Inspection on 19/05/05 for The Cedars (Geoffrey Harris House)

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 (Geoffrey Harris... 16/05/07

The Cedars (Geoffrey Harris... 19/07/06

The Cedars (Geoffrey Harris... 21/09/05

The Cedars (Geoffrey Harris... 25/10/04

The Cedars (Geoffrey Harris... 13/04/04

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

CARE HOME ADULTS 18-65 The Cedars (Geoffrey Harris House) Geoffrey Harris House Coombe Road Croydon, Surrey CR0 5RD Lead Inspector James OHara Unannounced 19 May 2005 09:30 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 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 Stationary 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 (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Cedars (Geoffrey Harris House) Address Geoffrey Harris House Coombe Road Croydon Surrey CR0 5RD 020 8680 1593 020 8681 8554 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Surrey Oaklands NHS Trust Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/10/04 Brief Description of the Service: The Cedars is a residential home for up to six adults with moderate learning disabilities, and associated challenging behaviour. It is owned, managed, and staffed by the Surrey Oakland’s Trust, a specialist health provider for people with learning disabilities. The Cedars is in a semi-rural setting, on a “campus” style site shared by a Day Centre and other residential homes. It is close to Lloyd Park and local transport links including the Tram. The unit also has a minibus, which is used to access other community facilities. The Cedars is a two storey six-bed roomed house with a communal lounge, dining room, kitchen, laundry and small office. The home also has a well-maintained garden. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected under the National Minimum Standards. This unannounced inspection took place in the morning. All of the service users were up and dressed and ready for the day ahead and all were appropriately dressed and well groomed. Methods of inspection included a tour of the premises observation of contact between staff and service users, discussion with service users and the deputy manager. Records examined included staffing records, training records, Person Centred Plans, Statement of Purpose, Service User Guide health and safety and fire records. Previous requirements and recommendations were discussed with deputy manager. What the service does well: What has improved since the last inspection? What they could do better: The home could improve further on the frequency of supervision for all staff and the home could ensure that all staff has an annual appraisal that includes a training programme so that they can better fulfil the aims of the home and meet the needs of service users’. The deputy manager said that the trust has agreed that all will have training on supporting people with Autism and Aspergers however this has yet to take place. The home should ensure that the fire alarm system is checked on a regular weekly basis. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 6 The inspector would like to thank the service users, staff and the deputy manager for their help and support on the day of the inspection. 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 (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 3. Information available to prospective service users is of s good standard which would allow prospective service users to make am informed decision about moving to the home. EVIDENCE: Both the Service User Guide and Statement of Purpose have been updated to include restrictions on the freedom of movement within the home as required at the last inspection. The deputy manager said that a member of staff has been identified to produce the Service User Guide in audiotape. The deputy manager explained that the trust now plans to provide staff with training on Autism and Aspergers as required at the last inspection however this has not yet taken place. The deputy manager explained that a date had been arranged for the diabetic nurse to advise staff on diabetes but this had been cancelled and a new date will be arranged. The home should inform the Commission for Social Care Inspection when the diabetic nurse has advised staff on this condition. The deputy manager also said that the home is seeking advice on Pradi-Willi Syndrome. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7and 8. It is very evident that service users are offered opportunities to participate in the day-to-day running of the home and they are able to express their wishes and concerns in a confident manner to the staff and management in the home. EVIDENCE: All service users now have a My Plan (Person Centred Plan) in place these plans include My Relationship Circle, How I Communicate, Individual Risk Assessments and My Dreams. All service users have regular contact with care managers. Service users hold regular meetings and minutes of these meetings are displayed on the service user notice board. It was evident from the minutes that service users are given an opportunity to express their wishes and concerns at these meetings. One service user was in the process of decorating his bedroom. A number of service users said that they felt free to discuss with managers, staff and other service users the way things work in the home. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 and 12. Opportunities for service users to attend employment, education, daytime activities and social activities are generally good, service users are encouraged and supported to be as independent as possible. EVIDENCE: On the day of the inspection all of the service users were up and dressed and ready for the day ahead. All service users appeared appropriately dressed and well groomed. All service users have a weekly plan of activities. One service user said that he was going on work experience at B&Q in Bromley; he was going alone on public transport. The deputy manager said that this service user had had travel training. The service user has epilepsy, he carries a Medi-Alert, and his mobile phone and risk assessments are in place. Another service user said that he was going to Croydon College for a picture making session he went on to explain what other activities he attends throughout the week. Other service users said that they activities planned for the day. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 11 Staff were observed to treat the service users with a great deal of respect and dignity during the period of the inspection. As required at the last inspection the homes Statement of Purpose and Service User Guide have been reviewed and amended to refer to restrictions on the freedom of movement within the home and the reason for the restriction. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 21. Arrangements made for the health care need of the service users is good as they are able to access community health facilities such as opticians, chiropodist, dentists and district nurses. Their overall health needs are being met. EVIDENCE: Service users are able to access community health facilities such as opticians, chiropodist and district nurses as required. The service users also have access to The Trust’s dentist. The deputy manager explained that a date had been arranged for the diabetic nurse to advise staff on diabetes but this had been cancelled and a new date will be arranged. The acting home manager has sought the wishes of the service users/relatives about arrangements to be made following terminal illness or their death. This information is now recorded in the service users files. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. The home has appropriate complaints and adult protection procedures procedure in place, which enables service users to feel confident that that they are protected from all aspects of abuse. EVIDENCE: The home has a book for recording complaints and all complaints. All relevant documentation includes details of the Commission for Social Care Inspection. Service users said that if they had any concerns they would know who to raise them with indicating the homes managers and staff. Staff training records indicated that staff had attended training on Adult Protection. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 and 30. The home appears to meet the needs of the service users and is in a good state of repair. EVIDENCE: The Cedars is a two storey six-bed roomed house with a communal lounge, dining room, kitchen, laundry, small office and a garden. The home is suitable for its stated purpose; accessible, safe, well maintained and meets the service users individual and collective needs in a comfortable and homely way. Each of the service users in the home has a single room, which is decorated and personalised to reflect their individual taste. One service user is currently decorating his bedroom. The home has three toilets and two baths. The toilets were clean and in good working order. It was noted at the last inspection that the bottom corners of walls in the downstairs hallway are chipped, and it was recommended that the home manager protect the corners with plastic covers. This is yet to be done. Since the last inspection new double-glazed windows and doors have been fitted to the home. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34, 35 and 36. Staffing records have improved and are generally good. Staff supervision sessions have increased for some staff offering the support and supervision they need to carry out their jobs however not all staff has regular supervision and this could have a negative impact on the service provided. The home has yet to employ the Trusts appraisal system thus ensuring that all staff has a training and development programme enabling them to fulfil the aims of the home and meet the changing needs of service users’. EVIDENCE: It was required at the last inspection that the acting home manager ensure that all staff files or training records include evidence/certificates that staff has completed NVQ courses and attended mandatory and other relevant training courses. This requirement has been met. It was required at the last inspection that the acting home manager ensure that records of all persons employed at the home are kept in the home and include copies of everyone’s birth certificates, passport, and two written references obtained in respect of the staff a recent photograph of all staff must also be included in staff files. This requirement has been met. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 16 It was required at the last inspection that the acting home manager ensure that all staff Criminal Record Bureau Checks is available in the home for inspection. As the acting home manager was not present on the day of the inspection these documents were not accessible. The acting home manager should contact the Commission for Social Care Inspection to arrange a time for staff Criminal Records Bureau Checks to be inspected. It was required at the last inspection that the acting home manager ensure that each member of staff completes an annual Appraisal. The deputy manager said appraisals have yet to take place. It was also required at the last inspection that the acting home manager ensure that all staff receives regular supervision at least eight times a year or once every six weeks. Frequency of supervisions for some staff has improved however others do not have supervision as required. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42. The home appears to meet the needs and wishes of the service users the management approach of the home creates an open, positive and inclusive atmosphere however the home does not have a manager registered with the Commission for Social Care Inspection to run the home. If a permanent manager is not appointed this could have an impact on the service provided to the residents. EVIDENCE: The acting home manager is a Registered Learning Disability Nurse and has a qualification from Kingston University on the Specialist Mental Health needs of People With Learning Disabilities, he is in the process of completing the Registered Managers Award and NVQ level 4 in Management and Care. The acting home manager has yet apply to the Commission for Social Care Inspection to become the registered manager for the home as was required at the last inspection. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 18 Evidence was seen of Portable Appliance Testing Certificate 12/04/05, Legionella Testing Certificate 12/12/04, Landlords Gas Safety Certificate 2/09/04 and a visit from an Environmental Health officer took place on the 17/03/05 Fire records were examined and these indicated that there were some weeks when the fire alarm system is not checked. There was evidence of three monthly fire alarm system checks carried out by the trusts works department, a recent fire drill, smoke detector tests, the home has a Fire safety risk assessment and all staff had attended an annual Fire Safety lecture. The acting home manager must ensure that the fire alarm system is checked on a regular weekly basis. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 2 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x x x x x Standard No 31 32 33 34 35 36 Score x 3 x 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Cedars (Geoffrey Harris House) Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 20 No. 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 3. Regulation 18 Requirement Given that the home supports people with Autism and Aspergers the home must ensure that all staff is trained on these conditions so that they are able work in a professional, confident, competent and knowledgeable manner. The acting home manager must ensure that all staff Criminal Record Bureau Checks is available in the home for inspection. The acting home manager must ensure that each member of staff completes an annual Appraisal. The acting home manager must ensure that all staff receives regular supervision at least eight times a year or once every six weeks. The acting home manager must apply to the Commission for Social Care Inspection to become the registered manager for the home. The acting home manager must ensure that the fire alarm system is checked on a regular weekly basis. Timescale for action 31/07/05 2. 34. 19(1)b. 31/07/05 3. 35. 18(1)c 31/07/05 4. 36. 18(2) 31/07/05 5. 37. 8(1) 31/07/05 6. 42. 23(4)a 30/06/05 The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 21 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 3. 34. Good Practice Recommendations The home should inform the Commission for Social Care Inspection when the diabetic nurse has advised staff on this condition. The acting home manager should contact the Commission for Social Care Inspection to arrange a time for staff Criminal Records Bureau Checks to be inspected. The Cedars (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor, Grosvenor House 125 High Street, Croydon CR0 9XP 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 (Geoffrey Harris House) G53-G53 S25845 TheCedars(GeoffreyHarrisHouse) unann V211003 190505 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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