Inspection on 27/06/05 for The Cedars Care Centre

This inspection was carried out on 27th June 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

The Cedars Care Centre 14/05/07

The Cedars Care Centre 11/01/07

The Cedars Care Centre 16/11/05

The Cedars Care Centre 24/01/05

The Cedars Care Centre 12/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE CEDARS NURSING HOME 12 Richmond Road New Barnet Hertfordshire EN5 1SB Lead Inspector Daniel Lim Announced 27 & 28 June 2005 @ 09.15 am 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 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. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cedars Nursing Home Address 12 Richmond Road, New Barnet, Hertfordshire EN5 1SB 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) 020 8364 8839 020 8449 9252 Dr Mark Kaplan of Cedar Gardens Care Ltd David Adams Care Home with Nursing 45 beds Category(ies) of OP - Old age registration, with number of places CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specific service user who is under 65 years of age has mental health needs may be accommodated home. This condition will need to be reviewed at such time as the service user attains the age of 65 years or vacates the home. Date of last inspection 24 January 2005 Brief Description of the Service: The Cedars Nursing Home is a care home registered for a maximum of 45 older people who require nursing care. It is one of a number of care homes owned by Cedar Garden Care Limited. The present owners have owned the home since 1999. The aim of the service is to provide quality nursing care in a supportive environment. The home is a large detached two storey house. There are thirty five single bedrooms and five double bedrooms located across the ground and first floors. All the bedrooms have en suite facilities. Air conditioning is provided in the home. There is a shaft lift serving the ground and first floor.The communal areas, including a dining room and two interconnected lounge areas, are on the ground floor. There is a well maintained garden with a patio area to the rear of the home. There is also a small parking area at the front of the home. The home is situated in New Barnet, a short distance from the Great North Road and in a quiet residential area. It is about a mile from shops and other community facilities located in High Barnet. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 27 & 28 June 2005 and took a total of 10 hours to complete. The inspector found that most of the National Minimum Standards assessed had been met and the overall quality of care provided was good. During this inspection, the inspector was accompanied by the manager of the home (David Adams). The inspector was able to interview six residents. The feedback received from them was positive. Completed questionnaires were also received from two residents and a healthcare professional. These indicated that residents were well cared for. Statutory records including five residents’ case records, the maintenance records and fire safety records of the home were examined. The premises including residents’ bedrooms, laundry, kitchen, gardens and communal areas were inspected. Staff on duty were interviewed on a range of topics associated with their work and staff records (including supervision and training records) were examined. In addition, the minutes of staff meetings and residents / relatives meeting were also examined. What the service does well: The home was clean and furnished to a high standard. All bedrooms had ensuite facilities and air conditioning had been installed. The statutory records such as resident’s case records, staff records and maintenance records were up to date and information was kept in an orderly manner. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 6 Staff interviewed were knowledgeable regarding their roles and responsibilities and there was documented evidence that they had been provided with training and were closely supervised. Arrangements were in place to ensure that the healthcare needs of residents are attended to. This was noted in records examined. Residents who were interviewed stated that they were satisfied with the quality of meals provided. The home had a comprehensive programme of social activities and the activities organiser had a record of activities provided for residents. Crafts and pictures made by residents were on display at the home. What has improved since the last inspection? What they could do better: The registered person must repair or replace the faulty freezer and ensure that food in the freezer is stored at a temperature colder than – 18 C. The registered person must ensure that nursing staff update their training in the care of residents with diabetes. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 7 The registered person must ensure that all new staff recruited have received a recent CRB disclosure before starting work at the home. This includes staff who have previously worked at another care home. The registered person must consult with the LFEPA regarding the homes evacuation procedure. The registered person must review the written agreement with relatives regarding the admission of certain residents into hospital to ensure that the rights and best interests of residents are protected. 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. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 9 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 standard(s) 1-4 The manager and his staff had a good understanding of the needs of residents and were able to ensure that their needs are met. EVIDENCE: Six residents who were interviewed indicated that their care needs had been met at the home and they were generally happy with the services provided. Completed questionnaires received from a further two residents indicated that the respondents were satisfied with the overall care provided at the home. The inspector was provided with letters and cards from relatives expressing gratitude for the care provided to residents at the home. A sample of five residents’ case records which was examined, contained comprehensive plans of care and details of how residents needs had been met. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 10 The inspector observed that residents in the home were clean, appropriately dressed and appeared well cared for. Contracts with residents had been provided. Those examined were comprehensive. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 11 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 standard(s) 7-10 There was evidence to indicate that the personal and healthcare needs of residents had been met. EVIDENCE: Feedback received from residents interviewed indicated that they had been treated with respect and their healthcare needs had been attended to. The sample of five case records examined were up to date and plans of care had been reviewed monthly. Records of medical and healthcare treatment were documented. This included physiotherapy treatment. Staff interviewed were knowledgeable regarding the care to be provided to residents. The plans of care of residents with pressure sores and diabetes were examined. They contained instruction / guidance to staff on the care to be provided. Staff who were interviewed were knowledgeable of this. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 12 The plans of care examined had been signed by residents or their representatives. The medication administration charts examined had been appropriately signed. The temperature of the medication fridge had been monitored daily and found to be satisfactory. The treatment room where the medication was stored was air conditioned and kept at a temperature of under 25 C. Residents interviewed stated that they had been given their medication. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 13 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 standard(s) 12 -15 The daily life and routines of residents were well organised and residents social and cultural needs had been met. EVIDENCE: The inspector spoke to the activities organiser and saw the home’s programme of weekly social and therapeutic activities. Residents interviewed were generally happy with these activities. The inspector was also able to view pictures and ornaments made by residents which were displayed along the corridor. Residents who were interviewed stated that they were satisfied with the meals provided. The menu was examined and noted to be varied and balanced. Choice of main dish was available at meal times. The kitchen was inspected and found to be clean. Kitchen staff had been provided with food hygiene training. A fire blanket and extinguisher were in place. Daily records of fridge and freezer temperatures had been documented. The inspector noted that the temperature of one of the freezers was too high CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 14 (warmer than - 18 C). This was brought to the attention of the chef and manager. A requirement is made for the temperature of this freezer to be maintained at a temperature which is colder than – 18 C. There was evidence that residents’ preferences and suggestions had been responded to. This was noted in the minutes of residents’ meetings and confirmed by some residents interviewed. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 15 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 standard(s) 16 &18 There was evidence that the rights of residents were protected and complaints taken seriously. Systems were in place to ensure that residents are protected from abuse and ill treatment EVIDENCE: The staff records were examined. These contained evidence that staff had been provided with adult protection training. Staff who were interviewed knew how to respond to allegations of abuse received. The complaints book was examined. Complaints made had been promptly responded to. Residents interviewed stated that they were well treated by staff and no complaints were received from them. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 16 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 standard(s) 19-26 The home was clean and maintained to a high standard, therefore providing a pleasant environment to live in. The facilities were adequate. EVIDENCE: The premises were inspected and found to be clean and hygienic. The required maintenance and safety certificates were seen by the inspector. These included safety inspection certificates for the portable appliances, electrical installations, lift, hoists and gas installations. The hot water was tested and found to be within the required safe temperature range of no higher than 43C. Residents’ bedrooms were inspected and found to be well furnished. Residents interviewed stated that they were happy with the accommodation provided. The gardens were attractive and seating had been provided. Residents were seen to be enjoying the garden. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 17 CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 Staff were competent and the needs of residents were met. However, further improvements are needed in staff training and the recruitment of staff. EVIDENCE: The staff rota was examined. This confirmed that the agreed staffing levels had been maintained. Staff who were interviewed on a range of topics (such as adult protection, palliative care, food hygiene, pressure area care and health and safety were knowledgeable regarding their roles and responsibilities. Training records examined indicated that most of the required training had been provided. The sample of three staff records examined contained most of the required documentation such as two references, satisfactory CRB disclosures, contracts and evidence of identity. One of the records examined did not contain a recent CRB disclosure. The manager explained that the staff concerned had a CRB disclosure from the previous care home where she worked and a new disclosure had been applied for. The inspector informed the manager that all new staff recruited by the home must have a recent and satisfactory CRB CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 19 disclosure before starting work at the home. A requirement is made in this report accordingly. A further requirement is made for nursing staff to update their training in the care of residents with diabetes. Most of the staff interviewed stated that they were happy with the way they were managed. Two staff who wanted to be anonymous, expressed dissatisfaction at the manager’s management style. The inspector advised staff concerned to follow the home’s grievance procedures if they wished to take the matter further. This dissatisfaction was also brought to the attention of the manager. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-38 The home was generally well managed and systems were in place to ensure the health and safety of residents. A number of deficiencies related to the home’s policies and procedures were noted. EVIDENCE: When interviewed, the manager was found to be knowledgeable and residents expressed confidence in his abilities. Weekly fire alarm checks, fire drills and fire training had been documented. The home had recently been inspected by the fire authorities (LFEPA) and requirements made had been responded to. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 21 The inspector was unable to conclude that the home’s evacuation procedure and plan were adequate. This was discussed with the manager and a requirement is made for him to consult with the LFEPA regarding this. Six residents and a relative who were interviewed were of the opinion that the home was well managed. With two exception, staff indicated that the home was well managed. Two staff indicated that the manager’s management style was sometimes dictatorial. Staff concerned were advised to follow the home’s grievance procedures if they wish to take the matter further. The inspector noted that the case records of some residents contained agreements with relatives regarding conditions for admission into hospital. The terms of the agreement did not clearly ensure that the rights of residents are protected. The registered person is therefore required to review this agreement to ensure that the rights and best interests of residents are protected. A sample of three financial records were examined. These were well kept and receipts had been obtained for transactions made. A statement from the company’s accountant was received. This indicated that the business was viable. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 3 3 2 2 CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 23 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. Standard 15 Regulation 16(2)(g) Requirement The registered person must ensure that food in the freezer is stored at a temperature colder than – 18 C. The registered person must ensure that nursing staff update their training in the care of residents with diabetes. The registered person must ensure that all new staff recruited have received a recent CRB disclosure before starting work at the home. This includes staff who have previously worked at another care home. The registered person must consult with the LFEPA regarding the homes evacuation procedure. The registered person must review the written agreement with relatives regarding the admission of certain residents into hospital to ensure that the rights and best interests of residents are protected. Timescale for action 30/7/05 2. 30 18(1) 13/9/05 3. 29 19(5) 13/8/05 4. 38 23(4) 13/8/05 5. 37 12(1),13( 1)(b) 13/8/05 6. 7. CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 24 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 Good Practice Recommendations CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Solar House, 1st Floor, 282 Chase Road, Southgate, London, N14 6HA 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 CEDARS NURSING HOME G59 S10419 Cedars Nursing Home V216027 27.06.05 Stage 4.doc Version 1.40 Page 26 - 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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