Inspection on 06/02/07 for Cedar Lodge

This inspection was carried out on 6th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 10/12/08

Cedar Lodge 08/01/08

Cedar Lodge 26/06/07

Cedar Lodge 16/05/06

Cedar Lodge 18/10/05

Cedar Lodge 17/05/05

Cedar Lodge 27/10/04

Cedar Lodge 15/09/04

Cedar Lodge 18/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOMES FOR OLDER PEOPLE Cedar Lodge Hope Corner Lane Taunton Somerset TA2 7PB Lead Inspector Jane Poole Unannounced Inspection 6th February 2007 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 Lodge DS0000059128.V326075.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 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 Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Address Hope Corner Lane Taunton Somerset TA2 7PB 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) 01823 286158 N Notaro Homes Limited Care Home 59 Category(ies) of Dementia - over 65 years of age (59), Old age, registration, with number not falling within any other category (59) of places Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. Registered for 59 persons in categories OP and DE(E). Numbers to include three service users between the ages of 55 and 65 years. Room 31 to used for ambulant independent service users only. Rooms 14 and 9 to only be used for service users with minimal moving and handling needs. Service users accommodated in rooms 43; 44; 45 must be continually assessed as to their mobility needs as these are only accessible via the stairs. The home to monitor dependency levels of service users overnight and increase night staff numbers accordingly when it reaches 45 service users. The home will ensure there are 4 suitably competent care staff working overnight when it reaches a capacity of 50 service users and 5 when it reaches 58 service users. The home to ensure social care hours are increased to at least 45 hours when it reaches 53 service users and at least 50 hours when it reaches 59 service users to allow for one-one social care. 16th May 2006 Date of last inspection Brief Description of the Service: Cedar Lodge is a large, detached, extended property, set in good size grounds in a quiet residential area, approximately 1.5 miles from Taunton town centre. The home is Registered with the Commission for Social Care Inspection (CSCI) for up to 59 service users over the age of 65 years, including people who require care due to a dementia. Notaro Homes Ltd owns the home. There is currently no registered manager but the manager in place at the home has applied to be registered with the Commission for Social Care Inspection. Amenities are close at hand, including a Post Office, shops and pubs. Service user accommodation is on three floors. Bedrooms are found on all three floors, a lift gives access to all but 3 of the bedrooms, which are Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 5 approached by a staircase. The current fee level at the home ranges from £361.00 to £421.00 per week. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors over an 8 hour period. The inspectors were able to spend time talking with the manager, staff and service users. All records requested were made available. The inspectors were given unrestricted access to all areas of the home and were able to observe care practices throughout the day. Prior to the inspection the inspectors received comment cards from 5 members of staff and 5 visitors/relatives. Some of the comments have been incorporated into this report. Since the last inspection the inspector has been made aware of complaints made and has attended a Vulnerable Adults strategy meeting in respect of one service user. One random inspection has been undertaken since the last key inspection. What the service does well: Many of the service users living at Cedar Lodge are unable to fully express their views and opinions. The inspectors spent much of the day observing service users and care practices. The majority of service users appeared content and animated. There is a full activities programme that covers a range of interests. During the day people were seen to be playing bingo and knitting. Service users moved freely around the home and had unrestricted access to their personal rooms and all communal areas. Visitors/relatives who completed comment cards stated that they were always made welcome and were able to see their friend/relative in private. There is suitable storage for medication and all senior staff have received training in this area. The inspectors viewed the Medication Administration Records and found them to be well maintained and correctly signed when administered or refused. There is evidence that service users have access to healthcare professionals appropriate to their needs. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Assessments and care plans show that the majority of people living at the home require care and support because of a dementia, however there is no ongoing training programme for staff in dementia care. Some service users also exhibit behaviour that can be verbally or physically aggressive and again there is no training programme in this area. The inspectors spent time observing the main meal of the day. Although the quality of food appeared good it was unclear how service users were assisted to make a choice. Two service users were assisted to eat in a way that was rushed and undignified. The main meal of the day was not a pleasant social occasion, people were kept waiting for some time and people sitting at the same table were not served at the same time. There was no salt, pepper or sauces available to service users. Complaints made have highlighted the need for all staff to receive training in the Protection Of Vulnerable Adults and this has now been arranged. Although the home have co-operated fully in the investigation of any allegation of abuse there do not appear to be robust procedures in place for the reporting and investigating of complaints and allegations. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 8 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 DS0000059128.V326075.R01.S.doc Version 5.2 Page 9 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 Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&4 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff do not receive appropriate training to meet the needs of service users admitted to the home. Intermediate care is not provided. EVIDENCE: The manager sees and assesses all prospective service users before a place is offered at the home. The inspector viewed the personal file of the most recently admitted service user. In addition to an assessment carried out by the manager, the home had also obtained a copy of a full assessment carried out by professionals outside the home. Assessments seen clearly stated that prospective service user had a dementia and associated needs. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 11 Staff spoken to stated that they had not received training in the care of people who have a dementia. Care plans and assessments viewed showed that some service users display behaviour that is verbally or physically aggressive. Staff again felt that they had not received adequate training to deal appropriately with these situations. One member of staff wrote in their comment card “sometimes we are put in situations where service users become aggressive and we have no training on how to deal properly with this.” Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The policies and procedures for the storage, handling and administration of medication are robust and promote safe practice. Care plans in the home have improved and now giver clearer guidance to staff. EVIDENCE: Since the last inspection the new manager has begun to update the care plans in the home to ensure that they are individual to the service user. The inspectors viewed four care plans in detail. Updated care plans showed a marked improvement on the previous format. They covered areas such as physical health, communication, social activities and mental health needs. All areas of need identified showed the intervention to be carried out and the aim of the intervention. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 13 Staff write running records on a daily basis, these records were poorly written and did not give clear details of the interventions carried out. It is therefore difficult to ascertain how the effectiveness of the care plan will be monitored. Personal files contain details of assessments carried out in respect of tissue viability, nutrition and behaviour. Two risks assessments carried out identified that service users displayed behaviour, which was verbally or physically aggressive, as previously stated staff have not received appropriate training to deal with these behaviours. There was evidence in the care plans that service users were accessing healthcare professionals outside the home and all appointments are recorded. There are adequate toilet and washing facilities around the home to ensure that personal care is carried out in private. All five visitors/relatives who completed comment cards prior to the inspection answered YES to the question “Can you visit your friend/relative/client in private?” The inspector observed the main meal of the day and noted that two people who required support with eating were assisted in a very undignified manner. The home uses a Monitored Dosage System for medication. There are appropriate storage facilities, including storage for medication that requires refrigeration and controlled drugs. All senior staff who administer medication have received training in this area and those spoken to felt confident in this role. Medication Administration Records (MARs) were viewed and these were well kept and correctly signed when administered or refused. The inspector viewed a sample of controlled drugs and found that records kept correlated with medication held. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the quality of the food appeared good the main meal of the day was not a pleasant social occasion. Friends and family are welcomed into the home at any time. EVIDENCE: Many of the service users living at the home are unable to fully express their views or opinions. The inspectors observed that people who were physically mobile moved freely around the home. There are numerous small lounges and seating areas and people were able to choose where they spent their time. During the day it was noted that some service users in the main lounge were encouraged to join in with organised activities, many service users appeared Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 15 content to sit at the front of the home watching the comings and goings, whilst others seemed happy to spend time in their rooms. In the afternoon some people were being assisted to knit by the activity worker. One person came to sit with the inspector and bought their knitting with them. Although they appeared to be enjoying the activity, the knitting was removed when the formal session ended. Since the last inspection the home has increased activity worker hours in the home by 15 hours a week. There are now two activity workers each morning and one person in the afternoon. Unfortunately at the time of this inspection one of the workers was on holiday. The home has begun to write pen pictures and life histories with the assistance of family. One member of staff stated that they found the life histories very useful because it helped to know the sort of things that interested the service user and helped with conversations. One service user spoken to stated that they went out for a walk with a member of staff everyday. All five visitors/relatives who completed comment cards prior to the inspection answered YES to the question “Do the staff/owners welcome you into the home at anytime?” There is ample communal space in the home meaning that service users are able to see visitors in private if they wish to. The main meal of the day is at lunchtime. The menu is displayed in the dining room, but it is not clearly visible to service users. The inspectors observed lunch. People were sat to the table for some time before the meal was served. The food was well presented and appeared to be enjoyed by the majority of service users. The inspectors noted that whole tables were not served at the same time meaning that one person may have their meal 15 minutes before the other people at the same table. A comment from one member staff to the inspector when asked about why some service users received their meals before others was “we serve the softs and slows first”. Although not all staff may share this attitude of expression it is a reflection on how staff perceive the service user with dementia. This attitude is undignified and abusive towards vulnerable adults. This evidence also supports the Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 16 inspectors judgement that the homes vulnerable adult procedures are not robust to ensure the protection of the service users. The manager is encouraged to monitor and discuss attitudes and comments at staff supervision sessions. Care staff offered people a choice of two drinks at the table but it was not clear how people chose their meal. When the inspectors questioned how the choice was made, one carer stated “I think the activity person asks them” another said “ we give them what we think is best” and another person said “They get asked before they have their dinner.” The comments are evidence that the mealtime is not a social occasion or carried out with a person centred focus. The inspector observed one member of staff assist two people to eat their lunch. The staff member initially mixed the whole of the dinner on the plate together to create a very unappetising ‘mush’, then sat between the two service users and physically fed them both at the same time. This was very hurried and extremely undignified for the service users. There was no salt, pepper or other condiments on the tables for people to help themselves to. Although the food served was well presented and appeared nutritious the lunchtime was not a pleasant social occasion. The staff appeared to treat the mealtime as a ‘task’ that had to be got through. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The systems in place do not adequately protect service users from abuse. EVIDENCE: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. All staff spoken to during the inspection were aware of the whistle blowing policy. In the last 6 months the home has received 4 complaints. One of these has resulted in the referral of a member of staff to the Protection Of Vulnerable Adults register and another resulted in a Vulnerable adults strategy meeting. The home have co- operated fully in the investigation of any allegation of abuse but do not appear confident and robust in their investigating and reporting procedures. At a vulnerable adults strategy meeting held in December 2006 the need for ongoing training in the care of people who have a dementia and working with Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 18 people who display challenging behaviour was highlighted, as was the need for staff to receive training in recognising and reporting abuse. Also for the manager to have training in the protection of vulnerable adults and the investigation of complaints. The manager stated that all staff would be attending training in the Protection Of Vulnerable Adults in the coming weeks. Recruitment files viewed showed that all staff are checked against the Protection Of Vulnerable Adults (POVA) register. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23 & 26. Quality in this outcome area is adequate.. This judgement has been made using available evidence including a visit to this service. Cedar Lodge provides a clean safe environment for service users but it is not enabling for people with a dementia. EVIDENCE: The home is located in a quiet residential area. It is within walking distance of a small park and convenience store. All areas of the home are fitted with a fire detection and call bell system. Service user accommodation is set over three floors with a passenger lift between. There are three rooms that can only be accessed by stairs. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 20 Whilst touring the building the inspectors identified two rooms where the doors open beside small flights of stairs. The home needs to risk assess these rooms to ensure that the occupants are not at risk of falling down the stairs. Two service users currently share one bedroom, there is no documented evidence to suggest that the occupants made a positive choice to share a room. One of the service users spoken to told the inspector that they would like a room of their own. There is a variety of communal space in the home including safe accessible gardens. Since the last inspection the home have made some improvements to make the building more homely. Pictures and ornaments have been placed in communal areas. Some signage has been provided to assist service users to identify their personal rooms. Corridors and communal rooms in the home are all the same colour and therefore to not assist service users with dementia to orientate themselves. At the time of this inspection all areas seen were reasonably clean and odour free. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff do not have the skills to meet the needs of the current service user group. The recruitment systems in the home are robust. EVIDENCE: The home employs 33 care staff and 8 ancillary workers. Two members of the care staff team have a National Vocational Qualification (NVQ) at level 2 or above. A further 7 members of the team have overseas qualifications equivalent to NVQ level 3 in care. Staff spoken to felt that training opportunities had improved since the new manager had been employed. New staff said that they were happy with their induction. As previously stated staff have not received training appropriate to the needs of the current service user group. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 22 The inspectors observed undignified practice at lunchtime and received comments that suggested a severe lack of understanding amongst staff of persons with a dementia. The inspectors reviewed the accident records and discussed several incidents involving extremes of behaviour between staff and service users. The evidence indicates a clear lack of skill, knowledge and experience amongst staff groups in caring for persons exhibiting varying types of behaviour. The registered person is also encouraged to develop a working knowledge of the Mental Capacity Act 2005, and to relate this to staff in an accredited training programme. Only two members of staff have an up to date first aid certificate. The home operates with 9 care staff on duty in the morning, 8 in the afternoon and 5 overnight. The managers and all ancillary hours are in addition to this. All 5 members of staff who completed comment cards prior to the inspection answered YES to the question “Is there always a senior member of staff to confer with?” The inspectors viewed the recruitment records of the three most recently appointed members of staff. All contained all required information including written references and enhanced Criminal Records Bureau checks. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is currently no registered manager at the home but the current manager has applied to be registered with the CSCI. EVIDENCE: There is currently no registered manager at the home, however a manager has been appointed who has applied to be registered with the CSCI. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 24 The manager has now been in place for 5 months and during this time has begun to make positive changes in the home including revising paperwork, arranging training for staff and improving morale within the staff team. Staff spoken to felt that the new manager was approachable and fair. One person wrote on their comment card “Since the new manager has started I feel I get the support I personally need.” The manager has begun to issue quality assurance questionnaires to gauge the views of service users and their visitors. Results of these are not yet available and will therefore be viewed at the next inspection. Meetings for service users, relatives and staff have also been set up. Staff felt that the meetings were an opportunity to express their opinions as well as receive information. The home does not act as an appointee or power of attorney for any service user. Small amounts of personal allowance are held by the administrator and records are kept of all transactions. As previously mentioned risk assessments need to be carried out on the service users living in rooms that open on to stairs. During the tour of the building it was not that one upstairs window was not restricted posing a potential risk to service users. A fire log is maintained, it showed that fire alarms are tested weekly and extinguishers and emergency lighting is checked on a monthly basis. The manager gave assurances that all staff have received training in fire safety although records of these sessions was not comprehensive. All accidents are recorded and the manager analyses these on a monthly basis. Up to date servicing certificates for equipment were seen. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 25 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 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 3 x x 2 x x 3 STAFFING Standard No Score 27 2 28 1 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score N/A 3 2 X 3 X X 2 Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 26 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 OP3 OP4 OP27 OP30 OP10 OP15 OP18 Regulation 18 (1) Requirement The registered person must ensure that all staff are suitably qualified, experienced and competent to meet the needs of the service user group. Timescale for action 31/03/07 2 12(4) [a] 3 13 (6) 4 OP38 13(4) 5 OP38 13(4) 6 OP38 13(4) The registered person must ensure that service users are assisted to eat in a way that respects their dignity. The registered person must ensure that appropriate measures are in place to minimise the risk of abuse to service users. This includes ensuring all staff are adequately trained. The registered person must carry out risk assessments in respect of service users living in rooms were doors open by the top of the staircase The manager must ensure that all windows above ground floor level are restricted to prevent risks to service users. The registered person must ensure that adequate numbers DS0000059128.V326075.R01.S.doc 28/02/07 28/02/07 28/02/07 28/02/07 15/04/07 Cedar Lodge Version 5.2 Page 27 of staff are trained in first aid. 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 6 Refer to Standard OP7 OP14 OP15 OP16 OP18 OP23 OP28 Good Practice Recommendations The registered person should ensure that written daily records are reflective of the care given to service users. Registered person should ensure that choices are offered to service users in respect of meals. The registered person should ensure that mealtimes are unhurried and allow service users adequate time to eat. The manager should undertake training in the protection of vulnerable adults and the investigation of complaints. Bedrooms should only be shared by service users who make a positive choice to do so. 50 of care staff should have a National Vocational Qualification at level 2 or above. Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. Extracts may not be used or reproduced without the express permission of CSCI Cedar Lodge DS0000059128.V326075.R01.S.doc Version 5.2 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!