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Inspection on 26/01/06 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 26th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 is a comfortable, clean, warm and welcoming home set in pleasant surroundings. Management and Staff are committed to delivering high quality of care to the service users. Management support their staff team and offer good training opportunities, in order for them to develop there knowledge and skills. There are clear procedures in place to protect the service users. The management is developing an excellent quality assurance programme that incorporates the views of staff, service users, families, friends and professional visitors. This enables them to continually monitor the service and develop their practice. Accurate systems and policies are in place to record and identify safe working practice within the home. The staff team is well established. They offer consistence of care to residents as well as support for each other. The inspector observed the staffs interaction with residents, they clearly have relaxed and positive relationships with each other. During the morning staff had played bingo with service users those who had taken part had enjoyed the mornings activities and the "winners" were delighted with their prizes.

What has improved since the last inspection?

The manager has replaced missing tiles in the laundry and work is due to begin Within the timescales given at the last inspection for the installation of a hand wash basin. The manager has improved their Quality Assurance checks and is continually developing the monitoring of the service they deliver.

What the care home could do better:

When recruiting new staff it is recommended that notes from interview process are retained to enable managers to evidence they have fully explored gaps in work history. It is also recommended that staff files contain a recent photograph and a copy of the staffs appraisal record.

CARE HOMES FOR OLDER PEOPLE The Cedars Christian Residential Home The Cedars 22 Redlake Road Pedmore Stourbridge West Midlands DY9 0SA Lead Inspector Linda Brown Unannounced Inspection 26/01/06 8:30 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.V278955.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 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.V278955.R01.S.doc Version 5.1 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 22nd October 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.V278955.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the hours of 8.30am –3.30pm. Time was spent touring the building, meeting and talking to Service users, staff and the management of the home. Three staff files were examined and the appropriate records were checked for the standards being inspected. Outstanding requirements from the previous inspection were checked and feedback was given at the end of the visit. The inspector would like to thank the management, staff and service users for the warm welcome shown to her and the hospitality she received. What the service does well: What has improved since the last inspection? The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 6 The manager has replaced missing tiles in the laundry and work is due to begin Within the timescales given at the last inspection for the installation of a hand wash basin. The manager has improved their Quality Assurance checks and is continually developing the monitoring of the service they deliver. 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.V278955.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6 Prospective service users have all the relevant information to enable them to make an informed choice about where they live. All residents are assessed prior to admission and trial periods are offered. The cedars do not take admissions solely for the purpose of intermediate care. EVIDENCE: The statement of purpose clearly sets out the aims objectives and philosophy of care, services and facilities in the home. The service user guide is detailed and contains all the relevant information. It is pleasing to see comments from residents are included in the guide. There is a copy of an inspection report and complaints procedure attached. However the guide needs updating to incorporate latest reports. The manager explained that there has only been one occasion when a resident was admitted whose first language was not English. Arrangements were made for her to receive a regular visitor who spoke her native tongue. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 9 Assessments are made prior to admission along with trial periods for service users. The Cedars does not admit service users in need of immediate care with a view to return them home. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 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): Not assessed at this inspection EVIDENCE: The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 Service users maintain contact with family, friends, representatives and the local community as they wish. EVIDENCE: During the inspection time was spent sitting and talking with residents in the lounge and speaking with individuals in their rooms. Residents told the inspector that their families and friends are able to visit any time. They are taken out regularly by the home, their families and friends. Some residents prefer to remain at the home, and their decision is respected. Activities are provided in the home to accommodate residents who no longer want to go out, however these are enjoyed by any resident wanting to take part. Families visiting during the inspection were able to use a small room off the lounge for privacy. Another resident had visitors in the dining room. However residents confirmed they could have visitors in their room if they preferred to. Notice boards display information for residents and families and written information as well as regular questionnaires are given to families at the time of admission as well as during their stay. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Policies and procedures are in place to protect service users from abuse. EVIDENCE: There has only been one complaint in the last year, the Cedars were pro active in addressing the complaint keeping appropriate records and promoting the policy .The complaints procedure is in the service user guide as well as in the statement of purpose. The policy is also on display on the residents /visitors notice board. Evidence was seen of a recent residents meeting where once again the complaints procedure was explained to service users. Whilst talking to service users one resident confirmed “I would tell my key worker if I was not happy” another said they would tell “Mrs Jenkins” Residents seemed confident their complaint would be listened to and addressed. All staff working at the home have completed the appropriate checks, they receive supervision and support and are provided with regular training. Adult abuse training has been undertaken by 14 of the care staff, training has been identified and planned for the remaining team members. Staff spoken to during the inspection confirmed that they were all aware of the whistle blowing policy. Risk assessments are in place for all service users as well as for specific areas of the building. There are systems in Place for the prompt reporting of any concerns. Residents stated they were well looked after and staff were kind and helpful. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed at this inspection. EVIDENCE: The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29,30 Service users are supported and protected by the homes recruitment policy and practice Staff are trained and competent to do their jobs. EVIDENCE: The manager is to be complemented for they’re through training programme. Core training is ongoing and identified on a traing matrix as well as individual files. NVQ is actively encouraged with 6 staff currently undertaking the qualification. Five staff have already completed NVQ3 six staff have achieved NVQ2 .The manager and deputy both having completed NVQ4. Staff appraisals are carried out and staff are asked to complete a very detailed Pre appraisal questionnaire reflecting on all areas of there work. The manager then meets with staff and training needs are identified. This meeting recorded and given to the staff member. In discussion with the manager it was recommended that a copy of this meeting be kept on staff files. Staff spoken to during the inspection confirmed how well the manager supports their training needs “if we need any training for example, diabetes training she gets it for us” “The manager is very supportive she listens and always has time if you need to see her even when she is really busy”. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 15 New staff undergo a detailed induction process which takes approximately eight weeks. Staff on induction confirmed they were receiving support compleating booklet and they have some training booked for the following week. The Manager and Deputy are proactive at recognising and identifying the training needs of their staff team. After experiencing a difficult time in home the manager laid on some additional specialist training in order to support the staff team. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 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): 33,38 The home is run in the best interests of service users and their health safety and welfare are promoted and protected EVIDENCE: The manager and deputy have introduced excellent reviewing processes for the accident reports. The Deputy completes monthly analysis, identifies concerns and actions them. She has completed her own assessment of each the care standards and identified areas that need to be improved. Resident’s families and visiting professionals are encouraged to complete questionnaires. Managers are constantly reviewing the form to make them user friendly, as often professionals do not have the time to complete detailed forms. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 17 Feedback from forms is used to improve service. Service users questionnaires identified confusion regarding the complaints procedure. Despite information being given to them and displayed on notice boards the manager spent time in a residents meeting to explain the procedure. The service users confirmed they were aware of the complaints procedure, one resident told the inspector they would “tell their link worker if the were unhappy” another said they would “tell Mrs Jenkins”. Two residents told the inspector they would “rather be at home but if you have to be in a home this is the best one” another told me that “The Cedars was much better than other places she had been” Several residents stated “it’s a lovely home the staff are lovely “ Service users confirmed that residents meeting were held and there views were listened to. Health and safety checks are completed within the required time scales with the exception of the gas safety checks which were now out of date .The deputy was already aware of this and in contact with the engineer during the inspection. The inspector will require conformation that the gas safety check has taken place. Environmental health inspected the home In July 05 seven requirements were made and work has taken place in all the required areas. The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 x 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 The Cedars Christian Residential Home DS0000025045.V278955.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP38 OP26 Regulation 23 13 Requirement The manager must ensure that the yearly gas safety inspection is completed The manager must provide a hand basin in the laundry area. The manager must provide adequate ventilation in the laundry. (Previously required in March 2005) Timescale for action 01/03/06 01/03/06 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 3 Refer to Standard OP29 OP29 OP29 Good Practice Recommendations It is recommended that Notes / evidence is kept from staff interviews to establish gaps in employment history. It is recommended that a recent photograph of staff is kept on their files It is recommended that evidence of staff appraisals is kept on staff files DS0000025045.V278955.R01.S.doc Version 5.1 Page 20 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.V278955.R01.S.doc Version 5.1 Page 21 - 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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