Inspection on 15/06/05 for The Cedars

This inspection was carried out on 15th June 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 02/11/06

The Cedars 12/12/05

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 15 June 2005 9:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Cedars Address 2 Harding Road Hanley Stoke on Trent Staffordshire ST1 3BQ 01782 209602 01782 208590 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) Mrs Jill Fares Miss Tracy Baddeley Care Home 6 6 6 Category(ies) of LD registration, with number MD of places The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15 September 2005 Brief Description of the Service: The Cedars is a long-term care home for six people with a learning disability and/ or mental ill health. Some residents 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. Residents have the opportuntiy to attend college for part of the week and activity staff from another home support the service users in attending college and organise a range of leisure activities. Residnts have the opportunity to go on holiday at their own cost. The home is able to provide care for service users whose main needs are for support, envcouragment and genral supervsion. The staffing levels allow for one staff member to be on duty at all times and for one staff to sleep at the home. The home monitors, supports and encourages the residents to access appropriate health care facilities and to maintain their own personal care. Residents are involved a range of domestic and household tasks within the home. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over approximately three and a half hours. A discussion was held with the staff member on duty and with five residents, both individually and together, that were at the home during the inspection. Lunch was taken with several of the residents. Four bedrooms were examined as well as the communal areas. A range of documents was examined including a sample of residents’ files. The staff member was observed interacting with residents and in dealing with residents’ finances. The process for administering medication was examined. Prior to the inspection, information was sought by a health professional who had regular contact with the home. Since the last inspection the CSCI has received no complaints and no additional visits have taken place. What the service does well: Residents spoken to liked living at the home. They liked the food and liked the staff. They said that the staff supported them to attend health care appointments and that staff were there if they wanted any help. The home had well developed plans showing the support that residents needed. Residents were involved in planning and reviewing the support they needed. The home had developed risk assessments so that residents were supported to take reasonable risks and that residents were not stopped doing things unnecessarily. Residents were involved in household and domestic tasks and were consulted over issues such as meals, trips and holidays. The health and personal care needs of the residents were met and residents had specialist treatment when they needed it. The residents had choices about their lives including whether to go to college, and over the daily routine and over the choice of meals. The home’s recruitment procedures made sure that all staff had references and had a criminal records check. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 standard(s) 3, 5, The home due to its staff and effective liaison with other professionals is meeting the care needs of the residents. The home provided residents with a contract that showed residents the terms and conditions of living at the home. EVIDENCE: Residents confirmed that they received health care services and that staff supported them to maintain their personal care and would provide support such as shaving and hair washing. Staff had received training in relevant areas and undertook induction training. An external health care worker who was consulted stated that the home was able to meet the health care needs of the residents and there was effective liaison with the staff. Records confirmed the involvement of such services as psychiatry and psychology. The examination of the residents’ documentation showed that residents had been provided with a contract by the home and by the funding authority. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 standard(s) 6, 7,8,9 The home’s care planning processes and risk assessments provided staff with the necessary information to know how to meet the needs of the residents. The home encouraged residents to make decisions about their lives and to participate in a number of household tasks providing them with the opportunity to develop and maintain their skills and to have control over their day-to-day routine and over some aspects of running the home. EVIDENCE: Residents had individual care plans that identified their health and personal care needs. In addition plans covered the residents’ need for occupational, educational, domestic and financial support. Records were up to date and had been reviewed. Areas of restrictions were shown and supported by risk assessments that were up to date and had been reviewed. Residents were involved in six monthly reviews over their progress and care plans. The home had a key worker system in place. Residents spoken to confirmed that were provided with choice and were encouraged to make decision over their lives. They stated that they chose when to get up and go to bed and where to spend their time. Attending The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 10 college was encouraged but several confirmed that they did not want to go. Residents were observed identifying what they wanted for lunch if it was different from that identified on the menu. Residents confirmed they could spend time in their rooms or in the communal areas and could go out of the home when they wished. Residents were consulted over financial issues and were involved in managing and budgeting their money. Residents confirmed that they had been involved in choosing where to go on holiday and that they were consulted about meals. Residents stated that they went shopping to buy personal items. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,17 Whilst the home did provide the option for residents to undertake educational courses and also a number of external social activities the low level of participation by the residents would indicate that the social and educational/ fulfilling activities on offer were not those that appealed to the resident. The home consulted residents over menus and provided meals that gave residents a varied menu. EVIDENCE: The level of attendance at educational and fulfilling activities varied with one residents spend nearly five days out of the home attending organised activities and two others out for two sessions at college a week. One resident attended a group at a day centre for one session a week. The other two did not attend any such educational/ occupational activities and all stated that this was their choice. Although there were a range of external leisure activities arranged by activity staff from another home none of the residents regularly took advantage of this. All the residents went out shopping alone or with another residents –some going out daily and others less often. One resident went out regularly with family and another visited their family weekly. All residents confirmed that most of the time they sat and watched the TV and there were The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 12 few activities going on in the home. The staffing level of one staff on duty provided little time for staff to undertake social and leisure activities. The care plans did not identify that residents had undertaken social activities recently. All residents accessed local healthcare resources and local shops. The home provided the opportunity for residents to attend church. Residents stated that they liked to food and that they got their own breakfast when they got up and they could chose from a range of cereals and toast. Lunch was of a snack type with the main meal at teatime. Residents confirmed they were consulted over the meals and could have an alternative if they did not like the choice on the menu. Supper and snacks between meals were available. The menus were varied. Residents weight was monitored. There were no residents that required particular food due to their cultural or spiritual needs. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 standard(s) 18,19,20 The health and personal care needs of the residents were met and the home had effective liaison with health care professionals. Whilst the home was administering medication appropriately the absence of appropriate training for staff could be detrimental to residents. EVIDENCE: The healthcare and personal care needs of the residents were identified in the care plans. Residents stated that the staff supported them where necessary to maintain their personal care but that the only support needed was for such things as shaving and hair washing. Residents said that their individual preferences were respected. The care plans identified the need for support, encouragement and monitoring. Nail care and hair care was attended to. Residents bought their own clothes and each dressed according to their style and preference. Residents had a key worker and met with them to discuss their care plan and care needs. Residents confirmed that they attended the GP when necessary and received dental checks, had their eyes tested and either attended the chiropodist or attended to their own nails. Discussion with an external health care specialist confirmed that the home responded appropriately to the mental health needs of the residents and liaised effectively with the mental health services. Residents stated that they attended out patient clinics. Regular general health checks took place. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 14 The home appropriately recorded, stored and administered medication. Comprehensive descriptions of medication along with the reasons for medication and the side effects were well recorded. A resident that selfmedicated explained when to take the medication and kept it locked in their bedroom. An assessment confirming their ability to self medicate was on file. The staff member on duty had not received training in medication. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 standard(s) 22 The home had a satisfactory complaints system in place and residents felt that their concerns would be listened to and acted upon. EVIDENCE: The home had a complaints procedure that was displayed in the hallway. A record of complaints was kept. The CSCI had received no complaints since the last inspection. Residents were aware of their right to complaint and explained how they would do this. They all had someone external to the staff at the home to whom they could take concerns. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 standard(s) 24,26,27,28,30 The standard of decoration and furnishings of the home provided the residents with a homely environment and provided residents with privacy, and with the opportunity to personalise their bedrooms. There were some minor issues that needed attention. The cleaning arrangements provided the residents with a clean and hygienic environment. EVIDENCE: The home was decorated and furnished in a domestic style. Since the last inspection three bedrooms had been decorated and carpeted and the dining room had been decorated. The lack of hot water upstairs evident at the last inspection had been repaired. One bedroom had new furniture. Externally there was a small rear yard. This had a table and chairs for sitting but these were worn. The area leading to the front area door was quite unkempt with a number of weeds between the paving stones. The home was within walking distance of local services such as the GP and dentist and small shops and Hanley was a 15- 20 minutes walk away. The home was on a bus route. The home provided all single bedroom accommodation. These were suitable furnished and were all lockable. Bedrooms had been personalised. Bedrooms The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 17 had TVs. One bedroom was being used for storing items from the office whilst it was being decorated. The home had suitable communal accommodation with a lounge and separate dining room. The kitchen was domestic in style and size. The home shared a small laundry with the two adjoining care homes. The home had a bathroom and separate toilet upstairs and a shower and toilet downstairs. The home had a no smoking policy and any residents that smoked did so in the rear yard. The home was clean and tidy and cleaning schedules were in place. The staff on duty was aware of infection control issues although had not receive training in infection control. Staff supported residents to keep their bedrooms clean and residents undertook vacuuming of the communal areas. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,36 Whilst the current staffing levels supported the residents to have their health and personal care needs met there was insufficient time to support and encourage the residents to participate in social and leisure activities of their choice. The home’s recruitment processes support and protect the residents. The residents benefit from staff that receive management support and regular supervision. EVIDENCE: The staffing levels allowed for one staff member to be on duty at all times and one staff member sleeping in. The staff member undertook cleaning and cooking duties as well as care tasks. Additional staff could be provided to enable staff with the opportunity to take residents for appointments. Staff absences were covered by staff from the other homes in the area owned by the same company. These staff were known to the residents. This level of staffing provided little opportunity for staff to undertake social/leisure activities in the home with the residents and during the inspection the staff member spend the majority of the time doing a deep clean of the kitchen and making lunch. Whilst the home had the support of activity staff from another home The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 19 these activities were based out of the home and the residents did not want to participate in the activities offered. A sample of personnel files showed that pre employment checks were being completed. Staff meetings were held and staff received individual supervision. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 Although the home’s procedures relating to health and safety were being implemented the lack of training in food hygiene could be detrimental to residents. The absence of an ongoing review of the home’s performance does not provide the residents with a home that is consistently improving and developing. EVIDENCE: No evidence was provided to confirm that the home was undertaking an ongoing review of quality that included the views of the residents. The home had a Health and Safety policy in place and procedures that supported this. Servicing was undertaken and the necessary fire testing and training was being undertaken. Procedures for the control of the legionnaire bacteria were in place. The temperatures of water and the temperature for the storage and cooking of food were being monitored. The home provided training in Health and Safety issues but all staff had not completed the The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 21 necessary training in food hygiene. Hazardous products were being stored appropriately. The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 2 3 2 x x 3 Standard No 31 32 33 34 35 36 Score x x 2 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Cedars Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 23 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 12&14 Regulation 16(2)(m) &(n) Requirement To consult with residents about a programme of activities and to provide a range of social , lesiure and fulfilling activities in and out of the home To provide staff with training in medication To ensure that residents bedroom are not used for storage To ensure that the garden be kept tidy and that suitable outside seating be provided To ensure that adequate numbers of staff are provided to meet the social and leisure needs of the residents To maintain a system for reviewing and improving the quality of care provided at the home To ensure that staff receive the necessary trainining in food hygiene. Timescale for action 15 August 2005 2. 3. 4. 5. 20 24 24 33 18(1)(c) &13(2) 23(2)(l) 23(2)(o) 18(1)(a) 15 August 2005 16 June 2005 1 August 2005 15 July 2005 16 September 2005 15 August 2005 6. 39 24 7. 42 18(1)(c) The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 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. 2. 3. Refer to Standard 14 20 30 Good Practice Recommendations To consider providing a small budget for activities To introduce a system of competency assessment for the adminstration of medication For staff to receive training in infection control practices The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 The Cedars E51 E09 S8208 The Cedars V234485 150605 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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