Inspection on 26/05/06 for Cedarwood Nursing Home

This inspection was carried out on 26th May 2006.

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 Nursing Home 02/05/07

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 Mrs Linda Preen Unannounced Inspection 26th May 2006 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 DS0000012605.V297087.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. DS0000012605.V297087.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 hannah@cedarwoodnursing.co.uk 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 DS0000012605.V297087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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 9th January 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 a family run venture and the service users and their families are encouraged to be involved within the home. Fees range from £475 to £500 according to assessed needs. DS0000012605.V297087.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Three Hours were spent prior to the inspection reviewing previous requirements and recommendations, and collating information provided by the service. No comment cards had been returned by residents or their visitors. The inspection took place over a period of seven hours as part of the statutory inspection programme. Three residents were chosen in order that their experience in the home could be monitored. This included looking at their records, talking to them and also to the staff concerning the care received. A limited tour of the environment was undertaken, and staff and maintenance records were seen. What the service does well: What has improved since the last inspection? Work has been done to improve care plans in order to assist staff in meeting resident’s assessed needs, and these care plans are regularly reviewed to ensure that they are up to date. Resident assessments have been expanded to ensure that all areas of their needs are identified including Physical, emotional and social needs. Some new armchairs have been purchased to increase resident comfort. A new call bell system has been installed and this is much less intrusive, enabling residents to summon help with minimal disturbance to others. DS0000012605.V297087.R01.S.doc Version 5.2 Page 6 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. DS0000012605.V297087.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 DS0000012605.V297087.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 does not apply in this home. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be assured that all areas of their lives will be included in the assessment and care planning process to ensure that identified needs may be met. EVIDENCE: A brochure, Statement of Purpose and Service User Guide are available, setting out the services offered. Assessments were carried out on the resident’s chosen to case track, and these assessments considered physical and emotional needs, choices, lifestyle and hobbies and interests. DS0000012605.V297087.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Care plans direct staff in caring for residents. Evidence that assessed needs were being met was available. Residents may be assured that their wishes in regard to arrangements at the time of their death will be carried out. EVIDENCE: Three residents were chosen to case track on this occasion. These residents had a variety of conditions and one was currently being nursed in bed. He said he was very comfortable and that his needs were being met. Records demonstrated that comprehensive care plans had been formulated to address assessed needs. These were individualised and specific to the individual and were regularly reviewed to ensure that they were up to date. There was however no evidence that residents or their advocate had any input into these plans or their review. A recommendation has been made in this respect. DS0000012605.V297087.R01.S.doc Version 5.2 Page 10 Records were available of General Practitioner and other Professions Allied to Medicine visits the home and that referrals for identified needs were made in a timely manner. Those residents spoken to confirmed that the standard of care was good and that staff were very caring. Medication records and systems were monitored and found to be satisfactory. A contract is in place for the disposal of unused medication. Interaction between staff and residents was observed to be relaxed and friendly, giving due regard for their dignity and privacy. Privacy screens were provided in shared rooms and staff were observed to knock before entering resident rooms. Resident’s preferred arrangements at the time of their death was recorded on the files seen. DS0000012605.V297087.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 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 daily interest and variation for people living in the home. Nutritious meals are provided. EVIDENCE: Records of individual choices concerning hobbies and interests, times of rising and retiring, and food was available on the files seen. An Activities co-ordinator is employed who arranges a monthly programme of activities. Such things as Crafts, Bingo, film afternoon, Lady’s Day, Gentleman’s Day and a visit from a tortoise were listed for June. One resident spoken to said she enjoyed armchair exercises. Individual records of involvement in activities are recorded. Despite this one gentleman stated that nothing is provided. In discussion staff stated that this gentleman declines offers to participate in activities and his records confirmed this. In addition to this some residents have their own televisions in their rooms or are able to watch it in one of the communal lounges. Visitors are welcome at any time and one lady who was celebrating her birthday had a visit from her family during the inspection. DS0000012605.V297087.R01.S.doc Version 5.2 Page 12 Lunch was observed during the inspection. This is served at small individual tables in the lounge areas and residents do not sit at a formal dining table. Staff stated that this option had been tried but residents preferred to stay where they were. Menus seen demonstrated that a varied nutritious selection of meals was provided. However there is no choice offered and residents were unaware of what the day’s menu was some 15 minutes prior to it being served. One resident said it was always a surprise! The cook stated that an alternative could be provided if residents did not like what was on offer but as they were unaware of what was planned, this would be very difficult. In the case of one resident, the cook was aware that she did not like fish, but did not come out to ask her what she wanted instead until all other meals had been served. This did not give any time for a proper alternative to be prepared and left the lady in question to eat on her own after others had finished. Residents who needed assistance to eat were given this in a sensitive manner and specialist cutlery and crockery were provided where this was needed. A discussion took place regarding the nutritional content of pureed food and advice was given to obtain specialist advice concerning the presentation and fortification of these meals. One resident commented that it was a pity I was not joining them for lunch, as it was very good. DS0000012605.V297087.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be assured that their concerns will be taken seriously and that they will be protected from abuse. EVIDENCE: A complaints procedure is available in the home, outlining action to be taken in case of concerns being received. There have been no recorded complaints or concerns in the home since the last inspection and none received by The Commission for Social Care Inspection. A copy of the Interagency Procedures for The Protection Of Vulnerable Adults is available for staff guidance. Staff training records demonstrated that staff had received training in this area, and in discussion staff were aware of the types of abuse which may occur and of their responsibilities in reporting any actual or suspected incidences. DS0000012605.V297087.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 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 maintained in a homely manner, is clean and hygienic and resident’s individual rooms are pleasant places in which to live. Resident’s health and safety is not always protected. EVIDENCE: A limited tour of the environment was undertaken. This demonstrated that all areas seen were clean, and decorated and maintained to a good standard. Resident’s rooms showed evidence of personalisation with small items of personal furniture, pictures and ornaments on display. Some fire doors in the home were propped open or wedged which presents a fire hazard. The Registered manager stated that this was because residents prefer their doors open, but she was reminded that this might be a hazard in case of fire. Some specialist door stays had been provided following DS0000012605.V297087.R01.S.doc Version 5.2 Page 15 requirements made at the last inspection but questions were raised concerning the suitability of these fittings in case of fire. A requirement has been made in this respect. DS0000012605.V297087.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. The homes recruitment practices protect residents from abuse. The home has a commitment to staff training. EVIDENCE: Duty rotas were seen. These demonstrated that there is one Registered Nurse with four care staff on duty during the daytime and one Registered Nurse and two carers at night. This would appear adequate to meet the needs of the current resident group, but is not calculated using the Residential Forum Guidance tool based on resident dependency, and should be reviewed if the resident’s needs change. Staff training records were seen. These demonstrated that the home has a commitment to training with monthly specialist training provided in addition to statutory training in Fire, Health and Safety, Moving and Handling, Control of Substances Hazardous to Health and Food Hygiene. Four care staff currently hold a National Vocational Qualification in Care with a further five working towards this award. This is in addition to the Registered Nurses employed in the home. Staff members spoken to confirmed that they received this training and that they looked forward to learning opportunities in the home. A selection of staff files was seen. These demonstrated that recruitment practices protect residents from potential harm, with references, Criminal Records Bureau checks and Health questionnaires being completed prior to employment. DS0000012605.V297087.R01.S.doc Version 5.2 Page 17 The home has an equal opportunities policy and employs staff from a range of ethnic backgrounds and age groups. DS0000012605.V297087.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. An experienced manager runs the home, in a way that benefits residents. Satisfactory systems are in place to monitor resident finances. Staff are appropriately supervised. EVIDENCE: The Registered Manager is a First Level 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. Regular staff meetings are held and the minutes for these were available for inspection. The manager conducts a quarterly audit of all areas of the home to ensure that standards are maintained and problems identified. The latest DS0000012605.V297087.R01.S.doc Version 5.2 Page 19 resident survey had just been completed and the results of this were awaiting collation. Resident finances are controlled at head office and records of transactions are kept on the computer in a clear and transparent manner. These were not available on this occasion but were satisfactory when seen in January of this year. Staff supervision records were available for inspection and staff confirmed that these sessions took place. Records of the testing of fire alarms, emergency lighting and maintenance of fire fighting and other equipment were seen and found to be satisfactory. A stated at standard 19 above, some work has been done concerning the wedging open of fire doors but advice is needed from the fire officer concerning the suitability of the design of door stops fitted. DS0000012605.V297087.R01.S.doc Version 5.2 Page 20 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 DS0000012605.V297087.R01.S.doc Version 5.2 Page 21 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 Standard OP19 Regulation 23(4) a Requirement Advice must be obtained from the fire officer concerning the type of door stays in use and the leaving open of resident’s doors. Timescale for action 14/06/06 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 3 4 Refer to Standard OP7 OP15 OP15 OP15 Good Practice Recommendations There should be evidence of residents or their advocates having input into their assessment and care plan as well as in the review of these documents. Advice should be sought concerning the nutritional content and presentation of pureed diets. Menus should be on display in the home so that residents are aware of planned meals. Residents should be offered a choice of meals at main meal times in sufficient time to make this choice meaningful. DS0000012605.V297087.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 DS0000012605.V297087.R01.S.doc Version 5.2 Page 23 - 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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