Inspection on 18/08/05 for Cedar House Residential Care Home

This inspection was carried out on 18th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cedar House Residential Care Home 24/05/07

Cedar House Residential Care Home 20/06/06

Cedar House Residential Care Home 01/12/05

Cedar House Residential Care Home 08/02/05

Cedar House Residential Care Home 30/06/04

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

CARE HOMES FOR OLDER PEOPLE Cedar House Residential Care Home 93 Seabrook Road Hythe Kent CT21 5QP Lead Inspector Wendy Mills Unannounced 18 August 2005 9:30 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 Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cedar House Residential Care Home Address 93 Seabrook Road, Hythe, Kent, CT21 5QP 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) 01303 267065 Cedar House (Hythe) Limited Christine Ransley Care home only 29 Category(ies) of Older People x 29 registration, with number of places Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2005 Brief Description of the Service: Cedar House is registered to provide residential care for up to 29 older people. The premises is a detached property with a garden to the side and rear on different levels and parking to the front. It is situated approximately 400 yds from local shops including a post office and a pub, a mile from Hythe centre and is on the local bus route. Each bedroom has a private wash-hand basin and call bell, some rooms have ensuite facilities. The proprietors, Mr & Mrs Barham, take an active role in the day-to-day running of the Home. The registered manager is Mrs Christine Ransley. The house has a well-maintained garden with a detached sunroom with easy access for the use of residents. On the ground floor there are two lounges and a separate dining room, which also incorporates a quiet sitting area. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection began at 1.15pm and lasted two and a half hours. One of the registered providers, Mr Tim Barham, the registered manager, Mrs Christine Ransley and the deputy manager, Mrs Sara Venables, assisted with the inspection. The inspector was able to speak in private to four residents and one relative during the course of the inspection. In addition, she spoke to several other residents in the main communual area. The way the home manages medication was inspected and key documents were examined. A tour of the home undertaken and both indirect and direct observations were made throughout the inspection. What the service does well: What has improved since the last inspection? There has been a significant improvement in the way the management team work together. There is an open and honest management culture and the registered manager is well supported by the registered provider and her deputy. There is now greater understanding of roles and responsibilities. There are now increased levels of funded staff training moving and handling has improved and a new, state of the art, hoist has been purchased. Staffing levels have improved since the last inspection and there is a committed care team. There has been better consultation with the residents, in particular, in respect of choice of food. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 6 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 Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 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 Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 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) No standard in this section was inspected at this visit. EVIDENCE: Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 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) 7,8,9&10 The residents know that their care needs are reflected in their individual care plans and that potential risks are managed. They know that their views are listened to and that their records will be kept securely and that confidentiality will be maintained. The systems of the management of medicines within the home are good and there are clear and comprehensive arrangements in place to ensure the medication needs of the residents are met. EVIDENCE: Residents said that staff ensure that appointments with GPs and hospitals are made and kept. Transport is arranged when necessary. They said that the staff care for them very well and treat them with kindness and respect. They were aware of that the home keeps records about them and were confident that these are kept securely. The systems for medication were inspected. Good procedures and practices are in place and is handled safely. The policy for taking medicines out of the home should residents go on leave requires review to ensure that secondary Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 10 dispensing does not occur, otherwise there are sound policies in place. MAR charts were in order and the medication cupboard was tidy and well organised.. Handwritten entries were noted to have been countersigned by two staff. The deputy manager said that staff who administer medication have now received training. Controlled drugs are in use and suitable storage, administration and recording systems are in place. the home has recently purchased a small, lockable, medication fridge for the storage of eye drops. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 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&15 The home makes every effort to ensure that the residents are able to enjoy an interesting and fulfilling lifestyle. It respects choice of lifestyle and fosters good relationships with family and friends of the residents. The home demonstrates a clear understanding of the importance of good nutrition but should continue to work to provide more interesting and varied menus. EVIDENCE: There are a number of activities that take place in the home. Care staff now have time to organise sessions such as chair exercises, skittles and bingo. An entertainer visits the home monthly. Some residents said that they would like more outings. Relatives said that they are made welcome to the home. Residents said that they enjoy their meals and that there is always plenty to eat. There was a plentiful supply of fresh fruit and vegetables in the home on the day of inspection. Menus, however, could be more creative and varied and it is recommended that the registered manager continues to work closely with the cook to ensure that agreed menus are delivered. It is also recommended that ice and lemon are provided for those residents who would like this as an addition to their drinks. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 12 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 The home has a satisfactory complaints system and the residents know that their complaints will be listened to and acted upon EVIDENCE: Residents said that they can talk to the staff about any concerns they may have. One resident said that if anything ever goes wrong “the staff do their best to sort it out.” The residents to whom the inspector spoke all said that they have no complaints but if they did, they knew they could talk to the Mrs Ransley or any of the staff. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 13 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) 19,20,21,22,23,24,25&26 The standard of the environment within the home is good and provides the residents with a homely and attractive place in which to live. EVIDENCE: A tour of the home was undertaken in the company of the manager, Mrs Ransley and the deputy manager, Mrs Venables. All areas were clean, pleasant and free from offensive odours. The accommodation is spacious and all bedrooms rooms are of a good size. The standard of décor is good throughout. The gardens are well maintained and there is a separate garden room and a quiet lounge. However, few residents choose to use these areas. There are plenty of bathing and toilet facilities and baths are fitted with hoists. All bathroom and toilet areas were very clean but it was noted that terry towelling hand towels are provided in these areas. Mrs Ransley said that these are changed daily but they could still provide a risk for cross infection and it is recommended that the home consider whether other hand drying methods would be more suitable. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 14 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&30 The staff have a good understanding of the support needs of the residents. There are positive relationships between the staff team and the residents. EVIDENCE: Indirect observation confirmed that the staff relate well to the residents. The residents said that the staff are very kind, friendly and helpful and that they come quickly if they ever need to ring their buzzer. Mrs Ransley said that they level of training has improved significantly and that Mr Barham, the owner has made funds available for this. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 15 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) 31,32,33&36 The registered manager is well supported by the registered providers and her deputy. The management team now provide clear leadership throughout the home. They demonstrate a commitment to self-monitoring and a continuous improvement plan. EVIDENCE: Conversation with the management team showed that they all have a good understanding of good care practice and that there is an open and honest management culture. Mr Barham has shown a commitment to investing in both the environment and in staff to make improvements. There is good communication within the home and residents are consulted about their wishes. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 x 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 3 3 3 x x 3 x x Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 17 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 26 Regulation 16(2)(j) Requirement The home must review the way it provides hand drying facilities in bathroooms and toilets. This is the only unmet requirement from last inspection.. Timescale for action 30th September 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. Refer to Standard 15 15 Good Practice Recommendations The Manager should continue to work very closely with cook to ensure that food handling is safe and that menus have plenty of variety. The home should provide ice and lemon for those residnets who would like this in their drinks.. Cedar House Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Residential Care Home H56-H05 S23381 Cedar House V238305 180805 Stage 4.doc Version 1.40 Page 19 - 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. 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