Inspection on 06/06/07 for The Cedars (7)

This inspection was carried out on 6th June 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Cedars (7) 31/01/06

The Cedars (7) 17/12/04

The Cedars (7) 22/07/04

The Cedars (7) 12/01/04

The Cedars (7) 05/08/03

The Cedars (7) 15/08/02

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

CARE HOME ADULTS 18-65 The Cedars (7) Ashbrooke Sunderland SR2 7TW Lead Inspector Hilary Stewart Unannounced Inspection 6th June 2007 10:30 The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 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 (7) DS0000015735.V334448.R02.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 Adults 18-65. 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 (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cedars (7) Address Ashbrooke Sunderland SR2 7TW 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) 0191 514 0900 0191 565 5706 European Services for People with Autism Limited Paul Lewins Care Home 7 Category(ies) of Learning disability (7), Sensory impairment (1) registration, with number of places The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: Number 7 The Cedars is a care home owned by European Services for People with Autism (ESPA), which is a registered charitable organisation. It provides accommodation with personal care and support for up to seven younger adults of mixed gender who have autism specific disorders, including one person who also has a sensory impairment. Nursing care cannot be provided. The property, a large Victorian villa with tastefully decorated and furnished spaced communal areas and bedrooms, is situated in the Ashbrooke area of Sunderland. It is walking distance of local shops, a park, churches and pubs and also near to a bus stop, from which a service regularly travel to the city centre. The home has the use of a private vehicle and there is a car park at the front of the building. People living at the home can easily access an enclosed garden at the rear. Contained within the grounds is a coach house which provides a specialist service for one person which is intensively staffed. This accommodation is included in the registration of 7 The Cedars and is also inspected by the Commission for Social Care Inspection. The home charges from £964.95p to £1500.08p per week. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 31st January 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run.. • The views of people who use the service and the staff . The Visit: An unannounced visit was made on 6th June 2007. During the visit we: • • • • • • Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit . We told the manager what we found. What the service does well: Staff on duty at the time of the visit were informative and helpful. The needs and wishes of each person who lives at the home have been assessed. This means that staff know about the needs of each person and what care and support they require. The staff team at the home value the differing needs of the people who live there and make sure that they are aware of each person’s preferences. They treat the people as individuals and support them to live the life they choose as much as possible so they will have new experiences and that they know that their opinions are valued. People who live at the home are supported by the staff to experience a variety of activities. This gives them choice as well as building their self-esteem and confidence. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 6 The staff team make sure that the home is clean, warm and pleasantly furnished so the people who live at the home have a comfortable place to live. Staff support the people who live at the home to use local services so they are part of the community. The staff are supervised and trained so they know how to provide the people who live at the home with good care. The staff make sure the people who live at the homes health care needs are met so they remain in good health. All of the people who live at the home have plans of care and risk assessments. This is so staff have the information they need to support each person and keep them safe. The home has procedures for staff for the administration and recording of medication. This is to make sure the people who live at the home receive their medication they need at the correct times. The home has procedures for dealing with complaints and protecting the people who live there from abuse. This means that the people who live at the home feel safe, know they can talk to the staff and that their views are listened to. 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. The summary of this inspection report can be made available in other formats on request. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The needs and wishes of each person who live at the home have been assessed. This means that staff know what care and support they require. EVIDENCE: The people who live at the home have their own individual files. They show that the people have had their needs assessed and they describe the actions the staff need to take to meet their needs. The manager and staff said that no one new has moved into the home since the last visit and a person could only move into the home if the manager and staff are certain that the persons needs can be met there. The home has a statement of purpose and a guide for people so they can decide if the home is where they would like to live. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home get personal support and at the same time staff make sure that their privacy, dignity and independence are respected. The people who live at the home are involved in writing their own care plan, whenever possible. They are supported to become more independent at the same time staff try to reduce the risks so they are kept as safe as possible. EVIDENCE: The deputy manager and staff said and records showed that the people who live at the home have individual files which show that their needs have been assessed. They take part in writing their own care plan as much as possible so they can record their hopes and wishes for the future. The staff have a record of the likes and dislikes of individuals as well as how to care for them. The deputy manager and staff said that the people who live at the home are supported to be as independent as they can be safely. Risk is assessed by staff which then shows how they can reduce risk as much as possible for people The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 10 when they for example take part in activities. The people are encouraged to make choices and decisions about what they want to do. There are house meetings held monthly. One person represents the home and takes the decisions from the meeting and the opinions of the people who live at the home to the managers of the organisation who run the home. The manager said that at the latest meeting the people were informed about changes to staff and they decided on their holidays for the summer. One person who lives at home said “ the staff listen to you”. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home can take part in various social activities so they can have new experiences and find new interests. They are treated with respect by the staff so they learn how to treat other people with respect. They are supported to see their friends and family so their relationships with people are maintained. They have a nutritious well balanced diet so they learn how to eat healthily. EVIDENCE: The manager and staff said that the people who live at the home have the same rights as everyone else to make choices but they have to look at the risks at the same time. Sometimes for instance some people are not able to go out on their own, as they may not be able to keep themselves safe. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 12 The staff and manager said that they regularly look at the options open to the people who live at the home in relation to work, leisure and social activities. At the same time they have to be realistic about the choices. The friends and family of the people who live at the home are encouraged to keep in contact with them. They can visit the home or staff will support the people to visit them. One person visits their family every three weeks. The staff were observed and they said that they always ask before they enter people’s bedrooms. Staff said that the people who live at the home can always have privacy if they want. One person when asked said that they liked their room. Another said, “ My room is private”. The manager and staff said that the people who live at the home use the local pubs and they go into the town. They use a local shop and people in the area talk to them when they are out. On the day of the visit one person had been to visit another person from the home that was in hospital. Another had been out on the bus and another had been for a walk in the park. One person said that they hoped to go and see their favourite singer in concert in the future. Staff said and records showed that the people have a variety of activities and trips out such as trips to town, to pubs and restaurants. Staff said and records showed that the people who live at the home go away on holiday, they all do different things. They go to a chalet in the country every year. One person said that they want to go to Norway. Staff said that they work with the people who live at the home around enabling them to have appropriate relationships and behave in ways that will help them get on with people. Staff said that the people’s rights are respected. The home’s menus are based on the known likes and dislikes of the people who live at the home. Staff said that they are always trying to find new menus and to provide interesting things for them to try. The staff said that at least three meals are served to the people, which are varied and nutritious. One person said, “I like the food” and that their favourite was potatoes. Fresh fruit and vegetables were in the kitchen. One of the people goes shopping for the food for the home another buys their own shopping. The home has won the Heartbeat award, which is run by the Local Authority. To win this they all had to promote a healthy lifestyle and be aware of food hygiene. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home have personal support when they need it so they can be as independent as possible. The staff monitor and promote the health of the people who live in the home to maintain their well-being. EVIDENCE: The manager said that they have recently looked at the medication procedures in the home to make sure they are working. All of the medication is checked weekly. The medication records were up to date. Any discrepancies are taken very seriously and the staff have a procedure to follow to make sure medication is given correctly. The manager and staff said and records showed that they have had training in how to administer medication. If it is thought to be safe following a risk assessment the people who live at the home can control their medication. The manager said that they have arranged for their local pharmacist to come and check the home once a year. Details of health checks, visits to their GP and hospital appointments are recorded in each individuals file. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 14 Records showed that the health needs of the people at the home are written up in detail so the staff have accurate information and know how to care for the people. The staff said that the health and welfare of the people who live at the home is constantly being monitored. Records showed that their health and well being is discussed in staff meetings. If there are concerns about a person’s health appropriate action is taken. The manager and staff could describe and records showed how people are provided with personal support when they need it. The people who live at the home looked smart and well groomed. One person said that the staff help them with their clothes and they go to the hairdressers and the dentists. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 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 complaints procedure to make sure that any complaints or problems are taken care of quickly. This helps good relationships to be maintained. Staff know about adult protection procedures so the people who live at the home are kept safe. EVIDENCE: The manager and staff said and records showed that they have had training in how to protect vulnerable people from abuse. They have this training once a year. Staff could describe the procedure to be followed if an allegation of abuse was made. The manager said that the procedures are followed in the home. One person who lives at the home when asked if they felt safe living there said yes. Some of the people at the home do not communicate with spoken words but they looked comfortable and relaxed during the visit. They approached staff and used gesture and signs to communicate with them. There is also a complaints procedure. The manager said and records showed that the home has not had any complaints since the last inspection. Staff said that they would support the people who live at the home if they wanted to make a complaint. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Safety checks have been carried out in the home so the people who live there are safeguarded. The home is comfortable and clean so the people have a pleasant place to live in. If some areas were updated and repaired this would improve the home even more. EVIDENCE: There are enough bathrooms and showers for the people who live at the home. In one of the bathrooms the suite is old and the grout is discoloured. The hall and stair carpets are stained and worn. The bedrooms looked comfortable and the people who live at the home had personalised them. They had been made very individual and comfortable. One person “ I would like new furniture for my room”. In one of the bedrooms the wallpaper was coming off the ceiling. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are supervised and get training so they know how to give the people who live at the home good care and meet their needs. People who live at the home are protected by the homes recruitment procedures. This makes sure that only suitable people come to work at the there. There are enough staff working at the home so the people who live there are provided with the care they need. EVIDENCE: Records showed and staff said that they receive training, which helps them with their work. One member of staff said that they thought the training was good. At least nine staff have vocational qualifications. The staff said they felt supported by their manager. Records showed and the manager said that staff are getting individual supervision when they should and they hold regular staff meetings. Staff said that they get individual supervision and are supported to do their job. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 18 Sufficient staff were on duty at the time of the visit and the manager and staff said that enough staff work at the home. Records showed that on other days enough staff had been on duty. The manager and staff said that as staff were having to support someone in hospital it had at times been difficult to cover the rota however the staff have been very flexible. The manager said that all staff have been CRB (Criminal Records Bureau) checked at an enhanced level to make sure they are suitable people to work at the home. Some records were looked at and they showed that staff had been checked before they started to work at the home. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager has the experience and vocational qualifications to run the home well so the people who live there are well cared for. The home has a quality assurance system so the service the people who live at the there get is looked at and improved. Monitoring visits of the home take place to check that the people who live there get the care they need and their health, safety and welfare is always promoted. EVIDENCE: The manager said that they have the relevant experience to run the home and have a recognised vocational qualification. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 20 Records showed that checks had been carried out on the equipment in the home; such as testing electrical equipment and the servicing the central heating boiler. Fire safety risk assessments had been completed. The fire logbook showed that regular fire drills and fire instruction take place. Staff said that they have fire drills and instruction. One of the people who live at the home said that they have to go outside when the fire alarm goes off. Records showed that regular training is provided for staff in fire safety, food hygiene and first aid. The manager said and records showed that regular monitoring visits take place at the home. The manager said that the people who live at the home are asked their views about the running of the home as much as possible and the home has a yearly improvement plan. One person said “the staff listen to you” and “the staff help you”. It was observed and staff said that they have a good relationship with the manager at the home. The people who live at the home were seen approaching the staff and deputy manager in a confidant manner. One person was observed informing staff of their opinions during the visit. The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 x 3 X 3 X X 3 x The Cedars (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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 YA24 Regulation 16 Requirement The carpets on the stairs must be replaced, the bathroom updated and the wallpaper coming off the ceiling in the bedroom be repaired. Timescale for action 01/09/07 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 (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 (7) DS0000015735.V334448.R02.S.doc Version 5.2 Page 24 - 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. 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