Inspection on 07/06/05 for Cedar Lodge Nursing Home

This inspection was carried out on 7th June 2005.

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 Nursing Home 26/08/08

Cedar Lodge Nursing Home 01/08/07

Cedar Lodge Nursing Home 15/08/06

Cedar Lodge Nursing Home 10/01/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Cedar Lodge 58-62 Kingsbury Road Edington Birmingham B24 8QL Lead Inspector Kath Strong Unannounced 7th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Address 58-62 Kingsbury Road, Erdington, Birmingham B24 8QJ 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) 0121 350 3553 0121 384 8411 United Care Ltd Care Home 36 Category(ies) of Dementia - Over 65 - Old Age (36) registration, with number of places Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the Home is registered for nursing care for a maximum of 36 service users for reasons of old age (OP) 2. That a temporary nurse manager will be employed on a full time basis within the home until a permanent manager (subject to registration) is employed. 3. That in addition to the manager there is a minumum of one first level nurse and five care staff on duty throughout the waking day (14hrs). 4. That at night there is a minimum of one first level nurse and two care staff on duty each night. 5. Ancillary staff are to be employed in addition to the minimum staffing levels to cover catering, laundry and cleaning. 6. Issues in respect of the premises are to be addressed within timescales asagreed with Mr Patel. Date of last inspection 18/01/05 Brief Description of the Service: Cedar Lodge is a three storey property situated within the residential area of Erdington, West Birmingham. The home provides nursing care for up to 36 persons who are aged 65 years or over and may suffer from dementia, physical disabilities or terminal illness. The home is situated approximately one mile from Erdington centre where the main shopping facilities are located and a short distance from Sutton Coldfield. There is public transport within close proximity and Gravelly Hill interchange is convenient for those travelling by car. There is ample off road parking to accommodate at least seven vehicles situated at the front of the premises. Bedroom accommodation is available on each of the three floors, there are both single and shared rooms and some have en-suite facilities. The communal areas are located on the ground floor. The property has an extensive rear garden, which lends itself to outdoor functions during clement weather. The fabric of the home provides good potential for further development. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose for the visit was to conduct an unannounced inspection, which took place over a period of one day. The inspection focussed mainly upon the progress made by the home since the change of ownership, which took place mid February of this year. Throughout the visit in depth discussions were held with the quality assurance manager and the newly appointed manager of the home. The homeowner also attended at the conclusion of the inspection to receive verbal feedback. The many requirements made at the previous inspection and directed to the previous owner were reviewed. Relevant documentation was examined including the care plans of four residents. Three residents were spoken with individually and the staff shift handover was observed. A tour of the premises was also carried out. What the service does well: What has improved since the last inspection? A clear policy in respect of smoking has been introduced for the comfort of all the residents. Alterations have been made in the lounge which have increased communal space for residents. All communal corridors and the lounge have been redecorated which together with the improved hygiene levels throughout to give a much brighter appearance to the home. Stained carpets in two bedrooms have been replaced with laminate flooring and some carpets replaced in other bedrooms. A number of rooms have been re-decorated and the soft furnishings replaced. Soft furnishings were on order to complete the refurbishment of six more rooms. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 6 Pre-admission assessments are being carried out and recorded which together with improved personal care of residents has been a positive improvement in the home. The homes statements of purpose and service user guide have been developed and the service user guide made available to residents. All written policies and procedures have been reviewed. Outstanding work from a fire inspection has been completed and regular fire drills and testing of alarms are being carried out. The outstanding service of the emergency lighting has been carried out along with monthly testing of the system. A new nurse call system has been installed and a new commercial washing machine with a sluicing cycle has been purchased. Staffing levels have been increased utilising robust recruitment processes and appropriate induction programmes introduced. Formal supervision has commenced and training needs identified. Numerous improvements to the administration of medications have been made. 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 E54_S63476_CedarLodge_V232346_070605_UI 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 E54_S63476_CedarLodge_V232346_070605_UI 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 and 3 The homes Statement of Purpose and Service User Guide enable prospective residents to make an informed decision about their admission to the home. Not all of the residents are aware of their terms and conditions of residency. New residents are admitted on the basis of a full pre-admission assessment which means that the care needs are known prior to admission. EVIDENCE: Prior to the visit the inspector had been invited to comment on the proposed Statement of Purpose and Service User Guide. Following a few amendments the documents were determined to be comprehensive. The manager advised that copies of the Service User Guide were being distributed to residents or relatives respectively. New residents have been issued with a newly devised contract/terms and conditions of residency. The home must complete the process of providing all residents with a new contract. All recent admissions to the home had undergone a full pre-admission assessment prior to being offered a placement. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI 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 and 9 The health, personal care needs and preferences of residents are not fully documented and care plans failed to provide sufficient staff guidance on how to meet needs. There was improved documentary evidence in respect of the services of external professionals demonstrating that health care needs are met. Medication administration in the home is now well managed promoting health and reduced risks to residents. EVIDENCE: Some improvements were noted within the four sampled care plans but a great deal of work needs to be carried out to bring them up to an acceptable standard. Recent advances made include a dependency rating for each aspect of care, records in respect of pressure relieving devices; relevant risk assessments and detailed wound care charts. Improvements were noted regarding record keeping within various sections of the files, however further in depth information is required. The inspector determined and the manager acknowledged that care plans required a complete review of the structure and depth of content. They must include comprehensive assessments of both physical and mental health, behavioural problems, care planning and Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 10 comments and preferences of respective individuals. The home had introduced a system of regular and six monthly formal reviews. The manager advised that there had been improvements in respect of provision and recording of personal hygiene of residents but that further improvements were required and that this aspect of care was being monitored. Further information supplied was that relevant risk assessments had been carried out in order of priority and that further work was needed before reaching a satisfactory level, which covers all aspects of activities. There was evidence of visits made by multi-agency professionals. Liaison with and reviews by social workers had increased significantly. A number of comments were received from the three residents who were spoken with individually. “Everything is alright, the nurses are good”, “its now a friendly home, I have no complaints”. Safe practices in respect of the administration of medications had been introduced and the manager advised that she was regularly carrying out monthly audits. The written policies had recently been reviewed. The home had organised refresher training for 80 of the trained staff. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI 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) 12,13 and 14 The home did not provide evidence that the activities programme matches the expectations and preferences of residents. Links with the community are good with support that enriches resident’s social opportunities. There was limited opportunities for residents to exercise control over their lives. EVIDENCE: Information was provided that there is a daily in-house activities programme. The manager advised that the programme needed to be written and displayed within the home. The home is required to provide documentary evidence that residents are regularly consulted in respect of their preferences and wishes. Staff and relatives recently organised and provided a party for a resident who celebrated her 100th birthday, feedback provided was that it was well attended. During the Easter period Easter eggs and hot cross buns were given to all residents. A resident attends a day centre each week during the course of which she receives physiotherapy. Observations revealed that the home has a policy of open visiting. Opportunity did not arise to hold discussions with visitors. Although files indicated that details were now being recorded in respect of residents life histories, hobbies and preferences this needed to be expanded to Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 12 ensure that full autonomy was being provided for residents to exercise their rights and influence the day-to-day running of the home. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 13 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 and 18 The home has a clear and accessible complaints system in place so that residents and relatives know that their complaint will be acted upon. Arrangements for protecting residents are not satisfactory placing them at possible risk of harm or abuse. EVIDENCE: Shortly after the inspection CSCI received a written complaint in respect of care afforded to a resident, which was investigated. A summary of the findings are as follows: • Lack of personal care given to a resident leaving her in an unacceptable condition and inappropriately dressed • Inadequate cleaning of the home • Inadequate odour control • Inadequate attention to maintaining appropriate temperature within the residents bedroom • Bedroom carpet was worn and stained • Slippery seat pads on dining room chairs. The home will also need to monitor the situation and ensure that requirements are addressed. The written adult protection policy was determined to be satisfactory at the previous inspection and was not examined on this occasion. Information was given that no progress had been made in respect of the missing person procedure, the document required review and amendment. The inspector was informed that training in adult protection and dementia care was being organised but had not been provided to date. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 14 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, 24 and 26 The lack of adequate communal sitting and recreational space imposes restrictions on resident’s choices. The home does not provide sufficient assisted bathing facilities to meet the needs of residents. A mal odour persists in some areas of the home which indicates that inadequate attention is paid to maintaining a pleasant environment. EVIDENCE: The home offers extensive potential, the homeowner has agreed with CSCI a programme of improvements to raise the standard of accommodation and to put systems in place for the control of the spread of infection. In order to increase available space the kiosk and fireplace had been removed from the lounge and the room had been re-decorated. Further work needs to be undertaken to provide acceptable levels of seating for residents and visitors. Information was given that there are plans to extend the balcony situated on the first floor to create a second lounge for use by residents. The large dining Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 15 room has a pleasant outlook and access to the extensive, well laid out rear garden. Bedrooms are located on each of the three floors and vary in size and layout. The home currently has eleven en-suite rooms. Six bedrooms had been refurbished and other rooms were currently being re-decorated to include new soft furnishings. A large room situated on the ground floor is to be divided to provide an en-suite bedroom and a further room for use by visiting professionals. A random sample of occupied rooms were visited; where size permitted two comfortable chairs had been provided and the minimum amount of other furniture. Rooms were noted to be very personalised to the degree preferred by the occupant. Suited door locks had not been fitted to ensure that privacy is maintained. The home has seven separate toilets, four bathrooms and a shower room. There are plans to convert a bathroom on the ground floor to a walk-in shower room and a further bathroom to an assisted bath/shower room. The home has a supply of pressure relieving equipment, raised toilet seats and a shaft lift providing access to all floors. A new nurse call system has been installed. The assessment of the premises by an occupational therapist has not yet been carried out. The inspector observed a significant improvement in the levels of hygiene throughout the home however; further work is required to fully eliminate the mal odour. The manager advised that there was a shortage of housekeeping staff, which was currently being addressed. Due to continence problems the carpets had been replaced with laminate flooring in two bedrooms. Carpets had been either replaced or cleaned but some staining has persisted. A new washing machine with a sluicing cycle had recently been purchased. A room situated on the first floor was currently being converted into a sluice room and COSHH storage area. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 16 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 and 30 Residents were cared for by a positive and enthusiastic workforce committed to improving the quality of lives of residents. Robust recruitment practices to protect the safety of residents were in place. Staff had not received adequate training to enable them to meet the full and changing needs of residents. EVIDENCE: The new homeowner had introduced improved staffing levels during daytime hours. Although the number of staff on duty during the late shift was determined to be satisfactory for the current number of residents, the home must increase this by one carer when the occupancy rises to 30 residents. A second maintenance operative had been employed to assist with the refurbishment of the home. There was a shortage of housekeeping staff, interviews of prospective candidates had been arranged and the manager anticipated that the vacancy would be filled shortly. There are dedicated kitchen and laundry staff employed. There was evidence to support that all new staff are employed following appropriate recruitment practices with all relevant checks carried out. Some progress had been made in respect of staff training, fire drills were being regularly carried out and a number of staff had undergone manual handling training and a further course had bee arranged. All other mandatory training was being arranged including adult protection and dementia care. The staff shift handover was observed for the afternoon shift. All residents were commented upon by both sides and questions asked. The handover was noted Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 17 to be comprehensive, discussions including resident’s needs and preferences. The meeting was conducted in a friendly and professional manner. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 18 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) 38 31, 32, 36 and The manager has a clear development plan and vision for the home, which she effectively communicates to residents and staff. The arrangements for the induction of newly appointed staff are good and ongoing supervision ensures that staff have a clear understanding of their roles. The health and safety of residents and staff is promoted but at present fails to adequately protect the residents. EVIDENCE: The recently appointed manager has considerable experience and skills in the management of a home. She demonstrated that she leads by example and has high expectations in respect of standards. The quality assurance manager and the homeowner provide additional support. Observations revealed that the manager delegates responsibilities and tasks to staff in a professional manner. The CSCI are in receipt of an application in respect of the registered manager status. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 19 All newly recruited care staff are expected to complete an induction programme that complies with TOPPS training. The manager informed that the programme has been adapted for use for the induction of trained staff. With the exception of two ancillary staff all staff had received a formal supervisory meeting. A training session had been arranged for trained staff for later the same day to undergo instructions about staff supervision prior to work being delegated to them. Although they were not examined the quality assurance manager reported that all of the homes written policies and procedures had been reviewed and updated. The standard in respect of health and safety was not fully assessed but focussed upon the requirements made from the previous inspection. Regular fire drills were being carried out, staff training was being organised. The outstanding requirements from a previous inspection by a fire officer had been fully addressed. The fire alarm was being tested weekly and the emergency lighting monthly which had also been serviced. The manager had commenced collation of risk assessments in respect of the premises, staff residents, fire, food and infection control but further work is required to complete them. The home needs to commence random testing of hot water outlets and maintain documentation of such. Following an inspection by environmental health the home had arranged for the kitchen floor to be replaced. The pane of glass in the velux window of the staff toilet must be replaced. Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 x COMPLAINTS AND PROTECTION 2 2 2 2 x 2 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 2 2 3 x x x 3 x 2 Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 21 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 OP2 Regulation 5(1)b Timescale for action The registered person must issue 31st August a contract/terms and conditions 2005 of residency to all residents living at the home The registered person must 31st August ensure that a comprehensive 2005 care plan with clear objectives is in place for each resident which includes physical and mental health needs, personal preferences and means of delivery of care. The registered person must 31st August ensure that comprehensive 2005 records are made in relation to visiting professionals. The registered person must 30th develop and display a September programme of activities which 2005 takes into account residents preferences. The registered person must 15th provide documentary evidence of September 2005 residents right of autonomy via consultation in respect of their preferences, activities of daily living and the day-to-day operations of the home. The registered person must 10th July ensure that all aspects of 2005 complaints made against the Version 1.30 Page 22 Requirement 2. OP7 15(1)(2) 3. OP8 15(1)(2)b cd 16(2)n 4. OP12 5. OP14 16(2)mn 6. OP16 22(3) Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc home are fully addressed. 7. 8. OP18 OP18 13(6) 13(6) The registered person must review and amend the written missing person procedure. The registered person must ensure that all staff receive training in adult protection that had been arranged. The registered person must further provide sufficient communal seating and ensure choices are available for all residents regarding where they sit. The registered person must ensure that the commenced refurbishment works of the bathrooms are completed resulting in an adequate supply of assisted bathing facilities. The registered person must ensure that the aids and adaptations of the premises are assessed by an occupational therapist. The registered person must ensure that suited door locks are fitted to all bedroom doors that can be overrridden in an emergency. The registered person must ensure that all rooms are clean and odour free and that an effective schedule of routine cleaning is maintained. The registered person must ensure that all staff receive mandatory training, updates and training that has been identified to meet the residents needs. N.B. The home had commenced arrangements in this matter. The registered person must replace the damaged kitchen floor as directed from the environmental healht report. N.B. Arrangements had been 31st July 2005 30th September 2005 31st December 2005 9. OP20 23(2)e 10. OP21 23(2)j 31st October 2005 11. OP22 23(2)n 31st October 2005 30th November 2005 31st July 2005 12. OP24 12(4)a 13. OP26 16(2)jk 14. OP30 18(1)a 31st October20 05 15. OP38 23(2)b 31st October 2005 Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 23 16. OP38 23(4)d 17. OP38 13(4)b 18. OP38 13(4)c 19. OP38 13(4)bc made to address this requirement. The registered person must ensure that all staff regularly receieve fire training from a person competent to do so. N.B. The home had commenced arrangements to fufill this requirement. The registered person must carry out and document regular random testing of water temperatures of all hot water outlets accessible to residents. The registered person must replace the cracked overhead pane of glass in the velux window of staff toilet. The registered person must complete the work in relation to collation of risk assessments for the premises, food, fire staff, residents and infection control. 30th September 2005 15th August 2005 30th November 2005 30th September 2005 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 Good Practice Recommendations Cedar Lodge E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 E54_S63476_CedarLodge_V232346_070605_UI stage 4.doc Version 1.30 Page 25 - 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!