Inspection on 26/01/06 for The Cedars

This inspection was carried out on 26th January 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 03/08/07

The Cedars 07/08/06

The Cedars 16/09/05

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 26th January 2006 12.20 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.V279237.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. The Cedars DS0000017957.V279237.R01.S.doc Version 5.1 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.V279237.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th September 2005 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.V279237.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place over 4 hours one day in January 2006. 10 of the 38 National Minimum Standards were assessed at this visit ensuring that all the key standards had been assessed over the inspection year. 9 standards were met with one being nearly met. The inspector was given a guided tour of the home and experienced complete co-operation with the inspection process from the registered manager and care staff. The registered providers had plans underway to provide a separate accommodation unit within the grounds of the home to provide care for a further 24 service users with Dementia. This unit will be staff independently of the main unit but catering and laundry services will be shared. The inspector appreciated the views and opinions given by residents at the home and their visitors regarding everyday life at the Cedars. Overall the standard of care provided for the residents at The Cedars was good. What the service does well: What has improved since the last inspection? What they could do better: The registered manager must continue to encourage and motivate staff to progress the NVQ level 2 training in order that a minimum 50 of the staff team achieve this qualification. The Cedars DS0000017957.V279237.R01.S.doc Version 5.1 Page 6 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.V279237.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 The Cedars DS0000017957.V279237.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 and 6 • Residents could be confident their personal, social, spiritual and health care needs were assessed before moving in permanently to ensure the home would meet their needs. The Cedars did not provide ‘intermediate care’ therefore this standard could not be assessed. • EVIDENCE: Care plans contained a pre-admission assessment undertaken by the registered manager before residents moved into the home. These assessments covered all aspects of the prospective resident’s daily life and personal, social and spiritual well being and formed the basis of the ‘plan of care’. The Cedars DS0000017957.V279237.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): 8 and 9 • • Residents’ health care needs were fully met. Residents could be confident they were protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Care plans provided evidence of the personal care and support offered and provided to the residents at The Cedars. Records showed that where possible individuals were prompted and encouraged to maintain their independence with personal hygiene, including oral care. Care staff reported any changes in the residents’ health or well being to the senior on duty and recorded the detail in the individual’s daily record. Each care plan sampled at this inspection contained evidence of healthcare professional visits and subsequent actions to be taken by care staff. Records showed that the registered manager ensured relatives were kept informed of any matters affecting the health or well being of their loved ones. A dentist attended the home twice yearly to undertake routine dental checks and when requested for individuals. Records of optician and chiropody appointments were in the care plan. The Cedars DS0000017957.V279237.R01.S.doc Version 5.1 Page 10 There were no residents with pressure sores at this visit, the registered manager was able to confirm that staff had received training in tissue viability and that the home had a good relationship with the district nursing team. The home had a robust medications policy and procedure that was subject to regular review. Only designated staff were responsible for the administration of medicines. External medication training had been provided; this had not included a competency assessment. Records of medication received into the home and returned were maintained by the registered manager. An annual medication review of the home was undertaken by a pharmacist. The manager reviewed residents’ medication monthly and if there were any concerns the GP was consulted. Medicines were stored appropriately in secure facilities and records were checked daily by the manager ensuring a high standard was maintained. The Cedars DS0000017957.V279237.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): 14 • Residents were supported to exercise choice over their lives. EVIDENCE: The residents at The Cedars were not able to manage their own finances independently; all received assistance and support from families or representatives. Information regarding advocacy services was available. Residents were encouraged to bring personal possessions into the home in order to personalise their individual spaces. A full inventory of all belongings was made on admission to the home and a system was in place to record items brought in for individuals on an ad hoc basis. The registered manager confirmed that access to personal records was granted to residents and their representatives in accordance with the Data Protection Act 1998. Visitors spoken with during this inspection confirmed their loved ones were well cared for and respected at the home. Visitors were made very welcome and a tray of tea and biscuits was provided for them on arrival. It was reported that there were daily choices at mealtimes and a selection of activities to enjoy in the afternoon. The activities did not appear to provide stimulation for all the residents, a discussion was held with the manager regarding the provision of specific activities for people with dementia. The Cedars DS0000017957.V279237.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): EVIDENCE: These standards were not assessed at this inspection visit. Visitors consulted on the day reported they were aware of how to make a complaint and who to complain to and “why would anyone complain? The care is wonderful and so are the staff” The Cedars DS0000017957.V279237.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): 26 • The home appeared clean, pleasant, warm and welcoming. EVIDENCE: The inspector was given a guided tour of the premises and found it to be clean, tidy and fresh throughout with no offensive odours. Laundry facilities were sited away from food preparation areas. The registered provider had requested planning permission to make alterations to the existing house including re-positioning and extending the laundry facilities the provision of a staff room and the installation of a sluicing facility. The Cedars DS0000017957.V279237.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): 27,28 and 29 • • • The numbers and skill mix of the staff team meet the needs of the residents. The residents were in safe hands at all times. Residents could be confident they were protected by the home’s recruitment policies and procedures. EVIDENCE: The registered manager employed 4 care staff on day duty and 2 for waking night duty with a further staff member on call in case of emergency. Domestic staff were employed in sufficient numbers that the home was maintained clean and hygienic. The National Minimum Standards required that a minimum of 50 of care staff had achieved NVQ 2 in care by December 2005. This standard had not been met at the point of this inspection however, 4 members of staff had achieved the qualification and 6 were undergoing the training. Training and refresher courses in mandatory areas had been provided together with some service user specific training. Staff members demonstrated dedication and professionalism together with a good knowledge of the residents in their care. The home’s recruitment policy and procedures served to protect the health, safety and well being of the residents. The registered manager confirmed that no person starts to work at the home until two written references and a completed enhanced Criminal records Bureau check had been received. The Cedars DS0000017957.V279237.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 and 38 • • The residents could be assured The Cedars was managed by a person of good character and able to discharge her duties fully. The health, safety and welfare of the residents and staff were promoted and protected. EVIDENCE: The manager had been registered since 1996 and had completed the NVQ 4 qualification in management the day before the inspection. Periodic training in areas such as ‘Dementia for Managers’, Induction Standards and PoVA had been attended in order to maintain the manager’s skills and competence. A clear line of accountability within the home was evident. Residents demonstrated they were aware of the manager and her role and care staff reported they felt supported and valued. The Cedars DS0000017957.V279237.R01.S.doc Version 5.1 Page 16 The registered manager ensures the health, safety and welfare of residents and staff as far as is reasonably practicable. An allocated member of staff performs a weekly fire drill. Risk assessments were available for identified hazards for both within the building and in the grounds of the home. These assessments had review dates set and evidence of previous reviews undertaken. Portable Appliance Testing had taken place prior to the inspection, some shortfalls had been identified and work was in progress to rectify these shortfalls. Mandatory training and refresher courses had been attended by care staff further protecting the health, safety and welfare of the residents at the home. The Cedars DS0000017957.V279237.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 X 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 The Cedars DS0000017957.V279237.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 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. This is a repeat requirement and specifically refers to NVQ level 2 training. Timescale for action 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Cedars DS0000017957.V279237.R01.S.doc Version 5.1 Page 19 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.V279237.R01.S.doc Version 5.1 Page 20 - 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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