CARE HOMES FOR OLDER PEOPLE
Cedar House 249 Station Road Rothley Leicestershire LE7 7LD Lead Inspector
Keith Williamson Unannounced Inspection 5th December 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Cedar House Address 249 Station Road Rothley Leicestershire LE7 7LD 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) 0116 2303066 01162375520 Mr John Lowe Mrs Dorothy Lowe, Mr John Lowe (jnr), Mrs Lynda Lowe Zena Bentley Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of Registration. Date of last inspection 20/07/05 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 DS0000001795.V270049.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation. The inspection took place over one day, commenced at 9.30 am and was completed in four hours by one inspector. An opportunity was taken to view the care plans and other records in detail. Six residents were spoken with on this visit; a sample of the comments made from those residents is enclosed in this report. Two staff were also spoken with. The registered manager assisted with the inspection, spending time with the inspector discussing the management of the home. What the service does well: What has improved since the last inspection?
Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 6 No areas were identified at this inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. 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. EVIDENCE: The Statement of Purpose and Service User Guide were viewed, both documents being updated with the new managers details. Resident assessments are completed prior to their admission; these were seen on both “case tracked” residents’ files. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9. Residents are well looked after in respect of their health and personal care and medication needs. EVIDENCE: Individual resident care plans are in place, are detailed on a personal basis and are under periodic review. Residents and their relatives are included in the care planning process. Residents have the possibility of retaining their registered General Practitioner, and felt staff would summon them if required. Staff were viewed giving out medication, this continues to be seen as a high priority for staff, with further specialised training planned for the near future, this shall continue the focus on resident care. Staff spoken with had a very good understanding of the medication process. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None. None of these standards were viewed on this occasion. EVIDENCE: Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. Residents are well protected by having information about the complaints procedure. EVIDENCE: No complaints have been recorded by the home, or received by the commission for social care inspection since the last inspection of this service. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19. The premises are maintained to a very high standard with strong emphasis on residents’ comfort. EVIDENCE: An inspection of the public areas of the home indicated that the registered provider continues to make a good effort in maintaining the home to a very high standard with an effective maintenance programme. A new call bell system has been fitted recently. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None. None of these standards were viewed on this occasion. EVIDENCE: Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35. The management approach promotes effective care practice in the home for residents’ care and protection. EVIDENCE: Minutes of residents and care staff meetings were seen, and the results from a recent resident survey were also viewed; the manager stated these findings shall be made public, and be added to the next revision of the service user guide. Residents control all their own finances in the home, some assisted by their relatives. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? No. 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. Standard Regulation Requirement Timescale for action 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 5 Refer to Standard OP7 OP7 OP9 OP9 OP14 Good Practice Recommendations It is recommended that more detail be entered into the plans of care, with detail information on the personal assistance each resident requires and social care offered. It is recommended that a “front sheet” be entered into the care plan so reviews are recorded instead of re-writing the full plan of care. It is recommended that staff be trained by an appropriate health worker to monitor (delegated) medical conditions and administer medication appropriately. 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 an anonymous resident and relative questionnaire be circulated to all connected with
DS0000001795.V270049.R01.S.doc Version 5.0 Page 17 6 OP33 Cedar House 7 OP36 the home, these be dated and the results be published in the Statement of Purpose. It is recommended the manager organise formal staff supervision to commence on a planned and regular basis. Cedar House DS0000001795.V270049.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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