Inspection on 16/09/05 for The Cedars

This inspection was carried out on 16th September 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 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 03/08/07

The Cedars 07/08/06

The Cedars 26/01/06

The Cedars 13/12/04

The Cedars 21/09/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Cedars Sudbury Road Halstead Essex CO9 2BB Lead Inspector Jane Greaves Unannounced Inspection 16th September 2005 1330hr 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 DS0000017957.V249833.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 DS0000017957.V249833.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Cedars Address Sudbury Road Halstead Essex CO9 2BB 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) 01787 472418 01376 334892 Mr Balkrishna N Patel Mrs Anjana Balkrishna Patel Mrs Anjana Balkrishna Patel Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/12/2004 Brief Description of the Service: The Cedars is situated in Halstead, Essex, close to the town centre and local communities. The home has retained many of its original features and has large well maintained gardens, with a patio area and a sunroom. The home was built in the 18th century and has had a newer annex built onto the rear of the premises. The Cedars is a two storey building with access to the first floor by chair lifts in both parts of the building. The home is registered to provide care for 24 older people over the age of 65 with dementia. The home provides 24 hour personal care and support. The home is well furnished, decorated to a good standard and offers a homely and caring environment to the service users who live there. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place on 16th September 2005 over 3½ hours. The inspector gathered views and opinions regarding the service from 5 residents of the home, visiting friends and relations, care staff and management of the home. The Inspector was given a guided tour of the premises and experienced excellent co-operation with the inspection process from all staff members on duty. 14 of the 38 National Minimum Standards were assessed at this inspection with 13 met and one nearly met. What the service does well: What has improved since the last inspection? What they could do better: At the time of the previous inspection only 16 of the care staffing team were working towards their NVQ level 2 in care. At the point of this inspection 3 staff members had completed the course, 6 were working towards the qualification and 1 was in the process of enrolling. It was encouraging to see the progress made since the previous inspection. However, if the National Minimum Standard of 50 of care staff to achieve level NVQ2 or above by the The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 6 end of December 2005 is to be met, this hard work and commitment needs to continue. 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 DS0000017957.V249833.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 DS0000017957.V249833.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): 3 No resident moves into the home without having had their needs assessed and been assured that these will be met. EVIDENCE: The registered manager met with prospective residents prior to admission to the home to undertake a comprehensive pre admission assessment of needs. Where possible the registered manager involved family members during this assessment process in order to obtain a more personal insight into the resident’s complex needs. This ensured that residents and their families could be confident that the home was able to meet their needs satisfactorily. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 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 the following standard(s): 7 and 10 The residents’ health, personal and social care needs were set out in individual care plans. Residents were treated with respect and their right to privacy was upheld. EVIDENCE: The pre admission assessment made by the registered manager before the resident was admitted to the home was used to develop the individual resident’s care plans. Residents’ needs were identified and actions to meet the needs were detailed on the care plan for care staff to follow. All aspects of the residents’ lives, including spiritual, physical, personal and social needs were assessed with the detail used to formulate the plan of care. The Cedars had a key working system in place; the registered manager met with key working staff monthly in order to review individual residents care plans to assess changing needs and to update the care plan accordingly. If any concerns were identified at the care plan review the registered manager The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 10 involved the families and representatives of the residents when developing the changes to the plans of care. Observation and conversations with relations at this inspection confirmed that residents were shown dignity and respect at all times. All personal care was delivered in private. Residents had access to the telephone in the registered manager’s office for private use if required. All residents were smartly dressed and well groomed on the day of the inspection and visiting family members praised the care staff for this. One family member reported that their relation had been such a dignified and private person in earlier life and how pleasing it was that the manager and staff paid such attention to the detail of the care delivered. The ladies hair was groomed and their outfits were co-ordinated, clean and in good repair The Cedars DS0000017957.V249833.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): 12, 13 and 15 Residents’ lifestyles experienced in the home satisfied their social, cultural, religious and recreational interests and needs. Residents maintained contact with family/friends/representatives and the local community as they wished. Residents received a wholesome appealing balanced diet, in pleasing surroundings at times convenient to them. EVIDENCE: The residents had benefited from a dedicated activities person 3 afternoons per week until recently. The afternoon care staff team spent an hour every afternoon interacting socially with residents and playing games, reading magazines, colouring or whatever the residents fancied doing. The residents benefited from the services of a volunteer visiting the home twice weekly to spend quality time with them and to provide social stimulus. Music and movement sessions took place at The Cedars fortnightly and a church service took place monthly. The registered manager had arranged for outside entertainers to come to the home to entertain the residents every two to three months and activities such as ‘strawberry teas’ took place during the summer months. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 12 Family members spoken with at this inspection confirmed they were able to visit at any time and were always made welcome with a cup of tea on arrival. Residents were able to receive visitors in private if they so wished. Visiting relations on the day of the inspection confirmed the high quality of the food offered to residents at The Cedars. The inspector did not observe a mealtime at the home. However, the kitchens were clean and in good repair and stocks of food were plentiful, with fresh vegetables and fruit available. The residents enjoyed four meals a day with a cooked supper, such as teacakes, beans on toast or crumpets available before bed. There was a four weekly menu in place and this was changed quarterly. One family member reported that their relation had been weak and frail on entering the home but that in a short time appeared healthier and stronger, the family was sure the food offered had played an important part in the recovery. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 13 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): 16 and 18 Residents and their families could be confident that any complaints would be listened to, taken seriously and acted upon. Residents were protected from abuse. EVIDENCE: No complaints had been received by the home or by the Commission for Social Care inspection in the past year. The home had a clear, simple and accessible complaints procedure including the stages and timescales for the process. The contact details for the Commission for Social Care Inspection were included in this document. All staff employed at The Cedars had attended training in the Protection of Vulnerable Adults from abuse in the previous year. A refresher course for all parties was to be arranged once this year’s holiday season had ended. The recruitment practices within the home further protected the safety of the residents at The Cedars. Care staff members were only able to commence their employment at the home once a completed enhanced Criminal Records Bureau disclosure and two written references had been received by the registered manager. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 14 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 Residents lived in a safe and well maintained environment. The home appeared clean, pleasant and hygienic on the day of the inspection. EVIDENCE: The home employed a maintenance person 5 days per week to ensure the environment was kept safe and accessible for the residents. The attractive grounds were well maintained. On the day of the inspection the home appeared homely, comfortable and safe. There were two domestic staff employed for morning shifts 6 days per week and one domestic for one day per week. Training in the control of infection had been provided for all care staff and domestic staff employed at the Cedars. Relatives reported that no matter what time of day they visited the home there were no offensive odours present. The Cedars DS0000017957.V249833.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 and 30 Residents could be confident that they were in safe hands at all times. Staff members were trained and competent to do their jobs. EVIDENCE: At the previous inspection only 16 of the care staff team were working towards their NVQ level 2 qualification in care. The manager and staff had made good progress this year; 3 care staff had achieved NVQ2, 6 were working towards NVQ2 and 1 further member of care staff was waiting to enrol. This equated to 48 of the care staff team. The National Minimum Standard states that a minimum 50 of care staff must have achieved NVQ level 2 or above by the end of December 2005. Care staff had attended training in all the mandatory elements, such as infection control, moving and handling, fire safety, basic food hygiene and health and safety. Training in the care of people with dementia and death and bereavement had been provided for all staff members. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 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 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): 33 and 35 The home was run in the best interests of the residents. Residents’ financial interests were safeguarded. EVIDENCE: The registered manager had a safe and effective quality monitoring system. Annual surveys were sent to families, representatives and other stakeholders covering all aspects of care and facilities offered at The Cedars. The responses from these were summarised and an action plan was formulated to address any areas identified for improvement. A copy of this report was sent to residents’ families and to the Commission for Social Care Inspection. The registered manager was able to demonstrate that the home’s policies and procedures were reviewed at least annually in light of changing legislation and good practice advice. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 17 The families and representatives of the people living at The Cedars were responsible for looking after their pensions and providing incidentals such as hairdressing and chiropody. The registered manager arranged for these services, paid for them and then invoiced the families retrospectively. This arrangement was discussed with the families at trial visits and prior to admission to the home. This information was present in the Service User Guide. The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 19 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 OP28 Regulation 18(1)(a) Requirement The registered person shall, having regard to the size of the care home, the Statement of Purpose and the number and needs of resident, ensure that at all times suitably qualified, competent and experienced persons are working at the care home, in such numbers as are appropriate for the health and welfare of residents. Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Cedars DS0000017957.V249833.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 DS0000017957.V249833.R01.S.doc Version 5.0 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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