Inspection on 24/04/07 for Cedar Lodge

This inspection was carried out on 24th April 2007.

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 Lodge 21/10/05

Cedar Lodge 19/05/05

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 Chesterfield S43 1DX Lead Inspector Marie Bonynge Key Unannounced Inspection 24th April 2007 11:00 Cedar Lodge DS0000019958.V336565.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 Lodge DS0000019958.V336565.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 Lodge DS0000019958.V336565.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Address Devon Court 109 Devon Drive Brimington Chesterfield S43 1DX (01246) 477047 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) 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 DS0000019958.V336565.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st October 2005 Brief Description of the Service: Cedar Court provides personal care and support for up to ten younger adults with learning 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 to the north-eastern outskirts of Chesterfield, on a direct bus route and relatively close to local shops and amenities. The Registered Manager has the support of a team of care and hotel services staff, together with external administrative and management 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. Fees for this home are individually assessed. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place over one day in April 2007 and covered a lunch time meal and afternoon. 10 residents were accommodated and most of the residents were present during some part of this visit. Inspection methods used included informal discussions with 2 residents, a group discussion and direct observation. Discussions were also held with the Registered Manager, Deputy Manager and 2 members of staff. Records examined included residents care plans, staff rotas, daily records, medication administration charts, some maintenance certificates and accident records. A brief tour of the communal areas, kitchen and medication area took place. What the service does well: What has improved since the last inspection? Some of the bedrooms and one of the lounges have been redecorated. Care plans have been reviewed and updated to reflect a more person centred approach to assessment and care planning. Staff have received basic instruction in first aid. This was a requirement outstanding from a previous inspection and has now been met. Medication records have been reviewed to comply with a requirement made at the last inspection. This requirement has now been met. A personal computer for residents own use has been provided in accordance with a recommendation made at the last inspection. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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 Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. 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. Prospective residents to the home can be assured that systems are in place to fully assess their needs and provide a basis for their plan of care. EVIDENCE: There had been one new admission to the home since the last inspection. Comprehensive assessment information had been obtained prior to the admission of this resident from health and social services and specialist practitioners as appropriate. The home offers prospective residents the opportunity to visit for the day or for meals and makes the service user guide and statement of purpose available by giving these directly to prospective residents and their representatives. The service user guide is in large print and pictorial form that includes photographs of the building and tries to give an idea of what services are provided. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 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 in making decisions about how their care is to be carried out and are enabled to make choices according to their care plan. EVIDENCE: Comprehensive care plans were in place that identified the needs of individuals and their preferences. The necessary action to be taken by staff to meet these needs was clearly defined with detailed instructions so that continuity was ensured. Staff were aware of the content of the care plans and they were used as everyday working documents. Further development had begun with regard to care planning that used a more person centred approach and included full involvement with the resident. The manager expected that this documentation would be used for all residents. Full risk assessments enabled residents to pursue independent life styles within a risk management framework. Advocacy services were encouraged to be involved with the residents that also supported residents in their decision making. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Appropriate individual support is given that enables the residents to enjoy activities and recreation that is suited to their needs and preferences. Good quality meals are provided in a relaxed and informal atmosphere that residents clearly enjoy. EVIDENCE: Residents attended various day centres and age appropriate activities. These included college activities such as Information Technology and social groups. Residents also participated in growing flowers and vegetables in the allotments and gardens that belong to the home. Residents have won a number of prizes from exhibiting their produce in various shows and clearly have a sense of pride in their work. Hens, goats and ducks are also kept that residents take responsibility for looking after. Observations of residents indicated that they enjoyed the activities provided such as cinema afternoons. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 Page 11 Relatives and friends were encouraged to visit the home and residents were supported to visit friends and family in the community. Recreational activities were well documented and residents were looking forward to going on holiday this year staying in caravans. This visit took place over lunch- time, this was an enjoyable and relaxed meal taken in the dining room. Residents had chosen to eat together and change one of the lounges into a dining room following consultation and discussion. Menus were planned with residents’ preferences in mind and residents were involved in the preparation of meals according to risk assessments and care planning. The manager and staff have sought the views of residents and balanced the needs of individuals with living as a group, fully involving residents in the planning of daily routines and activities. The home therefore provides an excellent service in this area. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support and healthcare needs are met in the manner in which residents prefer and in accordance with assessed need EVIDENCE: Care planning clearly underpins the personal support that is given to residents. Regular health care check ups were planned and documented and any action was recorded with the outcome. Changes in residents needs were recorded and communicated to staff via handovers and daily records. Nutrition, skin care and weight were reviewed regularly and staff responded to any concerns noted. Some residents were being supported to give up smoking and healthy living was promoted. Residents were reliant upon staff to assist with the administration of medication. Medicines were stored in a separate locked area. Staff had recently completed a certified training programme regarding the safe handling and administration of medicines. This served to safeguard residents. Policies and procedures were in place that was appropriate to the setting. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training, policies and procedures were in place that assisted in the promotion and protection of residents’ rights. EVIDENCE: A pictorial complaints procedure was in place that was appropriate for the needs of those residents accommodated. A comprehensive written complaints procedure was also established. No complaints had been received by the home or the CSCI since the last inspection of the service. Policies and procedures in the home regarding safeguarding adults assisted in the protection of residents. Staff have attended training regarding abuse awareness and the procedures to follow if they were concerned about the welfare of a resident. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A homely, comfortable and personalised environment was provided that suited the needs and lifestyle of those residents accommodated. EVIDENCE: Cedar Lodge was well maintained and was generally decorated to a high standard with the exception of those areas designated as being in need of decoration this year. There is a homely atmosphere and residents felt free to go in any of the communal areas provided. The internal areas were clean and hygienic with dedicated cleaning hours being provided. The home is situated on a main bus route providing access to the nearby town and villages. Residents’ personal accommodation has been decorated according to the tastes of each person and residents have their own belongings arranged in the way that they want them. Two residents wanted to show the Inspector their bedrooms which were both furnished according to the preferences of that person. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are appropriately trained in order to meet the needs of residents. EVIDENCE: Training records were provided that supported the Inspectors observations that staff were well trained and knew the needs of residents well. Staff have accessed a range of training including moving and handling, fire safety, first aid and the safe administration of medicines. A structured induction and foundation programme was in place. Discussions with staff indicated that their first two days on duty were for observation purposes only and then they followed a programme of supervision and support. Staff said that this gave them a chance to really get to know residents and the induction programme had been of benefit. More than 50 of staff held a care NVQ 2 or 3 and there was a strong commitment to training and development throughout the staff group. A thorough recruitment procedure was operated that included obtaining a completed CRB and POVA First check and an interview process. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place that contribute to the home fulfilling its stated purpose and objectives and meeting the needs of the residents. EVIDENCE: The Registered Manager has worked at Cedar Lodge for many years and knows the residents well. Warm and positive relationships were demonstrated between staff and residents who were relaxed and felt comfortable expressing their choices and preferences. The Registered Manager has achieved NVQ 4 in management and care and has continued to further her training. An established quality assurance system was in place with monthly, unannounced visits being undertaken by the provider. The Manager was in the process of completing an audit with points for action in preparation for the forthcoming year. A strong overall management system was in place with regular meetings being held to discuss development. Resident questionnaires Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 Page 17 were completed annually and action taken on any comments, this also tied in with the residents meetings. Certificates of maintenance were kept in good order and up to date including those for gas safety and electrical safety. Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 Page 18 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 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 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 Page 19 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. 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. Refer to Standard Good Practice Recommendations Cedar Lodge DS0000019958.V336565.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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