Inspection on 19/09/05 for Cedarwood Lodge

This inspection was carried out on 19th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cedarwood Lodge 12/10/06

Cedarwood Lodge 25/07/05

Cedarwood Lodge 20/09/04

Cedarwood Lodge 20/05/04

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

CARE HOME ADULTS 18-65 Cedarwood Lodge Cedarwood Lodge Chipstead Close Redhill Surrey RH1 6DU Lead Inspector Mavis Clahar Announced Inspection 19th September 2005 11:00 Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cedarwood Lodge Address Cedarwood Lodge Chipstead Close Redhill Surrey RH1 6DU 01737 277726 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) Surrey Oaklands NHS Trust Mrs Julie Anne Parker Care Home 5 Category(ies) of Learning disability (5), Physical disability (5) registration, with number of places Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 5 persons accommodated may be in the catergory LD (Adults with learning disabilities) or may be Adults with a learning disability who have an additional physical disability (LD/PD). The age/age range of the persons to be accommodated will be: Four (4) adults under 65 years and One (1) named person over 65 years of age. 25th July 2005. 2. Date of last inspection Brief Description of the Service: Cedarwood Lodge is a purpose built bungalow owned by a private housing association. The home, which accommodates five severely disabled service users, is situated in a quiet residential area of the town of Redhill, with easy access to the town centre, and local amenities. The home provides care and support to five service users who have profound learning and physical disabilities. Accommodation is in single bedrooms. There is a good-sized paved area to the rear of the house, providing an even surface for the service users who are all wheelchair bound. Service users are protected from the sun by an electrical retracting awning, installed to the rear of the building. There is limited parking space to the front of the building. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This announced inspection took place on the 19th September 2005. The home received an unannounced inspection on the 25th July 2005. The first part of the inspection was spent apologising to the care workers, service users service manager and home manager for the late arrival of the inspector. The inspector noted the service users appeared to be relaxed in the company of their carers. The second part was spent with the service manager and home manager discussing points raised from the last report, following which, the service manager left. This was followed by a review of service users notes, speaking with service users and care workers, and ended with a tour of the home and gardens. The last part was spent giving feedback to the manager about the findings of the inspection. None of the four service users at this home are able to speak, therefore this report will reflect the observations of the inspector, results of discussions with care workers, review of the service users notes and some sign language used by the inspector to gain information from the service users It was noted by the inspector that all service users are assessed for health and social care needs and that good care plans are drawn from these assessments, and there is indication that the service users /care managers were involved in the development of the care plans. These service users are non-verbal, unable to read and write and so the manager has contacted Surrey Advocacy for help in providing these service users with an advocate What the service does well: The general friendliness of the care workers without being patronising to the service users is to be commended. Assessments and care plans and risk assessments all contain a good level of information about each service user. Care given during the day and throughout the night is documented, dated and signed. The layout of the service users files allowed for easy reading and a picture could easily be formed about the care the service users were receiving. Service users are accompanied to church in line with the requests of their relatives. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 3 were assessed at the last inspection. EVIDENCE: For information on these standards please refer to the report of 25th July 2005. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 The systems for consulting service users are good with a variety of evidence to show service users are consulted and their view acted upon. EVIDENCE: All four-service users are wheel chair bound, unable to read and verbally communicate. It was observed that the care workers used a variety of communication tools such as touch, facial expressions pictures, smell, and sign language to communicate with the service users These service users are not really able to make major decisions, but they are well able to decide whether or not they like a particular food, as they will not eat it. The care workers use the service users communication chart to convey information and the service users will show by their facial movements whether or not they are in agreement with the suggestions. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 17 The home was able to demonstrate that each service user is encouraged and supported to lead as independent, varied and fulfilling life as they are able to. The meals in the home are good offering both choice and variety, and catering for special dietary needs. EVIDENCE: The inspector observed care workers interacting with service users in a positive way, treating them with respect and allowing them to make choices and enabling them to enjoy these choices. Set meals are offered three times per day with hot and cold drinks and snacks in between. The dietician has advised the home to add extra helping of butter, cream and sugar to the diets of some service users. Advice was given for one service user to have restricted proteins. The inspector observed ample amount of food in the fridge, freezer and store cupboard, with a good amount of varied fresh fruit available. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The health needs of the service users are well met with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: All the service users at this home are registered with at one health centre, which they access as the need arises. The GP will visit on an emergency, but service users attend surgeries and clinics as the need arises. The care managers for the service users will refer them if needed for professional emotional care. In discussion with care workers the inspector was informed that care workers along with service users families and friends all help to maintain the emotional health of the service users. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The care workers have demonstrated a good knowledge and understanding of Adult protection issues, which protects service users from harm and abuse. EVIDENCE: Information gathered from care workers records, the home’s training matrix and from the manager has demonstrated that all staffs are due for, and have been put forward for refresher on Adult Protection update course. The home operates a key worker system that allows one to one relationships between service users and care workers. This system is reviewed on a regular basis and changes made to allow all the service users to interact on a one to one basis with the care workers. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The overall standards of cleanliness of the home, quality of the furnishings and fittings is good, creating a pleasing, comfortable and safe environment for the service users. EVIDENCE: The home’s environment is clean and is maintained by the care workers. There is a feeling amongst the care workers and service users of ownership of the home. Service users bedrooms reflects their individuality,lifestyles and preferences. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 assessed at last inspection. EVIDENCE: For information on this standard please refer to the report of 25th July 2005. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The service users are unable to demonstrate that they understands that their views underpin any significant changes to the home. EVIDENCE: Due to the severity of disablement of the serviced users it was very difficult to ascertain to what degree they understand about the running of the home or if they are aware of the importance of expressing their views on the running of the home. In discussion with the manager, the inspector was informed that the Trust is in the process of reviewing their review and development programme based on the Trust’s quality review standard. All relevant information has been sent up to the Trust only a fortnight ago, so response was not expected in time for this inspection. Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cedarwood Lodge Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000013589.V249888.R01.S.doc Version 5.0 Page 17 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Cedarwood Lodge DS0000013589.V249888.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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