Inspection on 10/08/05 for The Cedars

This inspection was carried out on 10th August 2005.

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 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 03/08/06

The Cedars 16/02/06

The Cedars 09/12/04

The Cedars 17/06/04

The Cedars 12/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE THE CEDARS BROOKFIELD DRIVE HOLMES CHAPEL CHESHIRE CW4 7DT Lead Inspector BRONWYN KELLY UNANNOUNCED 10TH AUGUST 2005 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. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Cedars Address Brookfield Drive Holmes Chapel Cheshire CW4 7DT 01477 532857 01477 544366 thecedars@clsgroup.org CLS Care Services Limited 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) No registered manager in post at present Care Home 27 Category(ies) of OP Old Age registration, with number LD(E) Learning Disabilities over 65 of places THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than 26 Service Users may be OP 2 No more than 1 Service User may be LD(E) Date of last inspection 9 December 2004 Brief Description of the Service: The Cedars is a registered care home providing personal care and accommodation for 26 older people and one person over the age of 65 years who has a learning disability. The home is managed by CLS Care Services Limited, a not for profit organisation which manages a number of homes in the Northwest. The Cedars is situated in the small town of Holmes Chapel in a well established residential area. Local community amenities such as shops and a bus stop are within a short walking distance. The Cedars was purpose built in the 1980s and has single bedroom accommodation on the ground and first floors. 8 of the 27 bedrooms have ensuite facilities. Communal facilites include two lounges, a smoking room and a dining area attached to the main lounge. There is a secure garden and patio area, which has been coulourfully planted with flowers by one of the residents. Oudoor seating is available for the warmer weather. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and commenced at 09.30 am, lasting for six hours. A tour of the building took place, and with the permission of the residents, a number of bedrooms were seen. Eight residents were spoken with privately and each agreed to answer questions and complete a comment card with assistance. Group discussions with residents also took place in the lounges. Three visiting relatives were spoken with during the inspection. The views of two care staff, one care team leader, the acting manager, the cook and the home service manager were also listened to. What the service does well: What has improved since the last inspection? Decoration and furnishings continue to improve and some parts of the home are starting to look more welcoming and homely. A first floor lounge, formerly a smoking room, has been furnished and made available for residents, providing a choice of sitting areas. A residents’ satisfaction survey has been completed since the last inspection. The front and rear garden areas have been much improved by one of the residents, who enjoys gardening as a hobby. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 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. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 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 standard(s) 1 and 3 There is insufficient information available in the home to enable people to make a choice about whether or not they may wish to live in the home. EVIDENCE: There is no service user guide or statement of purpose readily available in the home for prospective residents to see and be clear about the services the home provides to meet their needs. An old out of date version was finally borrowed from a resident’s room during the inspection. The individual records for four residents were seen which included evidence that their needs had been assessed before they moved into the home. However, these assessments had not been signed or dated. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 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 standard(s) 7 and 9 There is a clear care planning system in place to provide staff with the information they need in order to meet the needs of the residents. The medication system at the home is well managed, although alterations to the storage system should be made to improve safety. EVIDENCE: Four residents’ plans of care were seen and each clearly showed what staff need to do to meet all their needs. They were well written, up to date and reviewed on a regular basis. This ensured that residents’ changing needs were always recorded in the plans of care. The home’s policies and procedures for dealing with medication were being followed. For safety reasons, the staff were asked to ensure that the medicine trolley is securely locked away after use rather than the occasional practice of leaving it in the entrance hall for convenience. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 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 standard(s) 12 & 15 The meals in The Cedars are good offering both choice and variety and catering for special dietary needs. There are very few social activities provided in the home to meet the differing preferences of the residents. EVIDENCE: On the day of inspection, the lunch menu was roast chicken with stuffing, roast potatoes and fresh vegetables. An alternative, which some residents had chosen, was baked fish. Lemon curd tart and custard or fresh fruit or yoghurt followed this. The cook confirmed that she has some flexibility in the menu and tries to meet all individual requests where possible. The residents are given a choice at each meal, and the cook asks them individually for their preference each day. In answer to the question “Do you like the food?” in the service users’ comment cards, all eight residents asked replied “yes”. A number of residents commented how much they enjoyed their meals at The Cedars. The dining area was mostly homely in style. A row of white coats and hats, hanging next to a dining table, which are worn by staff going into the kitchen, detracted from this. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 11 Lunch was unhurried and a pleasant experience for residents. Two residents chose to eat separately, and three chose to take their meals in their bedrooms. One common theme shared and discussed by residents was the lack of stimulation and activities provided in the home. One resident said “ There used to be activities, but they have fallen off now. There are no outings anymore”. Other residents said they become bored, with little to do during the day. The care staff group also expressed concerns that there had been no activities co-ordinator working in the home for many months. Some extra hours had been set aside for this, but staff said they tended to be used for caring duties. Some residents commented that they no longer have residents’ meetings to discuss outings and activities. The records showed that the last meeting was held in January 2005. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 12 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 The home has a satisfactory complaints procedure and a ‘comment card’ system, ensuring that any resident’s complaints and those of their families are acted upon promptly. EVIDENCE: The internal complaints procedure is displayed in the entrance to the home, along with a notice giving the contact details of the CSCI should residents or families wish to get in touch. The system would be easier for visitors to understand if the CSCI notice was adjacent to the complaints procedure. Comments are encouraged about the service provided, and one visitor explained that the staff have quickly acted upon any comments or suggestions she has made about her mother’s care in the past. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 13 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, 21,23 and 26 Some improvements have been made to the décor and furnishings in the home, but the overall quality of the furnishings in the ground floor lounge is poor and does not create a pleasant and homely environment in which to live. EVIDENCE: The first floor lounge has been re-furnished, now providing residents with a choice of lounges. Some bedrooms have been redecorated since the last inspection, and those seen looked comfortable and homely. Residents have been able to bring their own possessions and items of furniture, including beds, with them. Many of the beds in the home are hospital type and have metal legs on show. These would look less institutional if they were covered up. The majority of chairs in the ground floor lounge have become badly stained and worn. Three chairs had no covers on the cushions, and residents were sitting on plastic covers. Two of these covers were later found in the laundry. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 14 Both residents and visitors to the home commented on the poor state of the chairs. The home was clean and smelled pleasant. One visitor commented on this and said the home “smells lovely and is nice and clean.” One ground floor bathroom was cluttered with three large waste bins and a wooden filing cabinet. This did not provide a comfortable environment for residents to bathe in. One resident has planted beds and containers with colourful flowers at the front of the home and around the rear patio. This has considerably improved the garden areas for the residents, many of whom commented on this gentleman’s achievements. Some of the ground floor corridors are showing signs of wheelchair damage, with plaster and wallpaper missing in places. A programme of re-decoration is in place, and hopefully this will be addressed in the near future. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 15 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 and 28 There are sufficient care staff working in the home most of the time to meet the needs of the residents. Some very recent new appointments will ensure further consistency of care for the residents. EVIDENCE: The staff team continue to be supported in their NVQ training and various inhouse training sessions to ensure that residents are well cared for. Agency or bank staff are currently covering one care team leader post and two care assistant posts. The recent recruitment of two care assistants should ease this situation. As mentioned earlier in the report, the lack of an activities coordinator is having a negative effect on the quality of life of the residents. Residents spoken with said the staff are kind and caring. Visitors to the home also spoke in a very positive way about the staff. One visitor said the staff had “done wonders” with her mother, and enabled her to become much more independent. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 16 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, 33 and 37 The home has no permanent manager in post at present, causing some uncertainty for staff and residents. Record keeping was generally good, but some of the record keeping could be improved upon to safeguard residents. EVIDENCE: There is no registered manager in post at present, and an acting manager has been appointed on a temporary basis until a new manager is in post. There has been no photograph taken of residents who have moved into the home during the past year. One should be available somewhere in the home for safety. Some residents’ assessment forms were not signed and dated by the person who carried out the assessment. A residents’ satisfaction survey has recently taken place in the home in the form of a questionnaire. The results of these have been collated, but could not be found on the day of inspection. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 17 Staff training in fire safety is on target for the year. THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 18 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x 2 x x x x 2 THE CEDARS F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 1 1 Regulation 17(2)(3) 5 Requirement A statement of purpose must be available in the home and a copy forwarded to CSCI The registered person must supply an up to date copy of the service users guide to CSCI and each service user A photograph of each resident must be kept in the home Residents must be consulted about their interests and wishes for a programme of activities. Arrangements and facilities must then be provided. The registered person must refurbish or replace any lounge chairs that are in poor condition. Timescale for action 14/09/05 14/09/05 3. 4. 7 & 37 12 17(1)(a) 16(2)(m& n) 14/09/05 30/09/05 5. 6. 19 16(1)(c) &23 30/11/05 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 21 Good Practice Recommendations Three large waste bins should not be stored and in use in a bathroom that is used by residents. F51 F01 S6500 The Cedars V242916 100805 Stage 2.doc Version 1.40 Page 20 THE CEDARS Commission for Social Care Inspection UNIT D, OFF RUDHEATH WAY GADBROOK PARK NORTHWICH CHESHIRE CW9 7LT 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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