Inspection on 25/07/05 for Cedarwood Lodge

This inspection was carried out on 25th July 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 19/09/05

Cedarwood Lodge 20/09/04

Cedarwood Lodge 20/05/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Cedarwood Lodge Chipstead Close Redhill Surrey RH1 6DU Lead Inspector Mavis Clahar Unannounced 25th July 2005 @ 9:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cedarwood Lodge Address Chipstead Close Redhill Surrey RH1 6DU 01737 277726 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Surrey Oaklands NHS Trust Mrs Julie Anne Parker CRH - Care Home 5 Category(ies) of LD - Learning Disability (5) registration, with number PD - Physical Disability (5) of places Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 - The 5 persons accommodated may be in the category LD (Learning Disabilities) or may be Adults with a Learning Disability who have an additional Physical Disability (LD/PD) 2 - The age/age range of the persons to be accommodated will be adults under 65 years. Date of last inspection 20 September 2004 Brief Description of the Service: Cedarwood Lodge is a purpose built bungalow owned by a private housing association. The home, which accommodates five service users, is situated in a quiet residential area of Redhill, with easy access to the town centre, and local amenities. The home provides care for five service users who have profound learning and physical disabilities. Accommodation is in single rooms. There is a good size paved garden to the rear of the building, 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 H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This unannounced inspection took place on the 22nd July 2005. The home received an announced inspection on the 20th September 2004. The inspector arrived at 08.30 am to find the staff very busy preparing the service users for their day. Two service users were going away for the weekend. The inspector noted that the four service users were served breakfast according to their requests. That means that no service user received the same breakfast. The first part of the inspection was spent with the service users at the breakfast table, observing care workers and service users interaction, speaking through sign language to service users, and verbal discussion with care workers about the care given to service users. The second part was spent reviewing service users notes, followed by a tour of the home and gardens. The last part was spent giving feedback to the deputy 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 through observation and the use of sign language and confirmed by the key worker that one service user was very excited about the planned weekend away from the home. He was up and dressed and kept smiling and laughing out loud when signs were made suggesting his going away on his holidays. 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. However, there is no indication that the service users were involved in the development of the care plans. These service users are non-verbal, unable to read and write and do not have an advocate. Following full discussions on the rights of the service users and the duty of care owing to these service users by the manager of the home a requirement was issued for the manager to seek advocates for each service user where family contact was missing. Further more the manager must involve the relatives or care mangers in the planning of care for these vulnerable service users. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Sweep the front of the house more often to get rid of the dead leaves. Make sure care managers action their support for the care plans by signing and dating them. Care workers to date their signature on the risk assessments. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 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. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 2 3. There is clear and consistent care planning system in place to adequately provide care workers with the information they need to satisfactorily meet service users needs. EVIDENCE: Review of service users file demonstrated that the home has established a good process of assessing service users needs. This was being enhanced and underpinned by the key worker and person centred approach to care. Care workers spoken to all seemed to have a good understanding of the needs of the service users, and are able to read the service users body language to ascertain their needs. The inspector found evidence in service users file, which was supported by care workers that notifiable incidents affecting service users such as service users being taken on holidays are not always sent to CSCI. A requirement was issued on this standard. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 6 9. The home continues to encourage service users to live active lives with the support of the care workers. 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. However, the inspector noted that although the care plans are very well laid out, there is no indication that the service user, relative/representative or care manager has been involved in the planning of the care. None of the care plans are signed. A requirement was issued on this standard. Consequently, it was very difficult to ascertain with any degree of certainty that the service users knew that their assessed and changing needs and personal goals are reflected in their individual care plans. Due to the severe disability of these service users, the inspector recommended that the manager contact the Surrey Advocacy Group to obtain advocacy service for those service users without family/relatives. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 11 All service users are vigorously risked assessed and all care workers sign the risk assessment to indicate their awareness of the risks associated with the particular service users needs and aspirations. It was noted that these signatures were not dated and a recommendation was made to have the risk assessment singed and dated. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12 13 15 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. EVIDENCE: Service users are encouraged and enabled to attend age/peer related social and cultural activities, but due to the severity of their disability they are unable to participate. On the day of inspection two service users were packing up to attend a rock concert in the New Forest for the weekend. The inspector was informed that service users are accompanied on shopping trips for food and personal toiletries. Three staff members are due to commence a life saving course in order that service users from this home can take up the offer of the use of the hydro pool at a nearby leisure centre which has offered the service users their own individual slot if they have suitable trained and qualified life savers with them. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 13 Service users are able to make friends outside the home. Only one service user in this home has contact with their family. Care workers at this home makes special effort to ensure the service users are involved in the community. One service user’s relative requests that the service user attends church on a regular basis and this request is carried out by care workers unless the service user is unwell. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 18 20. The home continues to offer individualised care to service users to ensure that their needs are met in a person centred way. EVIDENCE: Discussion with care workers and review of the care plans indicated each service user received the personal care or support as indicated on the care plans. All the service users are male and the care workers are a mixture of male and female. Service users are allocated a key worker who is changed on a regular basis so that service users get to know all the staff team. No service user at this home is risked assessed as capable to self-medicate. Staff trained to administer medication administers all medication. Medication record charts are mostly up to date. The checked administration record sheet was not signed, for the 8.00 am medication given on the day of inspection. A requirement was issued on this standard. The home’s guidelines for taking medication out of the home is satisfactorily completed. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 15 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 standard(s) 22. The home operates in a manner that supports service users. Relatives could air only one service user’s concerns and views as the other service users are not supported by relatives. EVIDENCE: It was evident from the service user’s files that concerns and views shared by the relatives are listened to and acted upon. However, this is only relevant to one service user. Hence the necessity for the manager to engage the services of advocates for the other service users as soon as possible, and to document the case managers involvement in the decisions made on behalf of the service users. The home has a complaints policy and procedure, and staffs spoken to on the day are aware of how to make a complaint, recognise and report abuse. The home’s complaints folder was reviewed and no complaints were recorded since the last inspection. Due to the serenity of the service users disabilities it is questionable whether or not they are able to make complaints. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 16 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 standard(s) 24 The standard of décor throughout this home is good, with evidence of continued improvement through maintenance. The home presents as a comfortable and homely environment for the service users. EVIDENCE: The home’s environment is clean and is maintained by care workers. There is a feel of service users’ ownership of the home and their bedrooms reflect their lifestyles and preferences. The communal areas of the home enable service users to have a choice in where to relax and watch television, eat and participate in other activities in the home. There is a large paved back garden with a retractable sun visor, which allows the service users to enjoy the outdoors without being in the direct sunshine. The flower borders are in need of tiding up and a gardener is employed, but has unfortunately gone off sick. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Care workers spoken to appear to be enthusiastic and committed to supporting the service users. Training and development of staff are up to date. EVIDENCE: The inspector was informed that due to the severity of disabilities of the service users, training of care workers is given high priority; in order that care workers will be more able to meet the assessed health and social needs of the service users. All care workers including long term agency staffs are trained and regularly updated in moving and handling, first aid, health and safety fire prevention, vulnerable adults protection, and administration of medicines. The training files for all staff was reviewed along with the staff rota and these documents supported this claim. The inspector observed good interaction between care workers and service users. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The management of the home is efficient effective. The manager and staff continue to offer a person centred service to the service users. EVIDENCE: The home’s policies and procedures safeguard the service users and promote their independence as far as possible and this was supported in discussions with care workers. All service users are registered with a local GP and have access to the services of the dentists, dietician and the services of the wider primary health care team. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 19 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 3 2 x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cedarwood Lodge Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 3 6 Regulation 37 15 Requirement CSCI must be notified of all notifiable incidents such as service users going n holidays. Demonstrate that consultation with service user/representative on how the service users needs in respect to health and welfare are to be met Risk assessments are to be dated along with care workers signatures.. Checked administration records must be signed time medication is administered. Timescale for action 22/9/05 22/10/05 3. 20 13 immediate. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations The manager to contact surrey advocasy group to obtain advocate service for the service users. Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cedarwood Lodge H58 H09 S13589 Cedarwood Lodge V225682 250705 Stage 4.doc Version 1.40 Page 22 - 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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