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Inspection on 10/04/08 for Cedar Lodge Residential Home

Also see our care home review for Cedar Lodge Residential Home for more information

This inspection was carried out on 10th April 2008.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The feedback from residents, relatives and staff confirms that the care provided by this home meets the needs of all concerned. From the 10 surveys completed by the residents 100% say that they receive the care and support they need and that staff listen and act upon what the resident says. One relative states `they are very considerate of my relatives needs for privacy and independence`. Another relative states `They supply a good service package of good food and good care`. Indeed the food was commented upon by several sources. The meal on the day was excellent and very tasty. One relative states `My relative enjoys the meals and always says there is plenty of food`.The environment was comfortable and very clean. From the 8 relative surveys returned, 100% say that the home helped their relative keep in touch with them. One of the main points made throughout this inspection was the emphasis on a friendly approach from all staff. This is confirmed by a health professional who says `Cedar Lodge seems to have a friendly "family" atmosphere`.

What has improved since the last inspection?

There has been and still is an ongoing environmental upgrade at Cedar Lodge. As you approach the home there is a new sheltered small garden that has been constructed by the local college under the Princes Trust. This small area is a sensory are and has seating and raised beds. Also to the front of the home extending the lounge is a newly constructed conservatory. This has comfortable cane furniture as seating for residents. Within the home there have been several upgrades including the dining room that now has new large circular tables, new chairs and new curtains. The dining room has new flooring and has been painted. The lounge looks lighter because of a new carpet and new lumber supporting beige chairs chosen by the residents. More chairs are on order and the kitchen is in the process of an upgrade. The hot water outlets within the home are regularly tested by the deputy manager and records kept. All this work and that planned ensures that the residents have a comfortable, safe environment in which to live. Progress has also been made on the requirements we made as a result of our last visit to the home. There have been good and considerate developments in the palliative care and end of life needs of new residents. This will ensure that the home is able to meet the needs of residents at the time of their death. Three staff spoken to were able to confirm they had received training on the protection of vulnerable adults and were aware of what to do in case they needed to report concerns. The policy at the home has been revised and contains the relevant information regarding making referrals and whistle blowing. These actions by the home have further ensured the protection of the residents. The quality of the recording in the daily progress notes has improved thereby ensuring that they accurately reflect the resident`s health and well being. The Service Users Guide is on the wall as you enter the home and has been produced in large bold type to make it more accessible to the resident group.

What the care home could do better:

This report does not make any requirements of the home and the challenge they now face is to maintain the good standard of care that they have achieved at this time.

CARE HOMES FOR OLDER PEOPLE Cedar Lodge Residential Home Hengrave Road Culford Bury St. Edmunds Suffolk IP28 6DX Lead Inspector Claire Hutton Unannounced Inspection 10th April 2008 10:00 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 Residential Home DS0000045594.V362273.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 Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Residential Home Address Hengrave Road Culford Bury St. Edmunds Suffolk IP28 6DX 01284 728744 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) Mrs Sandra Spendley Mr Michael Lewis Spendley Mrs Sandra Spendley Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one named person under the age of 65 with a mental disability 10th April 2007 Date of last inspection Brief Description of the Service: Cedar Lodge is a residential care home that has provided care and accommodation to older people since 1984. There is currently a condition of registration which allows the home to support and care for one resident under the age of 65 with mental health needs. The home is situated in a rural setting within its own grounds and adjoining woodlands on the outskirts of Culford, which is approximately five miles from Bury St Edmunds. There are no community facilities nearby and the nearest shop is in the village of Ingham. The home is spread over two floors with service users being able to access both floors by a central staircase or lift. There are 23 single bedrooms, eight of which are en-suite and one shared room, which also have en-suite toilet facilities. There is a lounge and a dining room and residents also have the use of a small sun lounge on the first floor. Since the last inspection a new conservatory to the front of the house has been built and this provides additional communal space for residents to use. The homes office is located to the gardens at the back of the home, in a wooden sun house type construction. Mr and Mrs Spendley became the Registered Providers of Cedar Lodge on the 1st September 2004, although both have been involved in the home for a number of years. Mr Spendleys mother owned the home prior to this date and Mrs Sandra Spendley became the registered manager on the 7th July 2003. The home has a statement of purpose providing information for prospective service users and states the current range of fees charged by the home, which ranges from £355.00 to £395.00 per week. These figures do not include hairdressing, toiletries, holiday’s, specialist dry cleaning, papers and magazines and activities away from the home. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. The inspection visit was unannounced and took place on a weekday and lasted 6.5 hours. This was a key inspection that focused upon the core standards relating to older people. The report has been written using accumulated evidence gathered before and during the inspection, including an annual quality assurance assessment completed by the home. This is a selfassessment. Surveys were received back from 10 residents at the home and all were positive – comments from residents are included throughout this report. Surveys were received back from 8 relatives, again these were all positive and comments are included where relevant in this report. A survey from a health professional was received and this confirmed that the home provided a good service. The 6 surveys received from staff working at the home were on the whole complimentary and spoke well of their recruitment process, training and support they received. The inspection process included visiting all communal areas of the home, and several bedrooms, discussions with staff and residents, observations of staff and resident interaction, and the examination of a number of documents including residents care plans and associated documents, medication records, the staff rota, records and policy relating to health and safety and records relating to staff recruitment. Part of the inspection included interviewing 3 staff in private who were on duty at that time. The deputy manager, the registered manager and the owner were present throughout the inspection and contributed positively to the process. What the service does well: The feedback from residents, relatives and staff confirms that the care provided by this home meets the needs of all concerned. From the 10 surveys completed by the residents 100 say that they receive the care and support they need and that staff listen and act upon what the resident says. One relative states ‘they are very considerate of my relatives needs for privacy and independence’. Another relative states ‘They supply a good service package of good food and good care’. Indeed the food was commented upon by several sources. The meal on the day was excellent and very tasty. One relative states ‘My relative enjoys the meals and always says there is plenty of food’. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 6 The environment was comfortable and very clean. From the 8 relative surveys returned, 100 say that the home helped their relative keep in touch with them. One of the main points made throughout this inspection was the emphasis on a friendly approach from all staff. This is confirmed by a health professional who says ‘Cedar Lodge seems to have a friendly “family” atmosphere’. What has improved since the last inspection? What they could do better: This report does not make any requirements of the home and the challenge they now face is to maintain the good standard of care that they have achieved at this time. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 7 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 Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 8 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 Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering moving into Cedar Lodge can expect to have information about the home, be able to visit and have their needs assessed before they move into the home. EVIDENCE: Information about the home, including the Statement of Purpose, Service Users Guide and complaints procedure was issued to each person prior to or on admittance to the home. This information was also available as you enter the home attached to the wall. The Service Users Guide and Statement of Purpose had been updated before this inspection and were available in large text for people who may have difficulty with smaller printed text. Three peoples’ care plans and personal files were tracked. Each person had a pre admission needs assessment completed covering all aspects of their health and personal and social care needs. The manager and deputy had completed Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 10 these assessments with one individual in their home before they moved to Cedar Lodge. Prospective individuals were provided with the opportunity to visit Cedar Lodge before making a decision to move into the home. One resident regularly visited a friend before they to decided to move in. From the resident survey returned by 10 residents, 100 said they had a contract and received enough information about the home. The Home does not provide intermediate care. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 11 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, 11, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to have care plans, which reflect their health, personal and social care needs and include individual’s end of life needs. Medication practices were sufficiently effective to protect people. EVIDENCE: The care plans and associated documents for 3 individuals were examined. Care plans provide a comprehensive overview of the individual. They identify the preferred daily routines of the person and the interventions for carers to help support the individual where required. The daily records expanded to give an accurate picture of the person throughout the day to monitor their health and well being. A monthly review sheet confirmed that residents are being involved in a monthly review of their care plan, which included a statement from the individual on how the home is meeting their needs. Care plans have specific forms, which record visits by the general practitioner, district nurse and other health professionals. The outcomes and course of treatment following the visit are recorded separately on a progress form. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 12 Where concerns are identified to an individual’s wellbeing, assessments have been completed and action taken to minimise the risks. These include moving and handling, falls, maintaining good mental health, pressure area care and self-medicating. Inspection of these documents confirmed they are being reviewed and updated on a regular basis. One relative told us ‘The home has always met the needs of my relative and looked after her with loving care’. Another relative told us ‘Cedar Lodge management and staff have always treated my relative with respect and affection. She is very secure and happy with the home and treatment’. The deputy manager had completed a considerable amount of work on end of life care. Both the manager and deputy had visited the local hospice and had taken advice when developing a new element to care plans. The care plan that is ‘thinking ahead’ works through decisions to be made with residents and next of kin. Preferred care options at the time of dying are recorded along with advanced statement of wishes and advanced decisions. This will enable the home to provide the appropriate care as expressed by each resident at the time of dying and death. This care plan is being implemented for new residents to the home. The deputy manager had put together a folder with information that would be relevant once a person had died. This included: how to register a death, coroner procedures as well as information on bereavement and the local cemetery. The procedures for storage, administering and recording medication were reviewed. Medication Administration Record (MAR) Charts are being properly completed and the correct codes are being used. The home uses dosset boxes, which are prepared on a weekly basis by the local pharmacy. An audit trail of medication is being kept, receipt of medication is reflected on the MAR charts and identifies where changes have occurred. The returns book identifies the date and amount of medication returned. Medicines being stored in the fridge were labelled and dated. The temperature of the fridge was being monitored and recorded and was seen to be with in the recommended safe limits. The controlled drugs register was seen. The stock of medication was checked against the register and was found to be accurate. The home has 2 people who self medicate and there are risk assessments in place to support this. All staff that administer medication are trained and have their competence assessed on a regular basis. All the above evidence ensures that residents are safeguarded and protected by the homes policies and procedures in dealing with medication. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be consulted about activities to ensure they are given the opportunity to participate in social, recreational and religious interests of their choice. People can expect to have a good range of fresh and home cooked food as part of a balanced and varied diet. EVIDENCE: Daytime activities are available to the people living in the home. On the day the hairdresser was there for the morning and 8 residents chose to have their hair done. In the afternoon a quiz was held in the lounge and most of the residents participated. One resident was busy doing a jigsaw puzzle; a few residents chose to sit outside, as the weather was good. In the lounge was a card stall for residents to purchase cards for special occasions. One resident purchased a card for their relatives’ birthday and posted it to them. A schedule of activities was seen displayed on the notice board in the entrance foyer, incorporating skittles, reminiscence sessions, communion, mobile library visit, movement to music, armchair exercises, quizzes of choice obtained from the Alzheimer’s society and Bingo. There was also a list of dates for sing-a-long sessions hosted by a visiting entertainer. One resident regularly goes out Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 14 independently for lunch and places of local interest. One relative told us that ‘there are activities to help keep residents mobile’ another relative said ‘they do not harass my relative join in social events’. There are regular residents meetings held within the home and minutes were available for all to read on the notice board. Residents are consulted on social events and had recently been consulted on the environmental developments within the home. One resident confirmed they had chosen the colour of the new chairs in the lounge. The visitor’s book reflects that residents receive regular visits from family and friends. Relatives were seen visiting during the inspection. Feedback from relatives included, ‘The atmosphere is extremely friendly and visitors are always made welcome at any time’. Another relative said ‘We have always been treated well and are on good terms with all the staff’. The home supports residents to celebrate special occasions such as anniversaries and birthdays. This was confirmed by a series of photographs on display in the corridor showing residents enjoying a party and blowing out candles on their birthday cake. One relative said ‘they make you so welcome. They even gave a party for my relatives wedding anniversary. I cannot think of anything they would not do for any of the people’. Residents had the choice of lamb casserole, broccoli, carrots, swede and roast potatoes. The vegetarian option was cauliflower cheese. For dessert there was pear and chocolate pudding. The food was commented upon positively by several sources. The meal on the day was excellent and very tasty. One relative states ‘My relative enjoys the meals and always says there is plenty of food’. The dining room was nicely presented. The circular tables chosen by residents make meals times very sociable. Residents with dexterity problems had been provided with specially adapted cutlery to help maintain their independence to eat their meal unaided. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. Residents at Cedar Lodge are protected and their views listened to. EVIDENCE: The complaints policy was seen displayed on the notice board in the entrance hallway. Each person on admittance to the home is provided with a copy of the complaints procedure. From the 10 surveys returned by residents 100 of them say that staff act upon what they say and they know who to speak to if they are unhappy and they know how to make a complaint should they wish to. The self-assessment by the home stated that the home had received 1 complaint and had made 2 safeguarding referrals. The complaints log confirmed that the 1 complaint has been made about the home since the previous inspection and that this had been responded to appropriately and to the complainants satisfaction. The 2 safeguarding matters were discussed and found to have been appropriately dealt with through the local safeguarding procedures. The home had developed their own policies and procedures for the protection of vulnerable adults, which make reference to the Suffolk inter agency policy for reporting allegations of abuse. This had recently been updated and refers to Customer 1st and whistle blowing. Three staff spoken to privately all confirmed Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 16 they had received safeguarding training and were aware of what to do should the need arise. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 17 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): 19,20,21,22,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a home that is safe, comfortable and clean and have access to specialist equipment they require to help maximise their independence. EVIDENCE: There has been and still is an ongoing environmental upgrade at Cedar Lodge. As you approach the home there is a new sheltered small garden that has been constructed by the local college under the Princes Trust. This small area is a sensory are and has seating and raised beds. Also to the front of the home extending the lounge is a newly constructed conservatory. This has comfortable cane furniture as seating for residents. Within the home there have been several upgrades including the dining room that now has new large circular tables, new chairs and new curtains. The dining room has new flooring and has been painted. The lounge looks lighter because of a new carpet and new; lumber supporting beige chairs chosen by the residents. More chairs are Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 18 on order and the kitchen is in the process of an upgrade. All this work and that planned ensures that the residents have a comfortable, safe environment in which to live. All fire exit doors, have been fitted with made to measure ramps to ensure safe exit to wheelchair users and people using walking aids. A bath chair has been fitted to enable resident’s easy access into and out of the bath. Residents were observed using aids and equipment to maximise their independence. A number of residents mobilise using walking aids. An assisted bath has been installed on the first floor and toilet raisers have been provided to aid people to access toilet and bathing facilities independently. To protect resident’s safety all radiators throughout the home have been guarded with covers made specifically to fit the radiators. All first floor windows have been fitted with restrictors and all hot water outlets are restricted to prevent scalding. The deputy manager stated that it was her responsibility each week to test the hot water outlets to ensure they are maintained within safe limits. All residents have been risk assessed as to their ability and confidence to use the staircase. Where residents are at risk they have been advised to use the lift or request staff support to assist them down the stairs. One care plan seen confirmed this was the case. The premises were found to be clean, with no unpleasant odours. There is an adequate supply of liquid soap, paper towels in bathrooms and toilets and disposable aprons and gloves where staff are required to assist residents with their personal hygiene. The laundry room is situated on the first floor, with a smaller washing room on the ground floor; this is for washing general items such as tea towels and towels. The laundry upstairs has a sluice disinfector to sterilise toileting aids to ensure they are kept clean and reduce the risk of infection. The laundry equipment is adequate to ensure laundry is processed in an appropriate way to prevent the spread of infection. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. Cedar Lodge provides sufficient staff that were well recruited, appropriately trained and supervised. EVIDENCE: The staff roster for the current and previous week was seen. Staffing levels consist of 4 carers on the day shift, 2 carers working 5pm to 10pm and two waking night staff between 10pm and 8am seven days a week. Additionally the staff are supported by the manager, deputy manager and a cook. From the residents surveyed 100 tell us that staff are available when they need them. Three staff files seen confirmed the home operates a thorough recruitment process, which includes obtaining all the appropriate paper work including Criminal Bureau Records (CRB) check and Protection of Vulnerable Adults (POVA) checks. All staff files seen had a statement of terms and conditions of employment signed and dated. Newly recruited staff had completed a formalised induction programme. This training introduced the employee to the principles of care, safe working practices, the organisation and role of the worker and the experiences and particular needs of the resident group. These Skills for Care Common Induction Standards (CIS) had been completed. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 20 Records confirmed that existing employees have completed training using local resources and a long distance learning provider. Recent training consists of fire safety, moving and handling, diet and nutrition, food hygiene, medication administration and infection control. The learning provider has tailored training packs, which` specifically relates to Cedar Lodge. They consist of information and question and answer sheets, supported by test papers during and at the end of the course. These papers are marked externally by the provider and certificates issued on successful completion. The 3 staff spoken with confirmed they had received this training with 1 staff member aware that they needed to do her medication update. Information obtained from the self-assessment identifies that 9 staff hold National Vocational Qualifications (NVQ) at level 2 or higher and that 3 are currently doing an NVQ qualification. This is from a total of 14 care staff employed at the home. One staff member said they are given the training relevant to their role and ‘management always keep us thinking of the individual needs of the service user’. Three staff spoken with during the inspection confirmed they felt supported in their work and were clear about their roles and responsibilities. They confirmed that they received formal supervision. They felt they worked well as a team and were mutually supportive and appreciative of each other. One relative commented ‘The staff are hard working and enthusiastic providing a really professional service’. Another relative said ‘Wonderful place, do there best, but still could do with more staff’. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 21 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): 31, 33, 34, 35, 36, 37, 38, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Cedar Lodge was well managed and residents were able to express their views. EVIDENCE: The registered manager holds a National Vocational Qualification (NVQ) level 4 and has a minimum of twenty years experience of working at Cedar Lodge. Whilst qualified and experienced the manager relies heavily on the deputy manager for the day-to-day control of the home. The deputy manager has recently completed NVQ level 4, management in care services. The quality assurance survey completed in October 2006 incorporated feedback from residents, relatives, friends and health professionals. This has been repeated again in during May and July 2007. This covered feedback on care received at Cedar Lodge, quality and choice of food, accommodation, Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 22 activities and staff support, attitude and professionalism. This continual monitoring enables the home to respond and reflect and improve upon the service they offer. At the last inspection the CSCI requested and were provided with a copy of the homes financial and business plan. From the information provided by the responsible providers it would appear that the home is financial viable. The proprietors of the home do not act as appointee for any of the people living in the home. Families or power of attorneys manage the financial affairs of the residents. Resident that are able manage their own finances and have access to a lockable cabinet in their room. Staff spoken with confirmed they received regular supervision and support from managers. The files examined in relation to staff had evidence of supervision and appraisals. From the 6 staff surveyed all said that their manager regularly or often met with them to give support and to discuss how they were working. Pre inspection information reflects that policies and procedures are being maintained and reviewed. However all the policies and procedure had the same date of review. A sample of policies and procedures seen at the inspection confirmed this. The safeguarding policy had been updated. The policies and procedures on death and dying had further been developed. In relation to health and safety matters mention has already been made in the environment section of this report to the safeguards put in place with regard hot water, radiators and window restrictors, stairs and infection control. Risk assessments have been revised and cover resident’s health safety and welfare. These include the arrangements to meet previous requirements for residents whom choose to have freestanding convector heaters and for residents using the stairs unsupported. The self-assessment completed by the home states that all equipment has been appropriately serviced and maintained. A sample check was done and evidence was seen that the hoist at the home – though not currently used, has been serviced in December 2007. All these actions ensure that the health and safety of the residents is being safeguarded. Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 3 3 Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cedar Lodge Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Residential Home DS0000045594.V362273.R01.S.doc Version 5.2 Page 26 - 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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