Inspection on 27/04/05 for Cedar Lodge Nursing And Residential Home

This inspection was carried out on 27th April 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 Nursing And... 19/04/07

Cedar Lodge Nursing And... 05/09/05

Cedar Lodge Nursing And... 20/10/04

Cedar Lodge Nursing And... 18/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Cedar Lodge Nursing and Residential Home St Catherines Road Frimley Green Camberley, Surrey GU16 6PY Lead Inspector Mavis Clahar Unannounced 27 April 2005 @ 13:45 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Nursing and Residential Home Address St Catherines Road Frimley Green Camberley Surrey GU16 6PY 01252 837019 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) Forest Care Limited Mrs Jane McAuley CRH - Care Home 63 Category(ies) of OP - Old Age (62) registration, with number of places Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 - Up to 49 of 63 beds may be used for the provision of nursing care for older people from the age of 60 years. Date of last inspection 20th October 2004 Brief Description of the Service: Cedar lodge is a purpose built nursing and residential home, set in its own landscaped gardens. The home is surrounded by woodland and created an atmosphere of peace and tranquility. The home is privately owned and is managed by forest Care Ltd. Accommodation is mainly in single rooms with en-suite faacilities, although there is capacity to accommodate couples in shared bedrooms. The home is situated in the outskirts of Frimley Green in a quiet location, with ample car parking facilities. All around the home, there is excellent access to the garden for wheelchair users. Seating is strategically placed for the comfort and privacy of service users and their visitors. The home cater for Older People with nursing or residential needs. There is a variety of aids and equipment around the home to enable service users to move around independently. Toileting facilities are strategically placed within easy distance of communal areas. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection to be undertaken in the Commission for Social care Inspection year April 2005 to march 2006. This unannounced inspection took place on the 27th April 2005; that means no one at the home was aware of the inspection. The inspector arrived at 13 45 hours at the end of service users lunch, but was able to observe staff interacting with service users, serving tea and helping service users to retire to the living room in preparation for the afternoon activity. The Pianist arrived, and the inspector joined the service users in the lounge who were singing along to songs such as “You are my Lilly and my rose”. Service users requested songs mostly from Fred and Ginger Rogers dance music. One particular service user had a magnificent singing voice, and when the inspector complimented her on her singing she said, “I used to sing and dance in my young days”. The inspector was able to shadow staff members after gaining the consent of the service users. The inspector observed staff attending to service users in a polite and respective manner, and a good rapport was seen between staff and service users. The inspector formed the opinion that service users were happy and confident in the care of the care workers. During the inspection the inspector spoke with service users, relatives of service users, care staffs the Chef and the manager. A tour of the home and gardens was also conducted. Staff files and service users files and staffing rotas were reviewed. What the service does well: The atmosphere of the home is relaxed and friendly. Service users appear to be happy and contented and this is reflected in a number of complimentary letters the home received from relatives of service users. Service users relatives spoken to on the day of inspection, spoke highly of the care their relatives were receiving. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 2 3 The home is operating effectively in regards to the standards inspected. The open and transparent style of management coupled with the genuineness of the staff would aid prospective service users and their relatives to make an informed choice as to the suitability of the home. EVIDENCE: The home continually reviews the service user’s guide and statement of purpose and copies are sent to CSCI. The inspector reviewed service users assessments and care plans, which demonstrated the homes’ ability to meet the assessed caring needs of service users. Following assessment the service user is allocated a named carer and nurse with the necessary skills to provide care based on the assessed needs. Where there is an identified gap in the care workers knowledge, this is rectified through the training budget. Care staff told the inspector “I work from care plans which are regularly updated and reviewed with the service user, I ensure care is given to the best of my ability. Standard 6 does not apply to this home. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 8 9 10 Service users’ plan of care sets out clearly actions to be taken by care workers to ensure the assessed care needs of the service users are met. The service users health is monitored regularly, and preventative and restorative care provided accordingly. EVIDENCE: A sample of service users care plans including risks assessments were reviewed. These were reviewed updated and signed following discussion with service user, relative or care manager if applicable. Service users with behavioural problems are referred to the Ridgewood centre for assessment by the psychogeriatrition. It was noted that some service users used the home’s GP whilst others had their own GP. The home utilizes the services of the domiciliary opticians, but whilst dentist and chiropody service are available, to the home and able service users are escorted to their surgeries. Service users relatives spoken to on the day of inspection all said they were happy with the care given to their relatives and that they were regularly consulted on the care or any changes. The service users themselves supported this. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 10 The inspector was told that registered nurses conduct the drug round, which is administered within the guidelines set by the Nursing and Midwifery Council. The inspector observed that the monitored dosage system is in use at the home. Staff questioned about this system expressed their satisfaction with the system as it lessens the degree of errors. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 14 Service users maintain contact with family, friends and the local community as they wish. Service users have autonomy and can exercise choice in their lives. EVIDENCE: The inspector was told the home operates an open visiting policy. The inspector observed that service users with visitors spoken to on the day of inspection were entertaining their visitors in private in their bedrooms. One visitor said that her relative sometimes have lunch at the local pub, as the relative was from the area and used to visit the pub with her late husband as a couple in times past. In discussion with staff the inspector was told that staff regularly helps service users to make choices for example dietary choices especially service users with diabetes. Service users are encouraged to bring personal items with them when they are admitted into the home, and this is reflected in their bedrooms. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 17 18 The homes’ complaint procedure is adhered to. Robust procedures are in place for responding to suspicion or evidence of abuse or neglect. Service users are aware of their right to complain. EVIDENCE: The home’s complaint policy and procedure was reviewed and was found to be satisfactory. At the time of inspection no complaints were received since the last inspection. Service users said they knew how to complain if they wished to do so. Service users who express a wish are encouraged to participate in the local and general elections. Those not using the postal system are escorted to the poling station on the day. Staffs spoken to were all aware of the homes’ adult protection policy and the whistle blowing policy and how to use them. They informed the inspector that they have been trained to recognise, report and document any instances, which they think is not suitable care for service users. Review of random sample of staff records revealed that staff are trained and have yearly update on recognising abuse. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 20 21 22 23 24 25 26 The home is in good decorative order, is warm and comfortable and presents as a homely and comfortable environment for the service users. EVIDENCE: The layout of the home is on two floors, with spacious well-ventilated bedrooms, each with en-suite facilities. Assisted bathing facilities with bath hoist are situated on each wing of the building. Service users personalise their bedrooms with their favourite paintings, family pictures and items of furniture. The home offers two sitting rooms with views to the patio and gardens, which are all accessible to wheelchair users. There is also one dining room and a hairdresser’s room to which service users can retire for quiet time. On the day of inspection service users were observed walking around the home’s communal areas without hindrance. The doorways and corridors are wide enough to allow easy access for wheelchair users. It was also noted that specialist nursing beds and grab rails were in place to promote the lifestyles of the service users. The home is clean, pleasant and free from offensive odours. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 29 30 The procedure for the employment of staff are robust and provides safeguards to offer protection to service users living in the home. The employment, category and number of staff available over a twenty-four hour period is sufficient to meet the needs of the current numbers of service users. EVIDENCE: The staff turnover in this home is relatively low. Staff spoken to on the day of inspection all said they were happy in their post, and have been in post for a number of years. Overseas carers are encouraged and enabled to study English language and a number of them are waiting to take their examination in a few months time. Criminal Records Bureau checks have been undertaken for all staff to ensure protection of service users. A random sample of staff files reviewed, revealed two references are available on file for each staff member, signed contracts are also included in their personal files, which also contained up to date record of training undertaken, and training planned with dates for training. Service users and their relatives spoken to say that staffs at the home were kind and caring, and that they had their own personal nurse and carer to whom they feel confident in asking anything. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 37 38 The Manager is supported well by senior management to provide a strong leadership; guidance and direction to staff, to ensure service users receive a consistent quality care. EVIDENCE: Information gathered from staffs, service users and relatives indicated that the manager was accessible and very supportive. The results of the Quality Audit conducted in January 2005 showed a vast improvement in the excellent responses, and a major decrease in the poor responses. Service users, relatives and staff made positive comments about the running of the home, care delivery and the general cleanliness of the home. Staff confirmed they had undertaken training regularly, and one registered nurse told the inspector that identified training deficit is discussed at supervision and is rectified as soon as a place is available on the course. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x x 3 3 Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 17 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement No requirement was issued on this inspection. 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. 1. Refer to Standard 38.3 Good Practice Recommendations To contact Surrey Vulerable Adults Team regarding the assessed vulnerbility of service users and staff as a result of the behaviour of one service user. Cedar Lodge Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 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 Nursing and Residential Home H58 H09 S17597 Cedar Lodge V223441 260405 Stage 4.doc Version 1.30 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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