Inspection on 06/10/05 for Cedar Lodge

This inspection was carried out on 6th October 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 Lodge 26/03/08

Cedar Lodge 24/11/06

Cedar Lodge 12/05/05

Cedar Lodge 20/09/04

Cedar Lodge 26/07/04

Cedar Lodge 05/01/04

Similar services:

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Insight - Eastchurch

Southfields

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33 St John`s Church Road

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

CARE HOME ADULTS 18-65 Cedar Lodge Cedar Lodge Chapel Road Charlwood Surrey RH6 0DA Lead Inspector Mary Williamson Announced Inspection 6th October 2005 10:00 Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Address Cedar Lodge Chapel Road Charlwood Surrey RH6 0DA 01293 862050 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) Ashcroft Care Services Ltd Mr Dominic Charles Wayland Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 18-40 YEARS 12th May 2005 Date of last inspection Brief Description of the Service: Cedar Lodge is a large detached home in very pleasant well kept grounds, situated in a residential area in the village of Charlwood. It is close to all local facilities and main services, with local shops within walking distance. The home offers accommodation on two floors for up to six service users with learning disabilities. There are six large single rooms, dining room, kitchen, sensory room, two toilets and two bathrooms. There is ample parking and the home has its own transport. The service users have complex needs. All service users are placed by local authority and have regular reviews. Ashcroft Care Services owns and manages the home together with a number of other homes in the area. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and the second in The Commission for Social Care Inspection programme year 2005 to 2006. Mary Williamson the lead inspector for the service undertook the inspection over a period of five hours. The registered home manager Mr. Dominic Wayland was present throughout the inspection. There are currently four service users living in the home and the inspector had the opportunity to meet with all of them. Communication was through sign language, gestures and individual signs with the help of staff. All the service users were well cared for by a team of staff who had a good understanding of their assessed needs. There was a relaxed and homely atmosphere in the home. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. There were no relatives or friends visiting the home during the inspection. One relative comment care and one visiting professional comment card were received. Both of these cards had good positive feedback. The staffing levels are high with some service users needing one to one or two to one support to meet their daily assessed activities. A group of service users went for a short drive and one service user went shopping for new clothes during the day. The staffing levels are high as some service users require one to one or two to one support to carry out their daily assessed activities. During the day some service users went for a short drive and one service users went shopping for new clothes. The inspector would like to thank the manager, service users and staff for their time, assistance and hospitality during the inspection. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 7 The lounge has a fire- place, which is not in use. This has been identified as a potential trip hazard and covered with a mattress for the safety of the service users. Consideration should be given to removing this during the refurbishment of the lounge or make this safe by providing a fire safety guard. The home also needs to provide a new carpet and curtains for the lounge. The seal behind the kitchen sink must be replaced as this is cracked and a health and safety issue. The ground floor bathroom needs to be re-commissioned as soon as possible. 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 DS0000013586.V257293.R01.S.doc Version 5.0 Page 8 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 DS0000013586.V257293.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, and 5. Prospective service users have the information necessary to help them, with support from their relatives to make an informed choice about where they want to live. Trial visits are offered to support this information. EVIDENCE: The home has a statement of purpose and service user guide in place. Each service user has a copy of this in their bedroom. There is a comprehensive assessment process followed prior to admission. The clinical specialist for the organisation undertakes this. A discussion then takes place with the home manager to discuss the suitability of the placement and if the assessed needs can be met. Trial visits are offered. This can be for a meal or an overnight stay. Several visits can be organised if necessary. Individual contracts of occupancy are in place, and are signed by the service user or their designated representative. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, and 8. Service users would have difficulty to understand if changing needs are reflected in care plans but the manager and staff monitor this and record changes when necessary. Staff support service users to make choices about daily living. EVIDENCE: Individual care plans are in place. These are based on input from service users whenever possible, relatives, and the pre admission needs assessment. The care plans were sampled during the inspection and with the exception of one were well documented, informative, and reviewed regularly. The funding authorities organise yearly reviews. One care plan needs to be updated and reviewed to include appropriate details of the home. The service users have very low levels of understanding and their communication skills are poor. However with staff support they are encouraged to make decisions about their daily lives. For example staff were seen to gesture and use simple signs to indicate meal times, outings, and activities, which were responded to by service users. Service users point to various objects to communicate needs, for example cup, coat, TV, toilet and Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 11 mini bus. The staff have a good understanding of the service users needs and it was evident that they have received training in communication skills. Makaton sign language is part of the staff development programme. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, and 17. Personal development programmes support service users to participate in appropriate leisure and community activities. Family links are promoted and maintained. The catering arrangements suit the service users needs and lifestyle. EVIDENCE: The service has developed individual programme of activities based on personal needs and choice. Staff support service users to follow these programmes on a one to one or two to one basis. These are monitored and reviewed regularly. Activities and community links include personal shopping, cinema, swimming, bowling, local pub visits, walks in the Local Park, group music, sensory room activities, board games and long drives in the country. Family links are encouraged and maintained. Relatives are encouraged to take an active part in the care planning process and are also invited to attend reviews of care. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 13 Staff, with the knowledge of service users likes and dislikes, plans the menus weekly. The choice of meals suite the age and lifestyle of the service users. Lunch was observed and consisted of soup, bread rolls, fruit and tea- cakes. The main meal is served in the evening. Sometimes the service users like to eat out and this is included in the activities programme. The menus were seen and the choice of food is wholesome and appetising. The kitchen is showing signs of wear and tear. The seal behind the sink needs to be replaced as this can harbour infection. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, and 19. Service users healthcare needs are seen to be appropriately met, by the systems in place. EVIDENCE: Sensitive personal support is provided to service users, as outlined in individual care plans. The staff group have a good understanding of the assessed needs of the service users. One service user is registered with a GP in Horley and three service users are registered with a GP in Newdigate. The special needs dental department at the East Surrey Hospital provides dental care. Chiropody treatment is provided by home visits. There is access to psychology and psychiatric support when required. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23. The home has a satisfactory complaints system in place. The organisation has an abuse awareness policy in place, which protects the service users. EVIDENCE: The complaints procedure is available to all service users who relay on staff or relatives to complain on their behalf. There have been no complaints since the last inspection. Abuse awareness training is provided to all staff in accordance with the homes policies and procedures. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 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 the following standard(s): 24, 25, 27,28, and 30 The general standard of the environment within the home varies. Generally the home provides a homely and comfortable atmosphere for the service users with a to live in. The bathroom on the ground floor is currently out of use. EVIDENCE: The home is very spacious and comfortable for the service users. It has a large lounge, dining room and sensory room with unrestricted access. However the lounge carpet is stained and worn which needs to be replaced. The fireplace and kerbstone are blocked with a mattress to prevent injury to service users. This needs to be removed, or made safe with a fireguard. The lounge walls have been decorated with murals which have been hand painted by a staff relative. One service user was able to point this out to the inspector. All the service users bedrooms are decorated and furnished to a good standard. These have been personalised to reflect individual personalities. There was a recent flood in the ground floor bathroom. This bathroom is currently out of use for repair and refurbishment. There is another bathroom on the first floor, which is currently being used by all in the interim. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 17 The home is clean and free from odour. The radiator cover in the front hallway needs to be repaired. There is a large enclosed back garden with garden furniture and a swing. This is well maintained and enjoyed by service users. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, and 36. The staff team in place offers consistency of care and support to the service users within the home. Staff are clear about their roles and mandatory training is in place. EVIDENCE: On the day of the inspection there were four service users living in the home and they were supported by six staff. Two service users have a package of care, which included a one to one ratio for all daytime activities. The duty rota reflected the assessed needs of the service users. The staff also undertake cleaning and cooking duties. They all have a job description and a contract of terms and conditions of employment. The deputy manager and three staff are undertaking NVQ Level 3. The two most recent members of staff confirmed the induction training they had received and this was also documented in professional development files. The organisation operates a good recruitment procedure. Three staff employment files were sampled, and all had the required documentation in place. All staff have a current CRB disclosure in place. All staff have formal supervision and staff spoken to confirmed this. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 19 Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 41, and 42. The home is well managed. Environmental issues identified in the report do not promote the health and safety of service users. The standard of record keeping is good. EVIDENCE: The home now benefits from a registered manager since the last inspection. He is currently undertaking his NVQ Level 4 in management. There is a positive and inclusive atmosphere in the home and staff stated that regular house meetings take place when everyone can air their views. Records relating to service users are well maintained and are kept secure in an upstairs office when not in use. Health and safety policies and procedures were seen during the inspection. Risk assessments are in place for all identified risks. The broken radiator cover in the hallway, the cracked water seal behind the kitchen sink and the kerbstone from the fireplace in the lounge must be risk assessed and acted upon. Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 21 Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 22 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 X 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X 2 2 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 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 3 3 X X 3 2 X DS0000013586.V257293.R01.S.doc Version 5.0 Page 23 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 6 Regulation 15(2)(b) Requirement The registered manager must ensure that service users care plans are kept under review, to include updating information. The registered person shall ensure that there are adequate numbers of bathrooms in the home for service user use. The registered person shall ensure that the home is kept reasonably decorated. The registered person must ensure that potential risks to service users health and safety are addressed. For example the hall radiator, kitchen sink and fire place kerb- stone. Timescale for action 30/11/05 2 27 23(2)(j) 30/11/05 3 4 24 and 28 17 and 42 23(2)(d) 13(4)(a) 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cedar Lodge DS0000013586.V257293.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 DS0000013586.V257293.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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