needs. Files continued to show residents’ physical and mental health were being monitored, with regular health care checks undertaken. Staff were alert to changes in residents’ health and wellbeing, signs and symptoms of relapse were recorded for use as a reference point in case of future mental ill health. Prompt and appropriate specialist healthcare advice had been sought when residents had become unwell, particularly for those with more complex health problems. None of the current residents look after their own medication, 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 their medication, in particular, when they needed to come back to the home if they were out. The arrangements for storing medication in the home were discussed with the manager and the records of administration, receipt and disposal of the medication were examined. Medication is received monthly in a monitored dosage system and is given out by a member of the senior team. Medications were stored in a trolley that was secured to the wall by way of a safety chain. The prescription administration sheets of five residents were examined in detail. The amount of medicines received for each resident was accurately recorded on the date that they were received into the home. Each administration of a medicine was recorded in the appropriate column on the recording sheet and, if there was an omission the reason for this was recorded. The manager has purchased a refrigerator in order to store medicines that require to be held in this manner. We spoke with the manager and two senior care assistants who confirmed that they had undertaken a course in the administration of medicines. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home has an effective complaints procedure so residents know their concerns will be listened to and acted upon. Staff received training about protection of adults to make sure that residents are protected from possible harm and abuse. EVIDENCE: The Commission for Social Care Inspection had not had cause to investigate any complaints at the home since the last inspection. No protection investigations have been undertaken. The manager was knowledgeable about protection issues. 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, “Not had anything to complain about but I would speak to any of the staff if I did.” Staff understood the importance of listening to residents’ concerns and how to respond to any issues that were raised. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 18 Records examined show that all of the staff have received training in the protection of vulnerable adults. Staff spoken with said they had training in understanding what abuse was and what to do if they suspected abuse. Records were available of staff training. Staff also confirmed they had undertaken NVQ training and this also included information and training in abuse. Residents spoken with and those who returned questionnaires 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. Residents’ meetings are held and are a forum for residents to raise matters with the manager and staff. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. The lack of investment in the home has resulted in the furnishings and fittings becoming mismatched, broken, not replaced and, overall, it does not provide for a comfortable, safe environment for residents to live in. EVIDENCE: The premises have not been kept in a good state of repair so that residents can live in a safe and comfortable environment. During our visit we discussed with the owner the progress they believed had made since our last inspection. They told us that the gutters of the home had been cleaned and security lights had been reinstated to the outside of the building. Two new shower rooms had been installed on the upper floor and both were now fully operational. Some minor electrical works had been undertaken to ensure that the lighting throughout the home was adequate. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 20 The requirements made to ensure that the lounge and conservatory decoration was finished have been accomplished to a satisfactory standard. 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 have been addressed and are now satisfactory. The carpet in the lounge needs replacing as there is a large tear (along its join), which could constitute a trip hazard as well as looking unsightly, and the conservatory carpet also needs replacing. We were informed that these carpets would be replaced during the residents’ annual summer holiday which is to take place in June 2008. The carpet in the hallway (near the office) was heavily stained with a watermark and requires replacing. Similarly, the stair carpet needs replacing. We inspected 14 bedrooms in detail. All but one required maintenance to differing degrees, including decoration, new sink and vanity units, new carpets, new furniture, fittings and curtains. One bedroom was seen to be in the final stages of redecoration and had been fitted with a new sink and vanity unit, however it was still awaiting new carpet lampshade and curtains. Since our last visit the owner has employed a handyman, which has helped to rectify some of the long-standing jobs that have needed doing in the home. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The staff group are well liked by the residents who feel that the staff have the skills necessary to meet their needs. However, there are insufficient staff to meet the social needs of the residents. EVIDENCE: We met with three staff members in a group during our visit. We were informed that staff numbers had been reduced due to a lower occupancy and that this was having an impact on the residents, particularly in relation to activities outside the home. Examination of the rota and a discussion with the owner confirmed this reduction. Since our last visit no new care staff have been employed at the home, therefore we were unable to identify if the recruitment process in the home had improved since our last visit. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 22 Training is provided for staff, and staff told us that they received training in mental health issues (if doing NVQ), de-escalation techniques, first aid, medication, health and safety, and moving and handling. The manager showed us the invoices as proof of these courses being undertaken, as no certificates have been sent from the companies providing the training, as the monies for the training are still owed. Residents spoken to were complimentary about staff and felt they had their needs met. Comments made by residents include: “The staff here are all very nice” and “I like the staff here and the manager is very organised”. We received a survey from a visiting social worker who commented “My client is happy at Cedar House but rarely goes out. I feel he would benefit from being taken out for walks”. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 & 43 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The manager runs the home in an open and inclusive manner, which supports the interests of residents. Lack of organisation, investment and financial backing by the registered provider 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. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 24 The manager of the home is experienced and has relevant skills. She has commenced the Registered Manager’s Award although, owing to lack of finances and funding from the provider, she is unable to complete the remaining units. The manager has day-to-day control and fulfils her duties well in respect of providing a good service to residents. Residents’ meetings take place, which allows the residents to let the manager know what they think about the service. Since our last visit there has been a commitment from the owner to ensure that the invoices to the home are paid on time. Staff spoken to said they were now receiving their monthly wages but that they required a recognised payslip with details of their earnings clearly stated. At the time of our visit, staff were still waiting for their P60 statement for the 2007-08 period. The owner’s son, who deals with the wages, promised that the staff would receive the P60 during the day of our visit. A selection of safety certificates were examined during our visit and all were found to be current. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 25 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 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 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 2 12 2 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 2 X Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 26 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 YA24 Regulation 23 Requirement The premises must be kept in a good state of repair at all times, so that residents live in a safe and comfortable environment. Previous timescales of 01/08 and 24/04/08 not met. So that the residents can live in a safe and comfortable environment, the carpets in the lounge, conservatory, hallway and stairway must be replaced. Previous timescale of 24/04/08 not met. Following consultation with the resident, a complete refurbishment of the accommodation of Room 2 must be undertaken whilst the resident is away on holiday. There must be sufficient staff working in the home to ensure that the residents’ physical, social and lifestyle needs can be met both individually and collectively. Previous timescale of 07/04/08 not met. Timescale for action 30/09/08 2 YA24 23 30/06/08 3 YA24 23 (1) (b) 30/06/08 4 YA33 18 (1) (a) 30/06/08 Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 27 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 Refer to Standard YA5 YA37 YA43 Good Practice Recommendations Contracts for residents should include details such as the fees payable per week so that it is clear to all what fee is due weekly and what it is for. Funding for the completion of the Registered Manager’s Award should be provided so that the service continues to benefit from a well-trained manager. 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. Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cedar House DS0000041209.V363628.R01.S.doc Version 5.2 Page 29 - 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!