Inspection on 09/01/06 for Cedarwood Nursing Home

This inspection was carried out on 9th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cedarwood Nursing Home 02/05/07

Cedarwood Nursing Home 26/05/06

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 9th January 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 Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 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.V276925.R01.S.doc Version 5.1 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.V276925.R01.S.doc Version 5.1 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 11th May 2005 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. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One hour was spent prior to the inspection reviewing previous requirements and recommendations, and collating information provided by the service. The inspection took place over a period of four hours as part of the statutory inspection programme. Two 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. What the service does well: 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 Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 6 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.V276925.R01.S.doc Version 5.1 Page 7 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): 3 Needs assessments do not cover all aspects of resident need. EVIDENCE: Assessments were carried out on the residents chosen to case track, but these assessments considered physical needs only and did not record resident choices, lifestyle or hobbies and interests. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 8 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 and 11 Care plans are inadequate to direct staff in caring for residents. Evidence that assessed needs were being met was not always available. Records of resident’s wishes at the time of their death were incomplete. EVIDENCE: Some work had been done to audit care plans and the Registered Manager had produced a guidance document for staff concerning the writing of these documents. However, information contained remains incomplete, contradictory and evidence of resident or their advocate being involved in the production or review of these documents is not always available. For example a resident with a diagnosis of dementia, has no care plan for her specialist needs in this area. A resident is recorded as having a wound, but there is no record of where this wound is. Another resident has a care plan for nutrition that states that she is able to take a good diet as long as it is cut up for her, but throughout her daily statement, constant references are made concerning her refusal to take fluids and diet. Care plans do not contain sufficient detail. For example “on pressure relieving mattress” with no indication as to the type or settings of these mattresses or if a pressure-relieving cushion is provided when the resident is got up. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 9 One resident is recorded as having a catheter in situ on her assessment, but there is no care plan for this or for care of her incontinence if this has been removed. Neither resident case tracked had a night care plan in place. Staff spoken to described communication methods used for those residents unable to communicate verbally but there was no record of this in the care plans to guide unfamiliar staff. Records of the preferred arrangements in case of death were recorded in one resident notes but not in the other. Requirements were made in this respect. Records of bowel action and baths/showers is kept in separate files that care staff complete Abbreviations are used in these documents that do not comply with the code stated so that it is unclear what is happening. These files are left in the corridor of the home with potential access for non-authorised personnel. Advice was given that all such records should be kept in resident’s individual files. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 10 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): 13 Residents are enabled to maintain contact with family and friends. EVIDENCE: Visitors are allowed at any time and two spoken to stated that they visit every day and are made very welcome by the staff in the home. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 11 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): These standards were not assessed on this occasion. EVIDENCE: Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 12 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, 24, 25 and 26 The home is maintained in a homely manner, is clean and hygienic and residents individual rooms are pleasant places in which to live. 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. All fire doors throughout 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 many rooms were unoccupied at the time. Requirements were made in this respect. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 13 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): 29 and 30 The homes recruitment practices protect residents from abuse. The home has a commitment to staff training. EVIDENCE: A selection of staff files was seen. These demonstrated that the necessary Criminal Records Bureau checks and references were obtained prior to employment. Evidence of the staff identity was also obtained. Staff spoken to confirmed that training is provided and posters advertising planned sessions on wound care and Fluid Balance and Hydration were seen. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 14 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, 35, 36 and 38 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. The Health and Safety of residents and staff are not always protected. 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. Resident finances are controlled at head office and records of transactions are kept on the computer in a clear and transparent manner. Paper copies of these records were provided for inspection. Staff referred to their supervision sessions in discussion but records of these were not monitored on this occasion. As stated at Standard 19 above, fire doors were wedged open in the home. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 15 Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 16 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X 3 3 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 2 Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement Timescale for action 01/02/06 2 OP7 15(1) & 2© 3 4 OP37 OP19OP38 17(1) a 23(4) a General assessments must cover all aspects of standard 3. (Previous date of 20/6/06 not met) Resident’s plans must be 01/03/06 reviewed to ensure that all identified needs are covered and that they do not contain any conflicting information. Evidence must be available that residents or their advocate must be included in the formulation and review of their plan. Resident’s personal records must 01/02/06 be stored in a secure manner. Fire doors must be kept closed at 01/02/06 all times, unless automatic closers are fitted that activate in case of fire. 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 Good Practice Recommendations DS0000012605.V276925.R01.S.doc Version 5.1 Page 18 Cedarwood Nursing Home 1. Standard OP11 Service users wishes in the event of their death should be ascertained. Cedarwood Nursing Home DS0000012605.V276925.R01.S.doc Version 5.1 Page 19 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. 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