Inspection on 12/12/05 for The Cedars

This inspection was carried out on 12th December 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Cedars 02/11/06

The Cedars 15/06/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 The Cedars 2 Harding road Hanley Stoke on Trent Staffordshire ST1 3BQ Lead Inspector Jane Capron Unannounced Inspection 12th December 2005 09:00 The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 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 The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 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 Adults 18-65. 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 DS0000064029.V273083.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Cedars Address 2 Harding road Hanley Stoke on Trent Staffordshire ST1 3BQ 01782 208590 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) Delam Care Ltd Miss Tracy Anne Baddeley Care Home 6 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (6) of places The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th June 2005 Brief Description of the Service: The Cedars is a long-term care home for six service users with a learning disability and/ or mental ill health. Some service users have both conditions. The property is a detached Victorian property in Hanley that is adjacent to two other care homes owned by the same company. The Care Manager is also responsible for the two adjoining homes. The home has a small back yard area and a small front garden and shares a laundry with the two adjacent care homes. The home has six single bedrooms, four upstairs and two on the ground floor. The home arranges for the service users that wish to attend college for part of the week and the home organises some activities both in and out of the home. The home organises a holiday for the residents each year. The home is able to provide care for service users with low level needs and the staffing level allows for one staff member to be on duty at all times. The home monitors, supports and encourages the service users to access appropriate health care facilities, to develop a healthy lifestyle and to take part in independent living tasks around the home. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a three and a half hour period. During the inspection discussions were held with four of the six residents, to look at how they found living in the home. A discussion was also held with the staff member on duty. A sample of residents support plans was examined as well as other documentation relating to health and safety and to the management of residents finances. Since the last inspection the commission has not received any complaints and no additional visits have been made to the home. What the service does well: The resident group had lived at the home for sometime and were quite satisfied with the service they received. They were all happy over their accommodation and were generally satisfied with the staff feeling them to be supportive. Residents benefited from being consulted over their daily lives and over aspects of running the home. All the residents had the opportunity to attend college. The residents were involved in a range of domestic tasks around the home including some meal preparation, cleaning their bedrooms and doing the weekly food shopping. All residents accessed the community regularly, some on a daily basis going shopping or out to college or to see friends or family. All the residents had been for a short break to Blackpool and all residents spoken to really enjoyed the holiday. One described it as being ‘ brilliant’. Residents enjoyed a relaxed atmosphere where routines were quite flexible. Residents decided when to get up and go to bed and how and where to spend their time. There was the freedom to choose whether to spend time with other residents in the communal areas or in their bedroom. The home had good support plans in place that outlined the needs of the residents and how they were to be met. Residents were involved in the care planning process being consulted over their needs and over how they felt the plans were working. The risk assessment process ensured that risks were identified and actions were in place to prevent unacceptable risks to residents whilst not placing them under unnecessary restrictions. The Care Manager has been in post for some time and had the necessary skill, knowledge and experience to effectively manage the home. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 6 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. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,5 It is the home’s policy to undertake an assessment of prospective residents’ needs to ensure that the home has the necessary information to make a judgement over whether they can meet a person’s needs. Residents are made aware of the service they will receive through the provision of an individual contract. EVIDENCE: The home has a stable resident group and there have been no admissions for several years. However prior to admission all residents were subject to an assessment and it is the home’s policy to do their own assessments as well as that from the local authority. The support plans demonstrated that all the needs have been identified. Plans were up to date and reviewed. Each resident had a copy of their contract that identified the service to be provided and shows the room they are to occupy. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 The home had developed good support plans that clearly provided staff with the necessary information to be able to meet the needs of the residents. The systems in place for consulting residents was ensuring that the views of residents were heard and acted upon. The risk assessments ensured that residents were not undertaking any unreasonable risks and were not subject to unnecessary restrictions. EVIDENCE: The home had well developed support plans that showed the needs of the residents and how these were to be met. The plans included the mental and general health needs, personal care needs, occupational and educational needs as well as any needs relating to financial budgeting. Residents confirmed that they had individual meetings with their key worker to go through their care plans and to look at any areas where changes were needed. Support plans were being reviewed. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 10 Discussions with residents showed that the home’s staff were encouraging them to make decisions and choices over their lives. Residents stated that they could choose whether to go to college and whether to join in with activities that took place. There decided when to get up and how to spend their time when in the home. They could decide when and if they wanted to go out often going shopping in Hanley. Where support in making decisions was needed this was provided. For example there were occasions when residents needed support in choosing what to where and over buying clothes. Observation showed that regular consultation was taking place with residents throughout the day and the staff member on duty was always available to provide support. The home had monthly resident meetings and there were ongoing discussions between the staff member and residents. The home also undertook individual meetings with residents to find out how they liked living at the home and over whether there were areas that they would like to change. All residents had needs relating to budgeting and this was recorded in their support plans. Residents were supported to make decisions over budgeting. The risks towards residents had been identified and assessed. Risk assessments covered such issues as accessing the community, smoking, the management of hot water and hot surfaces, using a kettle and the holding of keys. These were up to date and had been reviewed. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 The home supported residents to access educational and vocational activities and provided a range of activities both in and out of the home therefore providing residents with the opportunity to have a varied and fulfilling lifestyle. The residents befitted from a home that had flexible routines and provided residents with choices over their daily lives. EVIDENCE: All the residents have the choice to attend college. Two have taken up this opportunity taking courses in cookery, painting and decorating and gardening. One resident attends a day centre and undertakes some part time work. Residents spoken to said that they did not want to go to college and one stated that staff had involved a voluntary agency looking at work opportunities. Those not attending formal activities out of the home spent time helping around the home and shopping both for personal items and for the weekly food shop doing errands. All residents were involved in domestic tasks around the home. They said that they cleaned their bedroom with staff support, the assisted with laying, clearing the table and washing up. They said that their were asked about meals they liked and that these were put on the menu. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 12 Some of the residents are reluctant to take part in many activities often preferring to watch TV or spend time in their bedrooms. All the residents like watching the soaps on TV. Some watch TV in the communal lounge but others choose to watch in their bedrooms. Some residents do take part in activities organised by the home including board games, DVD evenings, baking, and beauty nights. The home also arranges some trips out and there are opportunities to go to the theatre and to organised events. All residents spent time out of the home either visiting family members, visiting friends in other care homes close by or by going shopping into Hanley. Residents confirmed that the saw their family. Two saw family members several times a week and went for overnight stays. Others saw family members less often. The home was aware of the sexual health needs of the residents and of their right to intimate relationships. Residents confirmed that the home’s routines were quite flexibly. They could get up and go to bed when they liked. They had their breakfast whenever they got up. If they did not like a meal on the menu they were able to have an alternative. Residents said that they were able to decide how to spend their time and could access any of the communal rooms and their bedrooms when they wanted. Bedrooms were lockable. Residents spoken to said they could have a key to their bedroom but had chosen not to. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Apart from eye checks the health care needs of the residents were being met with evidence of multi agency working taking place. The home provided support, encouragement and any practical help to ensure that residents maintained their personal care needs. EVIDENCE: Residents were able to undertake personal care tasks when they wanted and staff were available to give them any necessary encouragement and practical support. Whist most of the residents needed little practical support staff did provide help with shaving and monitored that residents were managing their personal care needs. Residents chose and bought their own clothes and staff provided support where needed. Residents confirmed that the home had a key worker system in place. Residents confirmed that they received health care services. They saw the GP when they felt ill, they attended the chiropody when needed and had dental checks. They residents could not confirm that they had received recent eye checks and no records could confirm this. The care staff monitored the mental health needs of the residents. Specialist mental health staff were also The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 14 involved, with residents having the support of Community Psychiatric Nurses, psychologists and psychiatrists. The residents that needed it had monthly checks to confirm the appropriateness of their medication. The care staff supported resident to attend outpatient appointments and attended any medical reviews. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home’s procedures and staff training in adult protection should provide the residents with increased protection. EVIDENCE: Residents said that they felt safe at the home and would raise any concerns they had with the staff. The staff member on duty had received training in adult protection and felt this had made her more aware of the issues. The home had a copy of the local authority adult protection procedures and had its own procedures in place to responds to any incidents. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,28 The home was satisfactorily decorated and maintained, and provided residents with accommodation. The bedroom accommodation was suitable for the residents providing them with privacy and a place to call their own but one bedroom did need the chair replacing. EVIDENCE: The home was suitable to meet the residents’ needs. The home was satisfactorily decorated and maintained. The home was located close to a number of similar care homes. The home was sited within walking distance of the local college, some local shops and health resources. The main shopping and cultural area of Hanley was within a 20-minute walking distance. Externally the home had a small rear yard. The front entrance area had been tidied since the last visit. Since the last inspection the dining room had been decorated and this had made a significant difference. The hallway had also been decorated and this made the home more homely. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 17 The home had a communal lounge and a separate dining room. The home had a domestic style kitchen and a small laundry that was shared with the two adjoining care homes. The home provided single bedroom accommodation and four of the bedrooms were seen during the inspection. These were of varying sizes but the residents were happy with their accommodation. Bedrooms had been personalised with posters, pictures and a range of personal belongings. Bedrooms were lockable and they had a lockable cabinet where residents could lock items away. Bedroom furniture was satisfactory although the chair in one bedroom was not comfortable and needed a new seat or replacing. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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 The residents were benefiting from staff that were aware of their role to promote residents’ independence and to provide them with a varied and fulfilling lifestyle. Whilst the residents benefited from staff that received relevant training the home needed to increase the number of staff that were suitably qualified. The level of staffing provided was able to meet the needs of the current residents EVIDENCE: The staff member on duty was fully aware of the residents’ needs and had a relaxed and friendly manner with them. She was aware of the aim of the home to support the residents to be as independent as possible and to promote their choices. Staff at the home had a job description. The staff member on duty was well motivated and interested in the residents. Residents felt at ease with her. She had taken a number of other courses including adult protection and food hygiene. A health care professional spoken to as part of the inspection process, said that staff liaised appropriately with her. As part of the company owning the home, Delamcare provided a range of training and supported a number of staff to undertake NVQ training. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 19 Due to the absence of the Care Manager during the inspection the amount of training undertaken by staff could not be confirmed although the staff member on duty stated that one of the other staff working at the home had undertaken training in adult protection and medication and another had undertaken training in infection control. There was one staff member working at the home that had NVQ 2 or above. The staffing levels were for one care staff member to be on duty throughout the day. Additional support to go out with residents and to do individual tasks with residents was provided by the Care Manager or a staff member from one of the adjoining houses. Since the last inspection a programme of activities has been introduced and this level of staffing has been able to support this programme as well as supporting the residents in maintaining their health and personal care tasks. Due to the level of need of the residents the home has no waking night staff but has a staff member sleeping at the home. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,41,42 The residents were benefiting from a home that had a manager with the necessary knowledge, skills and experience. The home’s quality assurance scheme enabled the home to evaluate its performance through internal audits and through consultation with the residents. The recording keeping systems were safeguarding the rights and best interests of the residents. Residents were protected by the home’s health and safety procedures. EVIDENCE: The Care Manager was well regarded by the residents. They felt that if they had a problem she would always listen to them and act upon it. Although the care staff undertook the day-to-day tasks around the home the residents said that the manager was available to them. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 21 Whilst the Care Manager was not available during the inspection previous knowledge and contacts at this and the next-door homes had demonstrated that she had the necessary knowledge, skill and experience to effectively manage the home. The home record keeping was of a good standard. Resident files were kept up to date and were kept securely in the office that was always locked when unoccupied. Suitable records were being kept of residents’ finances. Records were being kept of servicing and of all fire prevention checks. The home had quality assurance checks in place. Residents stated that the met with the staff both as a group and individually to discuss living in the home and were asked whether anything could be done to improve their experiences of living in the home. In addition staff undertake a range of checks both about the environment and over care practices. The home had a health and safety policy and procedures in place for safe working practices. The staff member on duty confirmed that she had undertaken the mandatory training. Records showed that all the staff had up to date fire training. The servicing of equipment including fire prevention equipment was up to date and the home had a current gas safety certificate and a valid electrical installation certificate. An accident book was maintained. The Cedars DS0000064029.V273083.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 3 4 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Cedars Score 3 2 X X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 3 X DS0000064029.V273083.R01.S.doc Version 5.0 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 2 3 Standard YA19 YA26 YA32 Regulation 13(1)(b) 16(2)(c) 18(1)(a) Requirement To ensure that residents have eye checks To ensure that the chair in the bedroom identified is comfortable for the occupant. To increase the number of suitably qualified staff Timescale for action 20/01/06 01/02/06 01/04/06 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 Refer to Standard YA30 YA35 Good Practice Recommendations To provide staff with training in infection control To consider staff undertaking Learning Disability Award Framework accredited training. 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