Inspection on 16/02/06 for The Cedars

This inspection was carried out on 16th February 2006.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Cedars 03/08/06

The Cedars 10/08/05

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 Inspection 16th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Cedars DS0000006500.V268850.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 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 DS0000006500.V268850.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Cedars Address Brookfield Drive Holmes Chapel Cheshire CW4 7DT 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) 01477 532857 01477 544366 www.clsgroup.org CLS Care Services Limited Vacant Care Home 27 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (26) of places The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 26 Service Users may be OP No more than 1 Service User may be LD(E) Date of last inspection 10th August 2005 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 facilities include one main lounge, a smoking room and a dining area attached to the main lounge. There is a secure garden and patio area, which is planted with flowers in the summer by one of the residents. Outdoor seating is available for the warmer weather. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over six hours on one day. A tour of the building took place, and with the permission of the residents, a number of bedrooms were seen. A variety of records were examined as part of the inspection. Part of the process of the inspection is to listen to the views of the residents that live in the home and listen to the views of their relatives and visitors. On this occasion, four residents were spoken with privately and group discussions took place in lounge and dining areas with a number of other residents. One visiting relative was happy to give their view of the home during the inspection. The views of two care staff, activities staff, care team leader, domestic staff and the manager were listened to. Four residents were each assisted to complete a comment card during the inspection. What the service does well: The residents living at The Cedars enjoy living there and are pleased with the care they receive from the staff group. Very good feedback was received during the inspection about the quality of the care provided. One resident described the staff as being “very patient and understanding”. The atmosphere in the home is warm and welcoming and there is evidence of good relationships between residents, relatives and the staff group. Various activities and outings take place, which residents can join in with if they wish. Some residents choose to live permanently in their bedrooms, and staff support them in this decision. The Commission for Social Care Inspection has not received any complaints regarding the home. The Cedars DS0000006500.V268850.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 DS0000006500.V268850.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 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 the following standard(s): 1 and 3. Standard 6 does not apply, as intermediate care is not provided. Residents have access to clear information in order to make a choice about whether or not to live at the home. Prior to moving in, their needs are assessed to ensure they can be met at the home. EVIDENCE: A new service user guide entitled ‘Your Guide to Living at The Cedars’ has been recently produced. A copy of this is given to all prospective and new residents so that they are able to make an informed choice about whether or not the home is suitable and able to meet their individual needs. A copy is available for any visitors to see. This guide provides information about what the home offers to residents living there and the range of facilities and lifestyle residents can expect. The manager or a member of the senior staff visit each prospective resident in their own home or hospital and carry out an assessment, to ensure their needs The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 9 can be met at the home. Examples of these were seen on the care plans in the home. Other professionals, when necessary, also provide social work or medical reports to assist in the assessment process. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10 Residents are well looked after in respect of their health and care needs. Personal support is provided in a way that enables residents to have privacy, dignity and independence. EVIDENCE: The care plans of four residents were read, and each contained sufficient information to ensure that all aspects of their health, personal and social care needs are identified and planned for. All contained risk assessments, moving and handling information, and information about contact with medical professionals. One resident had moved into the home 8 days previously, and staff had completed a thorough care plan, based on the initial assessment and subsequent observation by staff. Residents are involved in the preparation of care plans whenever possible. Of the four plans seen, two had not been reviewed since September and October last year. This is important, so that the up to date care needs of each resident are recorded. A requirement was made at the previous inspection to ensure that a photograph is available in the building of all residents, but this has still not been actioned. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14 Social activities provided in the home and links with the local community provide stimulation and interest for the residents. Routines at the home are flexible, enabling residents to have choice and control over how they spend their time. EVIDENCE: At the previous inspection, the residents commented on the lack of stimulation in the home. Since then, two staff members have taken responsibility for arranging activities. Residents said that the activities have improved and there is more ‘going on’ in the home. Group and individual activities are arranged such as quizzes, bingo, baking, craftwork and writing and reading letters. There are weekly outings to a local church coffee morning and some residents choose to attend a local church. Residents spoken with gave some examples of the ways in which they have some control over their lives at The Cedars. One resident enjoys gardening, and he has been encouraged to continue with his hobby. Some residents choose to live in their bedrooms and have their meals there. The staff respect this choice, and one resident was pleased that the staff did not continually try and persuade her to join the other residents in the lounge. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 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 the following standard(s): 18 Arrangements for protecting residents from abuse are satisfactory so residents are not at risk from harm or poor practice. EVIDENCE: Staff undertake training in adult protection as part of their induction training, in order to protect residents. The manager has recently completed some training in this area, and has plans to update the training of all the staff in The Cedars. The home has a thorough procedure and code of practice in relation to the protection of residents, which was updated in August 2005. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 The residents live in comfortable, well-maintained bedrooms that are kept clean. There are plans in place to improve the appearance of the shared areas of the home, to provide a more comfortable environment for the residents. EVIDENCE: Since the last inspection, new chairs and lounge furniture have been ordered are due for delivery in the near future. This will improve the environment for the residents. A first floor lounge has been turned into a smoking lounge for the residents, which does provides better facilities than the previous lounge. This has resulted in there only being one main lounge in the home that is non-smoking. Residents therefore do not have the choice of a second quiet lounge in which to sit with no television. There are plans to re-decorate the first floor of the home and re-carpet and redecorate the entrance to the home. The manager is aware that some of the The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 14 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. One resident has spent a lot of time and effort into improving the garden areas of the home. This has considerably improved the outdoor facilities for the residents, many of whom commented on this gentleman’s achievements, as in the previous inspection.. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 Staff at the home are well trained and supported and employed in sufficient numbers to meet the needs of the residents. The procedures for the recruitment of staff are robust providing safeguards to people living in the home. EVIDENCE: The home ensures there is a care team leader and at least two care assistants on duty throughout the day and evening plus designated care staff for a few hours each day arranging activities. One care team leader and one care assistant are on duty throughout the night. These levels can be increased according to the needs of the residents. The manager and a full time home services manager work office hours. General staff are employed in sufficient numbers to ensure the home is maintained in a clean and hygienic state. The majority of the general staff have completed NVQ level 1 in housekeeping, and are keen to commence level 2 training. The care staff group are continuing with their training, and hope to reach the government’s December 2005 target of 50 trained care staff in the near future. To date, 7 of the 16 care staff hold NVQ 2 (46 ) and 1 has almost completed which will bring the total to 50 . CLS have a good commitment to NVQ training. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 16 Residents spoken with said the staff are kind and caring. One visitor to the home also gave some positive comments about the staff group. One resident spoken with had recently moved into the home, and described the staff as being “very patient and understanding”. Two staff files were seen and contained evidence of two references and the necessary CRB checks having been obtained before the staff member commenced duties. Staff files also contained evidence that new staff members undertake an induction course. Agency staff are being used less than on the previous inspection, due to the recent recruitment of new staff. This will provide some continuity of care for the residents. There is now only one vacant care assistant post. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, and 38 The new manager is experienced and supported by senior staff, ensuring the residents live in a well run home. Policies and procedures for safeguarding residents’ money provide security. Regular staff training in health and safety matters ensures the safety and welfare of residents and staff. EVIDENCE: The new manager has experience at a senior level, and has recently commenced her training for the Registered managers Award. Staff supervision has not taken place as required in the past. As she is new in post, the manager is undertaking supervision sessions with all staff before delegating some of this to the senior staff group. New systems are being put The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 18 into place to ensure all mandatory training is up to date. Staff training in fire safety, moving and handling, food hygiene and first aid all contribute to the health and welfare of both residents and staff. Systems and safeguards are in place to assist residents who do not wish or are unable to care for their own money. Small amounts of money are sometimes left for safe keeping by relatives. The accounts and receipts for this were seen. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X X 3 The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 17(1)(a) Requirement A photograph of each resident must be kept in the home. (Previous timescale of 14/09/05 not met) Each resident’s care plan must be reviewed on a regular basis and revised where necessary. Timescale for action 31/03/06 2 OP7 15 31/03/06 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 OP31 OP19 Good Practice Recommendations The manager should complete her training for the Registered Managers Award within the recommended time scale. The manager should ensure that the parts of the home in need of redecoration are brought up to an acceptable standard within a reasonable period of time. The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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. Extracts may not be used or reproduced without the express permission of CSCI The Cedars DS0000006500.V268850.R01.S.doc Version 5.0 Page 22 - 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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