Inspection on 19/05/05 for Cedar Lodge

This inspection was carried out on 19th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cedar Lodge 24/04/07

Cedar Lodge 21/10/05

Cedar Lodge 12/11/04

Cedar Lodge 22/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Cedar Lodge Devon Court 109 Devon Drive Brimington S43 1DX Lead Inspector Susan Richards Unannounced 19 May 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Address Devon Court, 109 Devon Drive, Brimington, Chesterfield, S43 1DX 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) 01246 477047 01246 476111 Mr Norman Turner, Mrs Ann Gibbins, Dr Edward Marcion Ranjit De Saram Mrs Lisa Tulip Care Home 10 Category(ies) of Learning Disability (10) registration, with number of places Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12th November 2004 Brief Description of the Service: Cedar Court provides personal care and support for up to ten younger adults with learningn disabilities. The service aims to promote normal living, autonomy and choice for service users in accordance with their individual risk assessed needs. This is provided by way of planned care, which is subject to regular review. The home is purpose built and is situated within a residential area in the grounds of a registered care complex. It is located on the north east outskirts of Chesterfield, on a direct bus route and relatively close to local shops and amenities. The Registered Manager is supported by a team of care and hotel services straff, together with external administrative support. The home provides single room accommodation with a choice of lounge/dining space. There are communal bathing and toilet facilities, with four bedrooms providing an en suite facility. Remaining bedrooms have a wash hand basin provided. The home is decorated and furnished to a high standard and service users own bedrooms are personalised. There is access to a garden area to the rear of the home with seating for service users and car parking space is provided to the front of the home. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The Registered Persons must ensure that all staff receive basic first aid instruction/training and that written care plans reflect the care needs Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 6 interventions for those service users who are prescribed medicines on an as required basis. The Registered Persons should consult with service users with a view to providing a computer for their own personal use. 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 Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4 & 5 Service uses and their representatives are provided with the information they need to enable them to make a judgement about the suitability of the home and its services. Opportunity is provided for potential service users to visit the home before admission, thereby ensuring that the individual has a choice as to whether to live there and that the manager can properly determine whether the home are able to meet that individual’s needs. EVIDENCE: There had been one service user admitted to the home since the previous inspection and one service user who had moved to a home providing nursing care due to changes in their assessed needs. The care and associated records of the service user who had recently been admitted were examined and discussions held with that and a number of other service users. The Manager and team leader described the process of admission for the service user recently admitted to the home, which included pre-admission assessment and trial visits to the home. The service user also confirmed these. Key information regarding the home and its service provision was provided for each service users and their representatives, including key policies and Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 9 procedures, which were provided in suitably formats and also displayed on the service users notice boards. Information via local advocacy support was also evidenced. Comprehensive and up to date needs assessment information was documented for each of the service users’ whose care records were examined, which included pre-admission assessment information collated by the home and also via care management arrangements. There were good links established with Ash Green, specialist NHS healthcare facility for persons with learning disabilities. Information was also provided in respect of the arrangements for staff training related to the specialist needs and conditions of service users accommodated. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 6, 7, 8, 9, 10 & 11 Staff effectively assisted and supported service users to make decisions about their lives, both in terms daily living preferences and also in respect of their longer-term goals. EVIDENCE: The care plans of a number of service users were examined and their care discussed with them and also with the manager and staff. Care plans were formulated in accordance with individual’s risk assessed needs and evidenced regular reviews. There was evidence of the involvement of service users in their care plans and families/carers needs were accounted for. Individual needs and choices and lifestyle preferences were well documented for each of the service users whose care records were examined. There was an established framework in place to enable service user to makes choices about the care they received in accordance with their given capacities. One service user was being supported in her choice to move to more independent living and access to advocacy services was actively promoted. Key information about the home was openly provided for service users in formats suitable for them. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 11 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 standard(s) 11, 12, 13, 14, 15, 16 & 17 Service users were satisfied with the recent changes in the arrangements for activities, which had been introduced in response to their requests and provided regular access to a good range of activities for them to choose from. Service users were provided with a nutritious and well balanced diet and were able to make choices and be actively involved in meal planning and preparation. EVIDENCE: Service users spoke freely and enthusiastically about the activities they engaged in on a regular basis, both in terms of their leisure and recreational pursuits and also personal and educational development. Written records were also kept regarding individual’s abilities and lifestyle preferences and also the activities they engaged in. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 12 There had been a recent review in terms of the arrangements for, provision of and access to activities for each individual service user. This was in response to requests made by service users themselves. Feedback from service users and staff was positive in respect of changes made. The manager felt that this was working well so far and had identified a time period for further review with service users. Service users welcomed the inspector into the home and were relaxed and chatty. At the time of the inspection some were outside the home engaging in various activities. One service user decided that he was going to assist with preparing teas and was provided with staff support to enable him to do so. Another service user was planning what to do over the weekend and one service user was resting in their room before tea. Discussions were held with staff and service users regarding the arrangements for meals and mealtimes, which were satisfactory. The kitchen was clean and well equipped with adequate food stocks. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 18 & 19. Service users personal and healthcare needs were being met, although in respect of the administration of ‘as required’ medicines, service users care plans were not reflective of this. EVIDENCE: Service users personal support needs were accounted for and their care interventions were documented by way of individual care plans. Individual’s personal lifestyle preferences and likes and dislikes were clearly recorded and service user talked about some of the choices they made and their preferences. Records were kept of individual service users access to outside health care professionals for specialist advice and support and also for the purposes of regular routine healthcare screening in accordance with individual’s assessed needs. A number of service users attended ‘well woman’ and ‘well man’ groups where topics covered included advice on smoking and health and healthy eating. The arrangements for the management and administration of medicines were not fully examined on this occasion. However, the medicines administration records (MAR sheets) of a number of service users were examined. Some of Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 14 those detailed prescribed instruction for certain medicines to be administered on an ‘as required’ basis and some of these also indicated a variable dose. There were no detailed written instructions in the service users care plans as to the circumstances under which these should be given, including which dosage. However, staff spoken with who were responsible for the administration of medicines knew when and how much to give. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 22 & 23 There were clearly established frameworks in place in the home for the promotion of service users safety and protection and to enable service users and their representatives to raise concerns or to make formal complaints. Staff understood their responsibilities in relation to these and service users knew how to complain and were able to express their concerns and opinions. EVIDENCE: Information was provided for service users and their representatives as to how to complain. This was in suitable formats by way of the service user guide and a written procedure, which was displayed on the service users notice board. There had been no complaints made since the previous inspection. There was a recognised system for the recording of complaints All staff had attended training/updates in relation to adult protection and including local joint agency adult protection procedures via Derbyshire County Council Social Services, Learning Disabilities Adult Protection Lead. Staff had also undertaken recognised training and updates in relation to dealing with violence and aggression. This included non-physical and physical interventions. There was a established framework for enabling service users to air their view and make concerns known, which included regular meetings (manager and service users), one to one sessions with key workers and advocacy group meetings. Suitable policy and procedural guidance was in place in relation to the above and also regarding service users monies. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 16 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 standard(s) 24, 25, 26, 27, 28, 29 & 30 Service users are provided with a safe, clean and well maintained environment, which suits their needs and which is decorated and furnished to a high standard. Service users may benefit from the provision of a computer for their personal use. EVIDENCE: Areas of the home were inspected, including communal lounge/dining areas, bathrooms/toilets, kitchen and the bedrooms of a number of service users who the Inspector spoke with. Service users were pleased with the recent redecoration of their rooms and said that they had chosen their own colour schemes. All bedrooms are single accommodation, four of these have en suites and those remaining all have a wash hand basin provided. There was a planned programme in operation for the redecoration and renewal of the premises. There was a variety of equipment provided including the emergency call system, communal TV and video player and gymnasium/fitness equipment for service users own use. There was no computer for service users personal use, although staff felt this would be beneficial. Some service users were able to Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 17 access computers outside of the home. There were no service users accommodated requiring specialist environmental equipment/aids or adaptations. The manager advised of the recent visit from the Fire Officer and of the action taken to meet with recommendations made by him Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The Inspector will fully assess standards in this section at the next inspection for this service later in this inspection year. EVIDENCE: Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The Inspector will fully assess the standards in this section later in the inspection year. Staff had not received basic instruction in first aid. EVIDENCE: At the previous inspection for this service a requirement was made to ensure that all staff receive basic instruction in first aid. Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 20 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cedar Lodge Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 21 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. 2. Standard YA42 YA6 Regulation 13(4)c & 18(1)(a) 13(2) & 15(1) Requirement Staff must receive basic instruction in first aid. From inspection of 12.11.04. Service users who have medication prescribed, with instructions for a variable dose to be given when required must have a written care plan, which details the circumstances under which this must be given and the dosage required in accordance with that circumstance. Timescale for action 31.07.05 31.07.05 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. Refer to Standard YA29 Good Practice Recommendations The Registered Provider should, in consultation with service users, consider providing a personal computer for service users own use Cedar Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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 Lodge C52 C02 S19958 Cedar Lodge V228523 190505 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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