Inspection on 06/10/05 for The Cedars

This inspection was carried out on 6th October 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 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 20/06/07

The Cedars 27/06/05

The Cedars 23/02/05

The Cedars 01/09/04

The Cedars 01/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Cedars 78 Morton Terrace Gainsborough Lincs DN21 2RJ Lead Inspector Mr Doug Tunmore Unannounced Inspection 6th October 2005 09:20 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 DS0000041858.V255429.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 DS0000041858.V255429.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Cedars Address 78 Morton Terrace Gainsborough Lincs DN21 2RJ 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) 01427 612129 angelakirman@lincolnshire.gov.uk Lincolnshire County Council Angela Kirman Care Home 35 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (23), of places Physical disability over 65 years of age (1) The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Old Age, not falling within any other category (OP) (23) Dementia - over 65 years of age (DE(E)) (11) Physical Disability - over 65 years of age (PD(E)) 1 The maximum number of service users to be accommodated is 35. 2. Date of last inspection 27th June 2005 Brief Description of the Service: The Cedars is a home run by Lincolnshire County Council. It is a purpose built two-storey home that offers care and accommodation for older persons on a permanent and respite basis. The home has recently been registered for the short term care of people who have dementia. The home is situated to the north of the town, in a residential area on the main road. There are local facilities available and the town of Gainsborough is approximately a mile away. It is set in large, well maintained grounds, with gardens to the front and rear. There is also a safe garden for the use of residents who have dementia, which is also private. There is ample parking to the front and side of the property. The home operates on policies and procedures established by Lincolnshire County Council Social Services Department. The home has a day centre (which did not form part of this inspection) situated on the ground floor. The homes service users guide gives information to prospective residents as well as the care that they can expect when admitted to this home. The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.20 am. The main method of inspection used was called case tracking, which involved looking at policies and procedures relating to maintaining the safety and general welfare of residents. Residents were spoken to as well as visitors, the manager and care staff and observations were made of care practices. A partial tour of the home took place. What the service does well: What has improved since the last inspection? What they could do better: The home continues to provide a quality care service for those residents who undertake short term care placements at this home. No requirement or recommendations were made at this inspection. The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 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 DS0000041858.V255429.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 DS0000041858.V255429.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): The key outcomes were assessed at the last inspection. EVIDENCE: The Cedars DS0000041858.V255429.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): 9 & 10 Medication is administered as per the homes policies and procedures with residents enabled to administer their own medication if they so wish. Residents dignity and privacy is maintained when personal care is undertaken. EVIDENCE: Files seen showed that care plans were prescriptive regarding the intimate care needs required by residents and the need to maintain the privacy and dignity of residents. A carer was aware of the intimate care needs of residents and confirmed that she had undertaken the homes induction training and The National Training Organisation for Social Care, which addressed personal care issues. A resident commented that ‘the staff are good at this home and some are excellent from top to bottom and are very supportive when they move me from my wheelchair’. The home medication sheets were seen and showed that resident’s medication sheets had been signed when medication was given on the day of the inspection. Files seen showed that residents who self medicate have signed a The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 10 self-custody form and have been risk assessed by the home. One resident said that he self medicates and that the home undertook and two-day assessment on him before he could self medicate. The pharmacist carried out an inspection on the 08/08/05, which was found to be satisfactory. The Cedars DS0000041858.V255429.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 A variety of activities are available and residents are able to make choices about their participation. EVIDENCE: The residents preferences are written in the care plans and their views are respected. Residents said they enjoyed the activities that are on offer and they can choose whether to join in or not. One resident commented that ‘a activities list is put up on the notice board and he has played musical bingo the other night’. Each resident is consulted about their likes and dislikes and they have the opportunity to express their views and offer ideas at the residents meetings. Staff commented that the home has an activities organiser and care workers join in with residents when activities take place. The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key outcomes were assessed at the last inspection. EVIDENCE: The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The home is clean and tidy with a pleasant smell throughout the home. EVIDENCE: The home employs three cleaners, a laundry worker and a maintenance man who carries out the cleaning of carpets and general maintenance. All cleaners have undertaken manual handling of loads training. The laundry worker stated that she has undertaken adult abuse training and that she has been nominated for a basic food hygiene course. One visitor commented that she has not detected any unpleasant odours in the home during her visits. One resident stated that the home is always kept clean and tidy. A partial tour of the home by the inspector found it to be clean and smelt fresh. The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 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): 27,28,29 & 30 Residents are protected by robust recruitment practices. They benefit from a staff team who are well trained and receive appropriate levels of support. There are sufficient staff to care for the residents EVIDENCE: One personnel file seen of a care worker recently employed contained CRB checks (Criminal Record Bureau), references, application forms and interview notes. All care workers have been given The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The homes training record was seen which showed that, eleven care workers had NVQ (National Vocational Qualifications) level 2, two of these having NVQ 3, one worker is currently undertaking NVQ level 2. One care worker said that she is applying to undertake NVQ training. Three workers have the assessors award enabling them to assess other workers undertaking this training. Thirteen carers have undertaken the National Training Organisation for Social Care induction training. The home meets the standard for 50 of staff to be trained to NVQ level 2 by 2005. Statutory training such as fire training, moving and handling and first aid are undertaken at this home. Other training undertaken included; Dementia training, health and safety and recruitment and selection. The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 15 One care worker demonstrated a clear understanding of her role and responsibilities, she confirmed that she was supervised by a team leader as part of her initial training. A visitor stated that the staff are very welcoming and the carer who is checking my mum is very nice’. Residents said that staff are attentive and they don’t have to wait long if they need support. The duty rota showed that adequate staff numbers are on duty to meet the needs of residents during the day and night in this home. The Cedars DS0000041858.V255429.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): 33,35 & 38 Records seen show that residents health and general welfare and safety are promoted. The home ensures that the residents have the opportunity to voice their views and opinions. Accurate records are kept of residents monies. EVIDENCE: The home conducts residents improvement questionnaires for all those residents leaving the home after having respite care. Files seen showed that residents have made positive comments in these questionnaires about the care they have received. An evaluation of these questionnaires is also posted on the homes notice board for the information of residents and visitors. The minutes of the last residents meeting held on 06/09/05 showed that residents are encouraged to voice their views and are actively involved in issues relating to the running of the home. A resident said that staff are very approachable and he would have no hesitation in giving his opinions to them. The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 17 The home only deals with personal allowances of a small number of residents, which are kept at the home. All other monies relating to funding are paid to Lincolnshire County Council. Residents personal allowances were seen and it was found that an accurate record is kept and receipts are available for any monies spent, with signatures also obtained from the hairdresser or the visiting chiropodist. Visitors seen confirmed that they dealt with their relatives monies. One resident confirmed that he deals with his own finances and that he keeps petty cash in his room, which is locked. Supervision and appraisals of care staff are undertaken on a regular basis by the registered manager and team leaders. Care workers files showed that supervision has been undertaken on all care staff on a monthly basis. One carer confirmed that supervision is undertaken with the team leader. Files also showed that appraisals have also been undertaken on all staff There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks are carried out. The homes selfassessment shows that ‘policies and procedures are read and signed by staff and that they inform practice’. Certificates were available showing that the shaft lift, bath hoists and hot water outlets (checked) had been serviced. All wheelchairs seen on the day of the inspection had footplates, which were in use. The Cedars DS0000041858.V255429.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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x 4 STAFFING Standard No Score 27 3 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 4 x 3 x x 3 The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 19 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. Refer to Standard Good Practice Recommendations The Cedars DS0000041858.V255429.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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