Inspection on 02/05/07 for Cedarwood Nursing Home

This inspection was carried out on 2nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Nursing Home 26/05/06

Cedarwood Nursing Home 09/01/06

Cedarwood Nursing Home 11/05/05

Cedarwood Nursing Home 31/01/05

Cedarwood Nursing Home 15/06/04

Cedarwood Nursing Home 01/03/04

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

CARE HOMES FOR OLDER PEOPLE Cedarwood Nursing Home 492 Kettering Road Spinney Hill Northampton Northants NN3 6QP Lead Inspector Sarah Jenkins Unannounced Inspection 2nd May 2007 07:35 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 Nursing Home DS0000012605.V335610.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 Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedarwood Nursing Home Address 492 Kettering Road Spinney Hill Northampton Northants NN3 6QP 01604 643114 01604 719606 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) Cedarwood Nursing Homes Limited Ms Sarah Cliffe Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability (32), Terminally ill (32) of places Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Provide care for a named service user who has a diagnosis of dementia. The age range of the 32 service users is from 50 years onwards. No further service users in the category of OP PD(E) and TI(E) may be admitted into the home when there are already a total of 32 service users accommodated in these categories. To admit the person named in variation V34786 who is under 50 years of age. 26th May 2006 Date of last inspection Brief Description of the Service: Cedarwood Nursing Home provides nursing and personal care for up to 32 Service Users within the categories of old age, physical disability and terminal illness. The home is situated in a residential area within the suburbs of Northampton and has good access to local facilities and amenities. The accommodation offers 12 single rooms and 10 shared rooms with three lounge areas and a dining room. The business is family run and the service users and their families are encouraged to be involved within the home. Fees range from £345 to £550 according to assessed needs. Information about the home can be obtained from the Registered Manager in the form of the Statement of Purpose and Service Users Guide Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 3 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the nursing and care staff and observation of care practices. The Inspector spent two hours preparing for the inspection and six and threequarter hours in the home. The visit was undertaken in the morning to observe practices by staff and to meet with service users. The Registered Manager was not available at the time of the inspection, which was undertaken with senior staff on duty. The inspector had a telephone conversation with the Registered Manager the day after the inspection to explore some issues a little further and to offer feedback on the findings of the inspection. The pre-inspection questionnaire was filled in by the Registered Manager prior to the inspection and informed the inspection. The Commission for Social Care Inspection did not receive any feedback comment cards prior to the inspection due to a problem with the post What the service does well: What has improved since the last inspection? Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 6 Previous requirements and recommendations have mainly been met. A Quality Assurance audit has been undertaken and all issues raised by service users have been appropriately addressed. 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. The summary of this inspection report can be made available in other formats on request. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their needs will be assessed, and that they will be given good information to enable them to make an informed choice about the home. EVIDENCE: Service users case tracked were not able to describe the admission process nor how the home had been chosen on their behalf, but expressed general satisfaction with the way in which they had been introduced to the home and felt that the staff had been welcoming and able to care appropriately for them from the start. They commented that they felt “happy” with the home. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 9 The Inspector reviewed the admission process and preadmission assessment for a recently admitted service user from her records and from discussion with staff, and found that the process had been full and thorough. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident in the care and attention that they receive, and are supported to have good access to medical staff and doctors as needed. EVIDENCE: Service users were happy with the medical care that they received from both the homes staff and from General Practitioner surgeries. Nursing staff were observed to be alert to service users needs and to prompt Doctors visits appropriately. Records showed a quick response to service users identified medical needs. Each service user had a care plan, and although some could not remember discussing the care plan, they expressed satisfaction with the personal care that they were given. There was evidence on records that these plans had generally been discussed with service users and/or their relatives or advocates appropriately. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 11 Medication was seen to be generally well managed and service users reported that they received their prescribed medications on time. Advice was given on the need to be able to fully audit all medications held on site. A breach in hygienic practice by a staff member in relation to the administration of medicines was advised and discussed with the staff member concerned at the time of the inspection, and the Inspector is confident that it will be followed up appropriately. Service users were seen to be treated with respect by staff who had a full understanding of the importance of maintaining privacy and dignity at all times. Service users confirmed that staff were generally “very nice” and “very good” in this respect. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 12 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 group is good. This judgement has been made using available evidence, including a visit to the service. Social Activities are well managed, creative and provide interest and variation for people living in the home. Service users were complimentary about the food provision, which is nutritious, well presented and appetizing. EVIDENCE: An Activities co-ordinator is employed for 16 hours a week. She arranges a monthly programme of activities. A record of individual choices concerning hobbies and interests was available in the activities file and individual records of involvement in activities were seen. Staff stated that they felt the provision was good although some service users had no particular wish to be involved in organized activities, preferring a chat with a staff member. Staff recognized the social importance of chatting with service users and said that time for this was built in to the time they spent with service users. Advice was given on the need to ensure that up to date information on service users social needs and preferences is on their care plans. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 13 Visitors are welcome at any time and service users said that visitors were welcomed, and offered hospitality. The midday meal was observed during the inspection. This is served at small individual tables in the lounge areas. Service users expressed content with this arrangement. Menus seen demonstrated that a varied nutritious selection of meals was provided. Residents who needed assistance to eat were given this in a sensitive manner and specialist cutlery and crockery were provided where this was needed. Service users were highly complimentary about the food, which was seen to be appetizing and nutritious. Service users expressed full satisfaction with the provision of food at the home. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 14 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. Service users are protected by the good quality of staff communication and the trust that has been developed. Records of complaints investigations could be improved. EVIDENCE: Staff have received training in Protection of Vulnerable Adults and are generally aware of the issues, although a need for some update training was agreed. The inspector observed that the trusting relationships that had been established between staff and service users, was likely to ensure service users always raised any concerns with the staff or the management of the home. The Commission for Social Care Inspection has not received any complaints about the home recently. One anonymous complaint has been received by the home. Complaints are investigated by the home, but advice was given to ensure that records of investigations include evidence of the whole process, recording for example interviews with staff members. Care must be taken by the investigator not to make assumptions about the quality of care, albeit this was seen to be good at the time of the inspection. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 15 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): 19,26 Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. The home is reasonably clean and hygienic and service users individual rooms are pleasant places in which to live. Homeliness could be enhanced through refurbishment. Resident’s health and safety is not always properly protected, and consideration should be given to storage and tidiness. EVIDENCE: A partial tour of the environment was undertaken. This demonstrated that all areas seen were well maintained, and decorated to a reasonable standard. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 16 Resident’s rooms showed evidence of personalisation with small items of personal furniture, pictures and ornaments on display. The environment of the home is beginning to look a little shabby in places, particularly in communal areas and corridors where some carpets are stained and some of the furniture is worn. In discussion with staff it appeared that carpets were not very old and were regularly steam cleaned, and a question was therefore raised about how promptly domestic staff were able to deal with spillages to prevent staining. Storage of equipment around the home appears to be problematic and some storage and tidiness issues as discussed with the staff on the day of the inspection, and subsequently on the telephone with the Registered Manager, could present a Health and Safety hazard. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 17 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. Staff are well trained and experienced and responsive to residents individual needs. They are kind, committed and caring and residents feel safe in their hands. EVIDENCE: At the time of the inspection there were sufficient staff on duty to meet the needs of service users. The rota showed that this level of staffing was normal for the morning shift. Staff on duty reported that they felt that they had had good training for their roles and were advised of training dates for necessary training or refresher courses and opportunities to follow up specific interests. They were confident that they were properly trained for the jobs they were doing. Records and discussion demonstrated that training needs and refresher courses for staff were generally addressed promptly. There is an element of training, in the degree of information that is provided to staff throughout the home, in records and in notices for staff. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 18 The inspector spoke to a staff member who had been recently recruited. She described a professional recruitment process, induction period and ongoing supervision and support. This was evidenced in staff records. Advice was given on the importance of staff not starting their duties prior to the receipt of the “pova first” check as a minimum requirement. This appeared to have occurred as an oversight in one instance but was not general practice. The home has an equal opportunities policy and employs staff from a range of ethnic backgrounds and age groups. Service users felt that staff had “good training” and were properly equipped in terms of knowledge and experience for the roles that they undertook. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 19 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Management of the Home is effective and efficient and the home is run in the best interests of the service users. EVIDENCE: The Registered Manager is a Registered Nurse with many years experience in caring for this resident group. She has completed the Registered Manager’s Award. Staff spoken to confirmed that she is approachable and supportive. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 20 Quality Audit processes are fully and effectively undertaken; results are collated and issues arising responded to. Service users finances are controlled at head office and records of transactions are kept. Details of the appointments of Power of Attorneys on behalf of service users are sought at admission. The Inspector reviewed the records of the use of personal allowances for 2 service users and found that these were satisfactory. The home employs and accountant to undertake a full audit on financial matters. A sample of records relating to the management of the home, including Health and Safety checks, were sampled and found to be of good quality both in terms of content and regular updating. Although health and safety issues are generally well managed advice was given at this inspection of hazards created by poor storage. Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 21 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 1 Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP19 OP38 Regulation 13,23 Requirement Storage of equipment must be appropriate, to ensure a safe environment is maintained Timescale for action 30/05/07 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 Refer to Standard OP9 Good Practice Recommendations The Royal Pharmaceutical Society guidance on the administration of medicines in Care Homes should be accessed to check against current practices. Administration of medicines should be fully professional at all times. Staff should be alert to issues of tidiness in service users rooms at all times, and should encourage and assist the service users to keep their rooms free from hazards. Complaint investigations should show a record of the full details of how the investigation was undertaken including notes on staff interviews. 2 4 OP19 OP16 Cedarwood Nursing Home DS0000012605.V335610.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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