Inspection on 22/08/07 for Cedarwood House

This inspection was carried out on 22nd August 2007.

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

Cedarwood House 29/07/08

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 Cedarwood House Ltd Hastings Road Battle East Sussex TN33 0TG Lead Inspector Elizabeth Dudley Key Unannounced Inspection 22nd August 2007 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 Cedarwood House Ltd DS0000069155.V346267.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. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedarwood House Ltd Address Hastings Road Battle East Sussex TN33 0TG 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) 01424 772428 01424 775260 Cedarwood House Ltd Mrs Christine Butcher Care Home 20 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users must be aged sixty-five (65) years or over on admission. The maximum number of service users to be accommodated is twenty (20) New service Date of last inspection Brief Description of the Service: Cedarwood House is situated on the Hastings Road within approximately one mile of Battle town within a rural setting. The home provides car parking for around eight cars. The home provides personal care for older people and is also able to provide care for people with mental health needs of the older person. Resident’s accommodation is over two floors and consists of eighteen single and one double room, and a communal lounge and dining room. Assisted bathing facilities are provided. Both the gardens and the home are in the process of being refurbished by the new owners who have owned the home since January 2007. Current fees as of the 22nd August 2007 are between £350:44 and £410 Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 22nd August 2007 over a period of five hours and was facilitated by the home manager Mrs C Butcher. During the inspection a tour of the home took place, records that included health and safety, catering, care plans, medication and personnel files were examined and discussions were held with four residents and five members of staff. Prior to the inspection the CSCI sent out ten questionnaires to residents, ten to visitors to the home and two to health care professionals. Five of these were returned from residents, six from relatives and visitors and one from health care professionals. Questionnaires showed that generally people were very pleased with the service provided by the home: “The standard of care is very good”. “Delighted with the care and attention given to residents. It’s a very good home”. “The carers I have met are very friendly and have a good relationship with my mother.” What the service does well: The home is small and friendly with the majority of the staff having worked there for several years. It provides a homely atmosphere for nineteen residents. All prospective residents are thoroughly assessed by the manager to ensure the home can meet their expectations and can visit the home prior to admission. Activities taking place within the home include quizzes; board games and staff take residents for walks or into the nearby town. Residents said that they enjoyed the meals offered by the home and said that these were varied, well presented and that they had a choice of menu. A pleasant dining room is provided with mealtimes being encouraged to be a social occasion. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Care planning should identify the actions to be taken to meet the current needs of the residents and include more detail regarding their mental health requirements. Elements to safeguard residents, such as window restrictors on the upper floor were not in place, and residents were not fully safeguarded whilst refurbishment was taking place. The manager and provider should ensure that measures to ensure the safety of residents throughout the home is made a priority. The fire risk assessment is currently under review and the manager should contact the relevant authority to ensure that fire safety is adequate whilst refurbishment is taking place. The manager should ensure that regulations regarding recruitment are complied with, and that staff receive further training in the care of residents with dementia. Cedarwood House Ltd DS0000069155.V346267.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. Cedarwood House Ltd DS0000069155.V346267.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 Cedarwood House Ltd DS0000069155.V346267.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): 1,2,3,4,5,6 People who use the service experience good quality outcomes in this area Prospective residents receive comprehensive information to enable them to make a choice over whether they wish to live at the home. All residents are assessed by the manager prior to being admitted to the home to ensure that their needs and expectations can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comprehensive Statement of Purpose which doubles as the Service User Guide, and a copy of this is given to all prospective and existing residents. This document includes information relating to times of meals and activities on offer as well as the information required by the regulations. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 10 The Terms and Conditions of residence comply with the regulations all residents have received a copy of this. Each prospective resident is assessed by the manager to ensure that the home can meet his or her needs. The assessment identifies the psychological, personal and social care needs of the resident and residents are informed in writing of whether the home can meet their expectations and provide the care that is required. Residents or their representatives can visit the home prior to making the decision over whether they wish to live there, and residents are admitted on a four-month trial period. The home accepts residents for respite care but not for intermediate care. Cedarwood House Ltd DS0000069155.V346267.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 People who use the service experience adequate quality outcomes in this area Care plans do not sufficiently identify actions to be taken to fulfil the needs of the residents and do not describe in sufficient detail the care any changes in care required or how instructions from health care professionals are to be followed. Daily records are sufficiently detailed to show what care has been given. Medications are administered by staff who are trained in this procedure and this ensures the residents are safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: New care plans have recently been put in place, there is a good format for recording, care planning, risk assessments and contact with health and social Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 12 care professionals. Care planning initially takes place using the information gained at the preadmission assessment of the individual. A total of 4 care plans (20 ) were examined and these were seen to include the assessed psychological and personal care needs of the residents. The actions required to meet these needs were not detailed and did not provide sufficient information for those giving care. Instructions from doctors and other health care professionals and the actions to follow these instructions did not form part of the care planning but was written in the back of the care plan under doctors visits, therefore this would be missed by those giving the care. There were no details relating to the dementia care required, what form the dementia took or what triggered any exacerbation of this or the actions required to deal with this. Care plans did not indicate when a condition requiring treatment had been completed, and whilst showing evidence of monthly review did not show that all parts of each care plan had been reviewed monthly and changes to treatment had not been care planned. Risk assessments were in place and although these showed review had taken place there were no changes to the original assessment. Not all care plans showed that they were formed in conjunction with the residents, and one resident spoken with was unaware of the care plan. Residents and their relatives stated that they were pleased with the care given and that medical help was always accessed promptly and that they were satisfied with the staff responses to health care needs. Residents said that their privacy and choices were maintained and that staff were observant of these. The standard of medication administration generally safeguards the residents. All staff who administer medication have received training. The manager should ensure that medications are used within the expiry dates and should access the community pharmacist for advice on any medication matters. Drugs used as controlled drugs were correctly recorded and stored. Residents who are terminally ill can stay at the home with nursing care provided by community nursing services. Letters were seen thanking the staff for their care of those who had died at the home and thanking them for their care. Cedarwood House Ltd DS0000069155.V346267.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 People who use the service experience good quality outcomes in this area. A variety of leisure activities are in place, which provide the residents with interest and stimulation. A varied menu is provided which allows residents choice of home cooked and nutritious food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an activities programme which is displayed in the main lounge, this includes entertainers visiting the home, quizzes and board games and staff take residents out for walks or drives in cars. Residents have the opportunity to participate in the local age concern club. A quiz was taking place on the day of the inspection with six residents taking part enthusiastically. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 14 Discussions were held with the manager about how those who stay in their rooms would be informed about the activities as two residents said that they did not know what was being offered. There is further scope to improve the activities offered and given the registration category of this home; this should be explored in order to ensure that residents receive sufficient stimulation and variety. Residents are unable to make use of the garden due to lack of maintenance and there is no patio area at present, which is safe for them to use, however there are plans to improve the garden area. The majority of residents spoken with said that they were able to make decisions about how they wished to spend their day and what time they wished to get up or go to bed. There is an open visiting policy and relatives are able to come to the home at any time of day, a local minister holds services at the home every four or five weeks and residents’ own ministers of religion visit the home. The manager can arrange advocates for residents and residents are able to control their own finances if able. There is a five - week rolling menu, this is displayed in menus in the dining room, on a notice board in the lounge a copy given to all residents. The menu is varied and offers two choices at lunchtime, one of which is a vegetarian option. All residents spoken with said that they enjoyed the food. Meals can be taken in a pleasant dining room or in the residents’ own room. Residents were seen to be enjoying their lunch as a social occasion. There were fresh fruit and vegetables in evidence and most cakes and puddings are made at the home. The home has recently had an environmental health visit from which some requirements and recommendations resulted. The manager said that they are in the process of addressing these. The cook, manager and another member of staff recently attended a course on nutrition for the older person and the cook has the food hygiene course. All care staff that prepare or help with meals have undertaken the food hygiene course. Cedarwood House Ltd DS0000069155.V346267.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 People who use the service experience good quality outcomes in this area. Policies within the home ensure that residents can make a complaint and be assured that it will be dealt with in a confidential and professional manner. Staff are aware of their responsibilities towards those in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy is included in the service user guide and made available to all residents, the majority of whom said that they were aware of how to make a complaint. There has been one minor complaint since the last inspection relating to the cleanliness of the china provided to a resident and the manager addressed this. There have been no adult safeguarding issues; the manager and the staff have undertaken training in the protection of the residents at the home. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 16 Residents spoken with were aware of to whom to make a complaint, although they said they had no complaints about the home. Cedarwood House Ltd DS0000069155.V346267.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, 24,25,26. People who use the service experience adequate quality outcomes in this area. The home is in the process of refurbishment and when completed will provide a homely environment for residents. Safety measures in areas, which are being refurbished, and general maintenance around the home does not provide adequate measures to safeguard residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has been under new ownership since January 2007 and during this time, work has been taking place in the home to update and refurbish it. Some of this has been completed including redecoration of some of the bedrooms and communal areas and new furniture being purchased. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 18 The lounge and dining room were homely, light and airy with new flooring and some new furniture in place. The garden has not been maintained and has no area at present for residents to sit and could be dangerous due to uneven surfaces. There are plans to build a patio and landscape the garden. Some individual residents rooms were pleasant and airy whilst some still required work to be undertaken to provide a good level of décor and furnishing for residents. There two assisted bathrooms and one assisted shower. One of the bathrooms is at present being refurbished. The home provides 18 single rooms and one double room as resident’s accommodation; the double room currently is used as a single room. Seven rooms have en suite, three of which comprise a toilet, wash hand basin and bath or shower. Radiator covers were in place but one was off the wall and needed reaffixing as this could have caused injury to a resident. Two rooms upstairs (one of which was a bathroom) were in the process of refurbishment, the doors were unlocked and residents had access to the rooms, one of which had broken mirrors and exposed pipe work and rubble on the floor and the other containing a selection of tools. Information has been received since the inspection that this has been done. Few of the windows on the upper floor had working window restrictors and no risk assessments to address this a requirement will be made on this as this has been so for a long time During a telephone discussion with the provider he gave assurances that this would be completed in the week following the inspection. Hot water temperatures have been monitored by the maintenance person using a water thermometer, and records showed that with the exception of one room, these were within recommended parameters. The room concerned has no thermostatic regulator and although the resident cannot get to the basin, other residents could. The water temperatures recorded for this room varied between 48 and 50°C which is above the recommended safety parameters) and could lead to residents being scalded. The provider has been asked to address this and has agreed to do so within the week following inspection. Individual residents rooms were homely and most provided with a lockable drawer, all have door locks with keys being provided within the auspices of a risk assessment. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 19 The laundry area is outside the main building, is equipped with a washing machine and a new drier with most of the laundry being done by the domestic. The home does not provide red bags for soiled laundry, and sheets that are wet are put in with the other bed linen. The need for linen to be double handled could prove an infection control risk for residents and staff and it is recommended that the manager address this issue. There were no odours within the home, the standard of cleanliness was adequate across all areas, but there were environmental health recommendations regarding the kitchen, which is difficult to clean and has not had the benefit of redecoration for some time. Some areas of the kitchen were in need of deep cleaning and this was identified in the Environmental Health Authority report. Plans are being made for complete refurbishment of the kitchen. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 20 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 People who use the service experience adequate quality outcomes in this area Staff are employed in sufficient numbers to meet the needs of the residents in their care. Recruitment procedures are generally robust but management should ensure they are aware of change in regulations as they occur in order to ensure residents are safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff duty rota and discussions with staff and residents showed that the level of staffing provided by the home is sufficient to meet the needs of the residents over the twenty-four hour period. Four members (60 ) of the staff have the National Vocational Qualification level 2 or 3 in care with a further 4 undertaking level 2 or 3 this year. Staff stated that they have a six-week induction course and that this is a local induction. Records were seen of this and the manager stated that she is in the Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 21 process of commencing a nationally recognised induction course. Staff have attended a foundation dementia training course and all have attended manual handling and fire training. Four members of staff have a first aid course and all staff have to read the policies in the home as part of the induction, there have been two fire drills recently. Most staff have undertaken medication training. The majority of staff files had the documentation as required by the regulations in place, but one member of staff had a Criminal Records Bureau check relevant to a previous home, all staff must have a current Criminal Records Bureau check relevant to this home under the current or previous registered name of the home. Further dementia training is required to ensure that staff have a thorough understanding of the complex needs of the residents now the home is admitting residents for dementia care. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 22 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): 31,32,33,35,36,37,38 People who use the service experience adequate quality outcomes in this area. Resident’s views of the services provided by the home are obtained and used to influence the practices around daily living in the home. Areas within the home could put residents safety at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for three years and during this time has undertaken the Registered Managers Award; she is a registered nurse (level 1) and is registered with the CSCI. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 23 Staff, residents, and one questionnaire returned, spoke of improvements both to the environment and the general ethos in the home under the current provider. There is a quality monitoring system, which gathers the views of resident’s visitors to the home, and these are collated and used to inform practice within the home. It would be beneficial and allow a balanced view to be gained of the services provided if this was expanded to include the views of health and social care professionals that visit the home. There was evidence that some services provided, including meals, have been changed to reflect the tastes of the residents. The manager is not appointee for any of the resident’s money, this having been taken over by social services. Residents’ personal monies are kept for safekeeping and records seen of these were in order. Some policies and procedures have been reviewed recently, but a complete review of policies, especially those generic to the home as opposed to the company, to include any polices relevant to the needs of residents with dementia would benefit and safeguard residents and staff. Staff have received supervision on a bi monthly basis and records of this were seen. The provider is undertaking regulation 26 visits (provider monthly visits to the home as required under regulation 26), but there were no copies of the reports made following these in the home, with the manager stating that she was unaware of what the reports contained. The regulation identifies that a copy of these is made available to the manager and that this is available to CSCI. Issues of health and safety, which could cause injury to residents, were in evidence. Window restrictors on the upper floor were not working. Thermoregulatory valves were not present in one room, and although a risk assessment showed the current resident could not reach the taps. The home is registered for dementia care and therefore another resident may wander in and this had not been addressed. A large upright fan was in the hallway with a resident using it for support and a radiator guard was not secured and leaning against the wall, this could cause injury to a resident. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 24 Areas within the garden were not safe for residents, and as discussed in National Minimum Standard 19, areas that were in the process of being refurbished had not been made safe. Certificates relating to the servicing of utilities and equipment were in place and in date, the home is awaiting the testing of portable electrical appliances, and the fire risk assessment is in the process of being reviewed. Records identified that the staff had attended mandatory health and safety training. C Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 3 x x 2 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 2 2 Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation Reg 15(1)(2)( b) Requirement That care plans fully reflect the current needs of the service user and identify the care to be given to meet these needs. That care plans are reviewed following visits from health care professionals to incorporate any change in care or treatment. That audit of medication takes place on a regular basis to prevent medication, which is out of date being administered. That the manager operates a robust recruitment system, which takes into account any, changes to current legislation. That staff receive further training relating to the management of dementia. That reports are formed following monthly visits to the home by the provider and made available to the manager and to the CSCI on inspection. That all areas of the home identified in the main body of the report to implicate residents safety, are made safe and appropriate risk assessments to DS0000069155.V346267.R01.S.doc Timescale for action 30/10/07 2 OP9 Reg 13(2) 30/09/07 3 OP29 Reg 19 Sched 2 Reg 18(c)(i) Reg 26 30/09/07 4 5 OP30 OP36 30/12/07 30/09/07 6 OP38 OP19 Cedarwood House Ltd Reg 13(4) 30/09/07 Version 5.2 Page 27 7 OP38 Reg23(4) be put in place That the registered person contacts the appropriate authority regarding the fire risk assessment and for advice on minimising fire risk to residents during the refurbishment. 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP12 OP26 Good Practice Recommendations That further development of suitable leisure interests is put in place. That soiled linen is kept separate from other linen and double handling of this linen is avoided for infection control purposes. Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Cedarwood House Ltd DS0000069155.V346267.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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