CARE HOME ADULTS 18-65
Cedar House (Pitsea) London Road Pitsea Basildon Essex SS13 2BY Lead Inspector
Patricia Stanton Unannounced Inspection 10th January 2006 11.00 Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 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 (Pitsea) DS0000061931.V265452.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 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 (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Cedar House (Pitsea) Address London Road Pitsea Basildon Essex SS13 2BY 01268 01268 455 103 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) Kingswood Care Services Limited Teresa Mary Colgrave Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th May 2005 Brief Description of the Service: Cedar House is a five bed roomed house located in Pitsea close to the local town, bus route and shops. The home is within walking distance of Pitsea Centre, shops, pubs and medical centres. All bedrooms have en suite or adjacent bath or shower facilities. The home has a main lounge, kitchen diner, sitting room, laundry room, staff office, staff toilet and a bedroom on the ground floor. The first floor comprises of four bedrooms, three with en suite and a bathroom/toilet. The home has a large garden with BBQ, decking area, lawn area with flowerbeds and garden shed. The front of the property has off road parking for the homes vehicles. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The routine unannounced inspection took place on the 10/01/06. During the inspection records and documents were looked at. Three residents, one staff member, the assistant manager and the registered person were all spoken to during the visit. Time was spent in the lounge and in two young adults rooms, chatting and taking note of the young adults daily routine in the home. The inspector would like to take this opportunity to thank residents for their hospitality and the staff for their time and cooperation during the visit. What the service does well:
The home caters for all young adults needs and encourages them to be independent individuals who achieve their goals. Staff support each other and residents are treated with dignity and respect. Residents may air their views and opinions in reviews and house meetings to help decide on suitable care and daily activities. Residents looked happy and healthy and appeared to enjoy living in a home, which is decorated to a high standard. Residents receive a wholesome nutritious diet in pleasant surroundings. Residents have regular contact with significant others and friends. The home provides transport and preferred educational support and recreational activities for residents. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 7 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 (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Prospective residents individual needs are assessed and met within the home. EVIDENCE: Records evidenced residents are carefully assessed over a period of time and relevant information gathered prior to admission to ensure their suitability. One file confirmed a resident was visited eight times prior to being offered a trial visit of four days at the home. Records were thorough and included all relevant information. Risk assessments were complete and the resident appeared settled, happy and healthy at inspection. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Residents changing needs are reflected in their care plans. EVIDENCE: One resident was involved in a review the day before inspection, which reflected her ongoing improvement regarding care, communication and personal skills. The parents of the young adult praised the homes staff for assisting their daughter to become more independent and vocal. The young adult was attending a full time college course and at inspection appeared happy and well. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,17. Residents have the opportunity for personal development and take part in appropriate activities. Residents enjoy varied diet in pleasant surroundings. EVIDENCE: The home promotes individuality and residents are encouraged and supported to participate in appropriate educational and recreational activities. At inspection all four residents attended various college courses and stated how they enjoyed them. One resident stated she was able to look up information at college regarding any issue including sexual health matters but did not have access to the Internet in the home. Records of meetings confirmed residents decide with staff what activities they wish to participate in. One resident wanted to go to Jumping Jacks disco and another wanted to write to Dick Van Dyke. Files confirmed residents attend various activities including the pub, drives out, clubs, cinema and swimming. Individual activity planners were seen on file for each resident. Residents stated they have contact with friends, family and may invite friends back to the home. Residents appeared happy with the food offered in the
Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 11 home and one resident stated she was able to cook twice a week with the support of staff. Another resident who needed to loose weight had managed to loose over a stone since living in the home. The weight loss appeared to have helped his mobility since the last inspection. Another resident stated they enjoyed a Chinese takeaway the previous night. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Residents receive appropriate support for personal care as required. EVIDENCE: One resident read out to the inspector her daily guidelines for personal care and evidenced these included support with encouragement to self care whenever possible. Staff meeting minutes also confirmed, staff discuss ways to empower residents to reach maximum independence with rules for personal and domestic care. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion EVIDENCE: Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Residents live in a homely environment, which is safe, but fire exits could be improved. EVIDENCE: The home was welcoming, warm and comfortable decorated to a good standard and was clean and tidy. Residents were proud to show the inspector their rooms, which were decorated and personalised to a high standard. The staff office that is very small but organised well to allow staff easy access to files. The home has improved fire procedures for evacuation but not yet fitted a suitable lock enabling all staff members to exit the garden in the event of an emergency. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34. Staff are competent and appropriately trained to meet residents needs. Residents are protected by the homes recruitment policy and procedures. EVIDENCE: Staff appeared to meet the needs of residents accommodated. The number of staff on duty appeared sufficient to meet residents’ needs and the registered provider helps when required. The home employs only one agency staff and records confirmed all appropriate checks are sought prior to employment in the home. The home requests all agency staff have completed application forms, interview notes, two professional references, CRB, POVA check and training in first aid, manual handling, health and safety, POVA and epilepsy. However not all the letters evidenced the agency had completed these. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42. The home currently does not have a registered manager but the deputy manager is competent and accountable. EVIDENCE: The home is currently advertising for an acting manager to act up in current acting manager’s absence. The deputy manager at inspection appeared competent and capable undertaking training in management skills. Staff appeared to be happy and work well as a team and staff records evidenced the home is given the opportunity to make changes to reflect the changing needs of residents. The registered manager has been promoted to registered provider and stated at inspection that managers are to be given support to manage their homes more individually. Staff appraisals are ongoing to identify training needs and skills of staff. Communication between managers, staff and residents were mutually respectful and positive. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Cedar House (Pitsea) Score 3 X X X Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x DS0000061931.V265452.R01.S.doc Version 5.0 Page 18 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 13 (4) c Timescale for action The home must fit a suitable lock 01/02/06 to enable exit from the rear garden in the event of a fire. Time scale 01/06/05 not met. Requirement 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 Refer to Standard YA1 YA34 Good Practice Recommendations Service users guide should include details of the CSCI and local advocacy services. Agency files should evidence staff checks have been completed. Cedar House (Pitsea) DS0000061931.V265452.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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