Inspection on 03/08/06 for The Cedars

This inspection was carried out on 3rd August 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 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 16/02/06

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 Key Unannounced Inspection 3rd August 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 DS0000006500.V301170.R01.S.doc Version 5.2 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. DS0000006500.V301170.R01.S.doc Version 5.2 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.uk CLS Care Services Limited Mrs Karen Ann Alford 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 (27) of places DS0000006500.V301170.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 27 service users to include: * Up to 27 residents in the OP ( old age not falling within any other category) * One resident over the age of 65 in the category LD(E) (learning disability over the age of 65) Date of last inspection 16th February 2006 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 current weekly fees range from £343.34 to £410.00 plus premiums. Further details regarding fees are available from the manager. Additional charges are made for newspapers, hairdressing and toiletries, optical and chiropody. Prospective residents are able to read the latest CSCI inspection report, which is available in a copy of the Service User Guide in the entrance hall. A copy of this guide is also available in each resident’s bedroom. Other information about the home and CLS is available in leaflets on display in the hall. These outline the lifestyle that residents can expect when they move into the home. DS0000006500.V301170.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process of The Cedars included a site visit to the home which was unannounced and completed in one day. Time was spent sitting and taking with people who use the service and observing the day-to-day routines of the home and care staff as they provided support. Time was also spent looking around the building to assess its suitability to provide a comfortable, homely environment for the enjoyment of everyone and ensure their safety. As well as the views of the residents that live in the home, a number of visitors were spoken with and a community nurse. Their comments have been included in the report. The views of the staff on duty were also listened to. A number of CSCI survey questionnaires for residents and visitors were posted to the home prior to the visit. Three relatives and one resident returned completed questionnaires. What the service does well: The residents living in The Cedars are happy with the care they receive. Some of the comments received are: “The staff look after me well”. “I get the care I need”. “I am pleased that I feel comfortable and don’t need to worry”. Feedback from relatives and visitors was also very positive. One relative wrote in a comment card: “I think that the care the residents at The Cedars receive from the staff is wonderful”. 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. DS0000006500.V301170.R01.S.doc Version 5.2 Page 6 The Commission for Social Care Inspection has not received any complaints regarding the home. 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. DS0000006500.V301170.R01.S.doc Version 5.2 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 DS0000006500.V301170.R01.S.doc Version 5.2 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. Standard 6 does not apply, as intermediate care is not provided. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed before they move into the home. This ensures that each resident and their family know that these needs can be met when they move into The Cedars. EVIDENCE: The files of four residents were checked, including one of a resident who had recently moved into the home. 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 can be met at the home. Discussions also take place with the family and the resident’s social worker, if they have one. Completed assessments were seen on care plans. Written assessments are sometimes provided by health and social care professionals to give the home additional information about the care needs of new residents. The manager then makes a decision as to whether the resident’s care needs can be met by the home. DS0000006500.V301170.R01.S.doc Version 5.2 Page 9 When the resident moves into the home, the initial assessment information is used to develop a plan of care, along with observations by the staff and discussions with the resident and their family. DS0000006500.V301170.R01.S.doc Version 5.2 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): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health and social 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. They were well written and personcentred. All contained risk assessments, moving and handling information, and information about contact with medical professionals. There was evidence that staff support some residents to take risks such as going out alone and having a kettle to make tea in their bedroom. Residents’ interests, hobbies and previous lifestyle were also recorded. The most recent resident to move into the home had 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, which are audited by the manager on a regular DS0000006500.V301170.R01.S.doc Version 5.2 Page 11 basis. The reviewing and updating of care plans has improved since the last inspection. A visiting community nurse was spoken with during the inspection. She said that in her opinion, the care given to residents at The Cedars is excellent. She said the staff observe the residents well and take advice from the nurses if their medical needs change. She also commented that the staff group are “very keen on patient dignity”. Staff were observed to deliver care to residents in a sensitive, kind and appropriate way. One resident confirmed that the staff call out the doctor if she is “feeling poorly”. Policies and procedures for dealing with medication are in place, and there was evidence that staff are following these, ensuring safe working practices for the residents. The systems for recording, storing and administering medication were checked. All were in good order and well managed and audited by the manager on a regular basis. The staff spoken with displayed a good understanding of the importance of ensuring privacy and dignity when delivering personal care to the residents. Induction training for new members of staff includes privacy and dignity. Comments from visitors to the home were good. One visitor said that the staff communicate very well with her, and keep her well informed about her mother. Another said “I am very happy with the care my father receives”. DS0000006500.V301170.R01.S.doc Version 5.2 Page 12 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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their lifestyle and social activities and keep in contact with relatives and friends. Residents receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: Two part-time activities co-ordinators ensure that residents have a choice of activities both inside and outside the home. Group and individual activities are arranged such as quizzes, bingo, baking, craftwork, visits to the local garden centre, coach trips and writing and reading letters. Many one-to-one activities take place such as a walk to the village for coffee and reading the local papers. Posters showing the dates and times of activities were displayed in the home. DS0000006500.V301170.R01.S.doc Version 5.2 Page 13 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. The garden, both front and back, was full of flowers and tubs, admired by all. Some residents choose to live in their bedrooms and have their meals there. The staff respect this choice, and one resident spoken with was pleased that the staff did not continually try and persuade her to join the other residents in the lounge. A number of the residents have lived in the local area for many years, and continued contact with the local community is encouraged. Family and friends know that they can visit the home at any time. The daily menus each have two or three choices at each meal, and the cook confirmed that she has flexibility within the menu choices to meet the individual needs of residents. Special diets are also catered for. There is one main dining area in the home and food is served from a hatch to the kitchen. The food served for lunch looked appetising and well cooked, with plenty available for second helpings for those who wanted some more. The residents spoken with said the food was good and they enjoyed having a choice each day. Cooked breakfasts are available and thoroughly enjoyed by some residents. Some comments received from the residents about the food include: • “The food is quite good”. • “Food ok”. • “The food is wonderful – a little old fashioned, but I suppose they think that’s what older people like. Good old fashioned dinners”. • “I eat it alright. I was never one for enjoying my food, but this is ok”. DS0000006500.V301170.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear and accessible complaints procedure ensuring that any concerns of residents or their families are dealt with promptly and correctly. There are good procedures for protecting residents from abuse so that they are not at risk from harm or poor practice. EVIDENCE: The complaints procedure is available in the service user’s guide and a copy is displayed in the entrance hall. Information regarding how to contact the CSCI is also displayed. CLS encourages residents and visitors to express any comments they have about the service provided, and comment cards are on display in the entrance hall. CSCI has not received any complaints about the home since the last inspection. The pre inspection questionnaire indicated that the home has received one minor complaint in the past year and this was dealt with in an appropriate way. None of the residents spoken with has made any complaints, but all said they were comfortable in talking with the manager if they had any concerns. One resident said, “If I have a concern, the staff will act on it. This has happened”. DS0000006500.V301170.R01.S.doc Version 5.2 Page 15 The staff spoken with displayed an understanding of adult protection procedures. A training course on adult abuse and has been recently arranged for staff to update their knowledge. These training sessions will continue for new staff. There are policies and procedures in place for the protection of residents, which were last reviewed and updated in March2006. DS0000006500.V301170.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recent investment has improved the environment for residents, providing a comfortable, safe standard of accommodation with better facilities. EVIDENCE: Since the last inspection, the environment has been improved with the purchase of new lounge chairs. Residents said they had been involved in choosing the new furniture and commented on the improvement they made to the lounge. A lot of redecoration and refurbishment has taken place over the recent months, resulting in the home looking clean, fresh and homely. Some further work is planned for corridors and the first floor lounge. Residents spoken with were happy with their bedrooms, and those seen during the inspection were comfortable and homely. Six of the bedrooms are small in size, being under 10sq.mtrs. Eight of the bedrooms have ensuite facilities. DS0000006500.V301170.R01.S.doc Version 5.2 Page 17 At present, there is only one main lounge, the second smaller lounge being used as a smoking room. This does restrict the choices of where to sit for residents, although the residents spoken with said this did not bother them. However, consideration should be given to the provision of a choice of nonsmoking/quiet lounges in any future planning. The fire prevention officer made his last visit on 23/05/2005. Some recommendations are still outstanding. The environmental health officer visited on 12/08/2005 and there are no outstanding requirements or recommendations. One resident, whose hobby is gardening, has spent a lot of time and effort in planting tubs and flowerbeds around the garden. This has considerably improved the outdoor facilities for the residents. Many visitors and residents commented on how pretty the garden looked. DS0000006500.V301170.R01.S.doc Version 5.2 Page 18 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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: There are sufficient numbers of staff on duty to meet the needs of the residents. In the two months prior to the inspection, agency staff were used on very few occasions. The permanent staff in the home tend to cover for each other for holidays or sickness, and this provides better continuity of care for the residents. Staff are encouraged and supported in pursuing NVQ qualifications and are working towards the CSCI target of 50 trained care staff, which was 47 on the day of inspection. One staff member has nearly completed their training, and six are in progress. All the domestic staff have completed NVQ in housekeeping. Residents spoken with said the staff are kind and caring, and some of the comments received are: DS0000006500.V301170.R01.S.doc Version 5.2 Page 19 • • • • “They (the staff) look after me well”. “The carers make a fuss of everybody”. “The staff are very nice – all different”. “We (the residents) all get along very well with the staff”. Good policies and procedures are in place for the recruitment of staff. Four staff files were seen and each contained evidence of an interview, two references and the necessary CRB checks having been obtained before the staff member commenced duties. Staff spoken with said they felt supported by management. They described themselves as a stable staff group that did not have a big turnover. This provided continuity of care for the residents. Staff felt that CLS encourages their training, and they felt that plenty is available. Equality and diversity within the home can be seen in the way the residents are treated as individuals with different needs. The home strives to meet these needs as appropriate, and provide the necessary care to enable the resident to live their chosen lifestyle. DS0000006500.V301170.R01.S.doc Version 5.2 Page 20 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced and supported by senior staff, ensuring the residents live in a well run home. Opportunities are given to residents to express a view on the running of the home and services received. EVIDENCE: The manager has a number of years experience at a senior level and has recently commenced her training for the Registered Managers Award. DS0000006500.V301170.R01.S.doc Version 5.2 Page 21 A quality assurance system is in place, and residents and/or their families completed a satisfaction questionnaire last year. The results of this survey have been collated and a summary is available in the service users’ guide, outlining any areas for action or improvement. Residents can also voice an opinion during the residents and relatives meetings, which are held two monthly. As mentioned under standard 16, the home encourages comments or suggestions from visitors to the home, and forms for this are available in the entrance hall. As discussed in standard 18, 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 to be in good order. Staff supervision on a one to one basis is now underway and improving, although not all staff are receiving this on a regular basis. Health and safety matters are given good attention. There are policies and procedures in place and evidence that staff work in ways to promote the well being of residents. DS0000006500.V301170.R01.S.doc Version 5.2 Page 22 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 3 DS0000006500.V301170.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP31 Good Practice Recommendations The manager should complete her training for the Registered Managers Award within the recommended time scale. All care staff should receive formal supervision at least six times per year. 2. OP36 DS0000006500.V301170.R01.S.doc Version 5.2 Page 24 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 DS0000006500.V301170.R01.S.doc Version 5.2 Page 25 - 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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