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Inspection on 22/10/05 for The Cedars Christian Residential Home

Also see our care home review for The Cedars Christian Residential Home for more information

This inspection was carried out on 22nd 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Cedars provides a high standard of care in homely, clean and pleasant surroundings. Visitors are made welcome. There are appropriate policies and procedures and good recording systems detailing the needs of the residents and the care provided. The staff team is stable and there are good relationships between the staff and the residents. The manager is committed to providing an individual service to each resident, according to their preferences and needs. Residents confirmed that they are well looked after. One said, `we are all comfortable here` and another said, `It couldn`t be better`. A relative told the inspector, `I can`t speak highly enough of the staff`. These comments were typical of those made to the inspector.

What has improved since the last inspection?

The manager has ensured that the requirements made at the last inspection have been met, with the exception of some work in the laundry, which is planned. Following the last inspection, there have been improvements in several areas. These include improvements in infection control procedures, more detailed plans for people with specific medical conditions and improvements in medication procedures and training for staff. There are better strategies for the management of the prevention of falls. The arrangements for the supervision of staff and the facilities for staff are better. There is improved storage for records. Risk assessments have also been updated and expanded.

What the care home could do better:

There are plans to decorate the communal rooms at the front of the house and to change their function. These improvements were due to start the day after the inspection took place. Attention is still needed to the laundry, which is well equipped, but in need of decoration, some repair and improved ventilation. The inspector was informed that there are plans to address this in the near future.

CARE HOMES FOR OLDER PEOPLE The Cedars Christian Residential Home The Cedars 22 Redlake Road Pedmore Stourbridge West Midlands DY9 0SA Lead Inspector Chris Lancashire Unannounced Inspection 22nd October 2005 01:30 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 The Cedars Christian Residential Home DS0000025045.V265251.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 Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Cedars Christian Residential Home Address The Cedars 22 Redlake Road Pedmore Stourbridge West Midlands DY9 0SA 01562 882299 01562 882299 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) Mrs Jenkins Mrs Jenkins Care Home 22 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (22), Physical disability (2) The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 22 OP, 2 PD and up to 1 MD Date of last inspection 17th March 2005 Brief Description of the Service: The Cedars is a large Victorian property built in 1902 and registered as a care home in 1984 by the current registered provider. The property is located in a residential area of Pedmore close to the town of Stourbridge. It has easy access to a main bus route, shops and other amenities. The home is registered to care for a maximum of 22 people, 19 of whom fall within the category of old age, 2 physical disability and 1 dementia. There are 20 single bedrooms and one double bedroom. 15 of these rooms have en-suite facilities and two have a shower. Residents’ accommodation is provided on three floors all of which can be accessed by a passenger lift. There are bathrooms with assisted baths on the ground and first floors. The home has three lounges and a dining room, all of which are tastefully decorated and furnished to a high standard. There is generous garden space to the front and rear, which appeared well maintained for the time of year. Car parking is available at the front of the home. The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a Saturday afternoon and lasted for three hours. The inspector met most of the residents, although some were resting in their rooms and were not disturbed. There were several visitors in the home, one of whom discussed the home with the inspector. The inspector also toured the building and examined records relating to requirements made at the previous visit, discussing relevant information with the managers and staff. What the service does well: What has improved since the last inspection? The manager has ensured that the requirements made at the last inspection have been met, with the exception of some work in the laundry, which is planned. Following the last inspection, there have been improvements in several areas. These include improvements in infection control procedures, more detailed plans for people with specific medical conditions and improvements in medication procedures and training for staff. There are better strategies for the management of the prevention of falls. The arrangements for the supervision of staff and the facilities for staff are better. There is improved storage for records. Risk assessments have also been updated and expanded. The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 6 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 Cedars Christian Residential Home DS0000025045.V265251.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 Christian Residential Home DS0000025045.V265251.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): These standards were not assessed at this visit. EVIDENCE: The Cedars Christian Residential Home DS0000025045.V265251.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): Residents’ needs are recorded in a suitable plan. Their health needs are met and there are suitable arrangements for the storage and administration of medication. They are treated with dignity and respect. EVIDENCE: The inspector sampled the plans of three residents with specific health needs and found that their plans were suitably detailed. Plans also include social and personal needs and are in a format which is easy to understand. Needs which the staff cannot meet are met by visiting health professionals. A recognised assessment tool is used to assess tissue viability on admission. There re currently no residents with pressure sores, but, in the opinion of the inspector, staff would still benefit from training in this area, as recommended in the previous report. All residents are registered with a GP and letters on files indicate that they are enabled to attend a range of health appointments as required. Letters were seen confirming that annual medication reviews are carried out on residents. The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 10 There have been improvements in the arrangements for the administration of medication since the last inspection. Staff have undertaken accredited medication training and sampled administration sheets were found to be up to date and appropriately completed. The medication system is overseen and checked on a periodic basis by a pharmacist. There is no Controlled drugs cabinet and previous inspectors have recommended that the home should acquire one. This was discussed with staff, who informed the inspector that there are no controlled drugs in use, but a suitable cabinet would be obtained, should there be a need. Observation showed that residents are treated with dignity and respect. Care is taken of clothing and residents are enabled to present themselves in a dignified way. Staff were seen knocking on doors prior to entry and the privacy of those residents who were resting in the afternoon was respected. The Cedars Christian Residential Home DS0000025045.V265251.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, 13, 14, 15 Residents are enabled to retain their interests and lifestyle. They maintain contact with family and friends and remain part of the community. They make choices about their lives. Residents receive an appropriate diet in pleasant surroundings. EVIDENCE: Residents choose when they get up and go to bed. Breakfast is served in bedrooms. During the day, some residents choose to spend time in their rooms, where they read, listen to the radio or watch television. Others sit in one of the communal areas, or the garden. The staff respect the residents’ preferences in terms of religious observance, social and leisure interests and offer support when people wish to participate in events. Outside entertainers visit occasionally and there are quizzes and craft activities for those who wish to participate. The home does organise trips, but most of the residents prefer not to participate in these. There were several visitors at the home on the day of the inspection and they are made welcome. Staff are available to discuss matters of relevance to the resident. The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 12 Details of advocacy agencies are displayed in the foyer. Many examples were provided of residents making choices about their care. The care provided is on an individual basis and tailored to meet each resident’s needs. Bedrooms contain personal possessions. The menus show a variety of traditional meals. The preferences and needs of each resident in terms of food are known and respected. Alternative meals are provided, when needed. A record is maintained of food eaten. Residents confirmed that the meals are of a high standard. The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 13 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): These standards were not assessed at this visit. EVIDENCE: The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 14 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, 26 Residents live in a home which is well managed by an appropriately qualified and experienced manager so that their best interests are given priority. EVIDENCE: A tour of the building revealed pleasant and well-maintained rooms, with homely furniture and no obvious health and safety hazards. Residents described the home as ‘comfortable’. There are plans to change the use of some of the downstairs rooms, so that the dining room and one of the lounges are swapped round. This was due to take place the day after the inspection. These areas are also being decorated and partly refurbished. All areas were seen to be clean and pleasant. There are procedures for the laundry and for infection control. The laundry is no longer used as a staff cloakroom. There is an adequate supply of protective clothing and gloves for the use of staff. In the last report, the inspector required improved ventilation and a repair to the laundry wall. These have not yet been completed, but the manager assured the inspector that these would be addressed in the near future. The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 15 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): These standards were not assessed at this visit. EVIDENCE: The Cedars Christian Residential Home DS0000025045.V265251.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): 31, 35 Residents live in a home which is well managed by an appropriately qualified and experienced manager so that their best interests are given priority. EVIDENCE: Mrs. Jenkins has been Registered Proprietor and Manager of The Cedars since its opening in 1984. She has extensive experience and is suitably qualified in social care provision. Mrs Jenkins made herself available during this unannounced inspection and explained the work which has been carried out to ensure that the requirements of the last report have been addressed. Feedback received from residents and relatives was extremely positive regarding the management of the Home. The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 17 Mrs. Jenkins has been Registered Proprietor and Manager of The Cedars since its opening in 1984. She has extensive experience and is suitably qualified in social care provision. Mrs Jenkins made herself available during this unannounced inspection and explained the work which has been carried out to ensure that the requirements of the last report have been addressed. Feedback received from residents and relatives was extremely positive regarding the management of the Home. Mrs. Jenkins has been Registered Proprietor and Manager of The Cedars since its opening in 1984. She has extensive experience and is suitably qualified in social care provision. Mrs Jenkins made herself available during this unannounced inspection and explained the work which has been carried out to ensure that the requirements of the last report have been addressed. Feedback received from residents and relatives was extremely positive regarding the management of the Home. Mrs. Jenkins has been Registered Proprietor and Manager of The Cedars since its opening in 1984. She has extensive experience and is suitably qualified in social care provision. Mrs Jenkins made herself available during this unannounced inspection and explained the work which has been carried out to ensure that the requirements of the last report have been addressed. Feedback received from residents and relatives was extremely positive regarding the management of the Home. The manager monitors the operation of the home. Relatives and residents confirmed that they are regularly asked for their views, which are taken into account when making changes. The policies and procedures are updated as necessary and staff sign to indicate that they have read these. Residents are encouraged to manage their own finances if they wish to do so. Generally residents’ relatives manage their finances although small sums of monies are given to the Home on their behalf in order to purchase toiletries or pay for hairdressing. There is a thorough recording method of all financial transactions made with double signatures obtained and the home’s administrator carried out regular audits. The Home has a facility for the safe keeping of any monies and valuables and there is access to a safe if necessary. Since the last inspection the home has improved its practice and now obtains receipts from visiting service providers, such as the hairdresser. The Cedars Christian Residential Home DS0000025045.V265251.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 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 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X x The Cedars Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 19 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 OP26 Regulation 13 Requirement The manager must provide a hand basin in the laundry area. The manager must provide adequate ventilation in the laundry. The manager must replace tiles missing from the laundry wall. (Previously required in March 2005) Timescale for action 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP8 OP9 Good Practice Recommendations To consider providing staff with awareness training in respect of tissue viability. To consider the purchase of an appropriate Controlled Drugs cupboard which complies with the Misuse of Drugs (Safe Custody) Regulations 19. The registered provider/manager should consider the provision of a separate sluicing facility such as a mechanical sluice. DS0000025045.V265251.R01.S.doc Version 5.0 Page 20 3 OP26 The Cedars Christian Residential Home Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Christian Residential Home DS0000025045.V265251.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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