Inspection on 17/03/06 for The Cedars

This inspection was carried out on 17th March 2006.

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 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 25/10/07

The Cedars 31/01/07

The Cedars 12/06/06

The Cedars 02/11/05

The Cedars 25/02/05

The Cedars 17/08/04

The Cedars 24/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Cedars (The) Angel Lane Shaftesbury Dorset SP7 8DF Lead Inspector Gloria Ashwell Announced Inspection 17th March 2006 10:00 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 Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cedars (The) Address Angel Lane Shaftesbury Dorset SP7 8DF 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) 01747 852860 01747 852722 The Community Health Association of Shaftesbury Limited Mrs Helen Goodbody Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26) of places Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: The Cedars is a converted and extended detached premises close to the centre of Shaftesbury providing accommodation for 26 residents. The home is registered to provide nursing and social care to older people, including those with dementia type illnesses. The Cedars is owned by the Community Health Association of Shaftesbury; a charitable company limited by guarantee. Ownership of the home is represented by a Board of Trustees; the day-to-day management is undertaken by Mrs Helen Goodbody who is a Registered General Nurse. The home has a fully enclosed courtyard style garden, an open garden to one side and car parking at the front of the home. The home is located in the centre of Shaftesbury, close to shops and other amenities. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. The previous inspection took place on 2 November 2005; since that inspection no complaints against the home have been received or investigated. The inspection was conducted by Regulation Manager Sue Barber and Regulation Inspector Gloria Ashwell. The inspectors toured the home and spoke to some residents; many residents accommodated at the time of the inspection were unwell and unable to conduct a conversation. The inspectors also spoke to the visiting relatives of some residents. Together with the registered manager and deputy manager the inspectors considered other evidence relating to the National Minimum Standards, as described in this report. Additional information used to inform the inspection process included reports periodically sent to the Commission by the provider organisation. Standards assessed and found met during the previous inspection were not reassessed during this inspection; this report should therefore be read in conjunction with the report of the previous inspection. What the service does well: The home provides good care to residents in comfortable and suitably equipped premises. Residents and their representatives hold The Cedars in high regard; comments included “The care seems very good”. Within the limitation of their abilities residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. Meals are appetising and of good quantity and quality. Staff are kind and helpful to residents. Residents are treated with respect, their privacy is protected and staff understand and meet their needs. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 6 Medicines prescribed by doctors are safely stored and carefully administered to residents by trained nurses. 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. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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 Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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 The home does not provide Intermediate Care so Standard 6 does not apply. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. EVIDENCE: The inspector examined records of pre-admission assessment written by the manager when she assessed a prospective resident, from information provided by relatives and health and social care professionals. The records indicated that the needs and circumstances of the person had been comprehensively assessed. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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, 8 & 9 (Standard 20 was found met at the previous inspection) Care is delivered in accordance with a written plan of care based on appropriate assessments; simplification of care documentation systems would improve provision of information necessary to guide/direct staff in their work. The standard of health and personal and social care is generally good although the inspectors identified some weaknesses with regard to the care of particular residents. Medicine storage and handling is properly carried out to ensure that residents receive medicines as prescribed, to promote/maintain their health. EVIDENCE: Care plans and associated documentation are at present being reviewed; the current system requires a great number of separate records being kept for each resident, including many which are repetitive and sometime no longer relevant, because of changes in the person’s conditions and needs. It is recommended that a system of internal care plan audit be implemented, to simplify, clarify and when necessary, archive the records. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 10 Records indicated that there have recently been a number of incidents where staff have received minor injuries from confused residents; Mrs Goodbody said that staff have received training in the care of people with challenging behaviours and dementia. It is recommended that accidents and incidents be periodically audited to identify any patterns or trends, in order that actions to minimise risk of recurrence may be promptly implemented as needs arise. Medicines prescribed by doctors are safely stored and carefully administered to residents by trained nurses. The home uses a monitored dosage system for the administration of prescribed medicines; recording of administration should be improved as follows. Handwritten amendments to the printed medicine administration records (MARs) should be signed, dated and countersigned by a person who had checked the entry for accuracy. When a variable dose was prescribed the records did not state the amount administered on each occasion. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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): 15 (Standards 12 & 13 were assessed and found met at the previous inspection) Meals are appetising and of good quantity and quality; opportunities for menu choice should be improved. EVIDENCE: Meals are served in the dining rooms or in resident’s bedrooms, in accordance with their individual preference and health condition. The inspectors were present at the serving of lunch; the meal was appetisingly presented and clearly enjoyed by the residents, although there is minimal opportunity for the choice of lunch and this should be improved. The inspectors were informed that breakfast and supper menus provide more opportunity for variation according to each residents preference. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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): 16 & 18 Complaints are managed properly and residents and their representatives said they are confident their concerns are listened to and taken seriously, in accordance with the complaints procedure. The home protects residents from harm and abuse. EVIDENCE: No complaints against the home have been received or investigated since the last inspection. The home has a policy/procedure for the prevention of abuse and staff have received training in this subject to ensure the proper protection of residents. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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): Standards 19, 22, 23, 24 & 26 were found met at the last inspection EVIDENCE: Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 14 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): 29 & 30 (27 & 28 were found met at the last inspection) The home’s recruitment systems properly protect residents from the risks of potentially unsuitable staff being employed. The home has made arrangements to meet the recommended standard for at least 50 of care staff to hold a National Vocational Qualification in care. Staff receive training appropriate to their work. EVIDENCE: The records of 2 recently employed staff members were examined and found to contain all required information with evidence of appropriate checks having been made in advance of employment to ensure the suitability of each applicant. There are always trained nurses on duty in the home. Trained nurses continually direct and supervise the work of care and household staff. At present only 1 of the 19 care staff currently employed by the home holds a National Vocational Qualification in care; 10 more are at present training for this qualification and when completed the home will meet the standard for at least 50 of the care staff to hold an NVQ. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 15 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, 33 & 35 (36 & 38 were found met at the previous inspection) The registered manager is suitably experienced and skilled to properly undertake her role and responsibilities. Residents and their representatives are satisfied with the home and feel staff care for them well and put them at their ease. The home has implemented a quality assurance system to ensure that residents remain satisfied with all aspects of the home. The home does not manage the finances of residents. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 16 EVIDENCE: Mrs Goodbody has been the registered manager of The Cedars since it first opened as a nursing home; she is a trained nurse and holds NVQ4 in management. Mrs Goodbody is supported by a deputy manager. The home holds occasional Residents Meetings and carries out periodic analysis of the opinions of residents and their friends and relatives to ensure the maintenance of good satisfaction levels. The home does not manage the finances of residents; their monies are managed on their behalf by relatives or lawyers. As noted in the reports of previous inspections, on occasion linen cupboard doors were left open contrary to fire regulations; the inspectors suggested the installation of a buzzer or magnetic closure to minimise this circumstance. Records and discussion indicated that a member of staff had received injuries following use of a cleaning fluid; it is recommended that this be reported to the Health & Safety Executive as a COSHH related accident. Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 18 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 OP9OP9 Regulation 13 Requirement When a variable dose is prescribed the amount actually administered on each occasion must be recorded. Handwritten entries in medication instructions must be signed and dated by the writer and countersigned by a member of care staff who has checked the entry for accuracy. Linen cupboard doors must be kept shut when not in use, in accordance with the written instructions on the label on the door. Previous timescale of 15/01/06 not met. Timescale for action 18/04/06 2. OP9OP9 13 18/04/06 3. OP38OP38 23(4) 18/03/06 Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 19 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 OP7OP7 OP8OP8 Good Practice Recommendations A system of internal care plan audit should be implemented, to simplify, clarify and archive the records. Accidents and incidents should be periodically audited to identify any patterns or trends, in order that actions to minimise risk of recurrence may be promptly implemented as needs arise. In advance of each meal residents should be offered a choice of menu. The accident whereby a member of staff received injuries following use of a cleaning fluid should be reported to the Health & Safety Executive as a COSHH related accident. 3. 4. OP15OP15 OP38OP38 Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Cedars (The) DS0000020499.V282747.R01.S.doc Version 5.1 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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