Inspection on 21/09/05 for The Cedars (Geoffrey Harris House)

This inspection was carried out on 21st September 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Cedars (Geoffrey Harris... 16/05/07

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

The Cedars (Geoffrey Harris... 19/05/05

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 O`Hara Unannounced Inspection 21st September 2005 09:50 The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 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 (Geoffrey Harris House) DS0000025845.V250508.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 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 (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 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 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) Surrey Oaklands NHS Trust Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: The Cedars is a residential home offering support for up to six service users with learning disabilities and associated challenging behaviours. It is owned managed and staffed by Surrey and Borders NHS Trust. The Cedars is in a semi rural setting in a campus style shared by a day service and other residential homes. It is close to Lloyd Park and local transport including a tram-link to Croydon town centre. The home also has a minibus enabling service users to access other community facilities. The Cedars is a six bed-roomed house with a communal lounge, dining room, kitchen and small office. The home also has a small well-maintained garden. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 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 some had gone to day services and some had plans for the day ahead. One service user was admitted to hospital from his parent’s home and the home manager had arranged to visit him at the time of the inspection. Two members of staff Sue Moore and Barbara Bowey were very supportive in the inspection process. Methods of inspection included a tour of the premises observation of contact between staff and service users, discussion with service users and staff. Records examined included Person Centred Plans, service user meeting minutes, service users risk assessments, medication records, staffing rota’s and fire records. What the service does well: What has improved since the last inspection? Since the last inspection the home has a new manager, he has applied to the Commission for Social Care Inspection to become the registered manager for the home. The home has provided training opportunities relating to the particular needs of the service users so as to ensure that staff are able to work with service users in a confident and knowledgeable manner. Service users are now more involved in completing their own Person Centred Plans thus ensuring that their personal wishes and aspirations are considered. One plan examined was very comprehensive, detailed and it was evident that a lot of time, work and commitment from the both the service user and staff had been spent in order to complete the task on this occasion the inspector has graded this standard as a 4 Commendable. Staff supervision sessions have increased thus offering staff the support they need to carry out their jobs. The Cedars (Geoffrey Harris House) DS0000025845.V250508.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 (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 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 (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 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 the following standard(s): 1 and 3. There is evidence to suggest that the home is providing staff with training relating to the particular needs of the service users thus ensuring that staff can work with service users in a confident and knowledgeable manner. EVIDENCE: No new service user has moved to the home since the last inspection however all the procedures are in place should they be needed. A requirement was set at the last inspection that staff should attend training on Autism and Aspergers. Surrey and Borders NHS Trust has now arranged that staff at the home will attend training on Autism and Aspergers on the 18th and 25th of October this year. Staff on shift said that a date had been arranged for the diabetic nurse to advise staff on diabetes but this had been cancelled. The diabetic nurse is due to visit the home next week and the new home manager plans to arrange another date. The new home manager should also seek advice on Pradi-Willi Syndrome and pass this on to staff. Staff on shift stated they and the majority of the staff team attended training on epilepsy on the 09/09/05. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 9 The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 6 and 9. Service users are now more involved in completing their own Person Centred Plans thus ensuring that their personal wishes and aspirations are considered. Service users plans sampled indicate that individual risk assessments and risk management strategies are carried out and monitored thus enabling service users to participate in activities in the home and in the community with appropriate support. EVIDENCE: All service users have a My Plan (Person Centred Plan) in place these plans include My Relationship Circle, How I Communicate, Individual Risk Assessments and My Dreams. Service users risk assessments sampled indicate that they are reviewed and updated were necessary on a regular basis. Following training on Person Centred Planning some staff and service users have completed or are completing Person Centred Plans. One of these plans was examined. The plan included photographs of service user involved in domestic and social activities such as cooking, laundry, trampoline, holidays and other social events. The plan also included pictures of the service uses friends and family, an activity chart and an action plan. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 11 One member of staff said that “it should be looked at as if all the staff left the home then this plan would give a very good picture of the service user and their needs and wishes to any new staff”. Other staff/key-workers are working with service users to complete the Person Centred Plan. The Person Centred Plan was very comprehensive, detailed and it was evident that a lot of time, work and commitment from the both the service user and staff had been spent in order to complete the task on this occasion the inspector has graded this standard as a 4. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 13, 15, 16 and 17. Provision is made so that all service users attend appropriate social activities, day centres and become part of the local community. Appropriate arrangements are made so that all service users have regular contact with their friends and families. EVIDENCE: Two service users travel independently into Croydon shopping or to the cinema. Other service users need support to access the community. One service user works on Mondays and Wednesdays at Croydon Cemetary as a gardener. Two other service users attend Croydon College completing courses on Making Pictures, Woodwork, IT and Skills Link. Another service user attends aqua aerobics and another attends a sports group on Fridays. Service users are also supported to visit local cafes, cinemas, and swimming pools and go on daytrips in the homes minibus. All service users had an annual holiday this year, some service users went to Wales and others went to Minehead. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 13 All service users have strong family links, some service users go home for weekend stays and visits, staff said that some service users stay with their families over the Christmas period. There is an open visitors policy and the home just ask that visitors phone to ensure their family member is going to be in before they visit. Service users hold regular meetings and minutes of these meetings. It was evident from the minutes that service users are given an opportunity to express their wishes and concerns at these meetings. The homes menus seemed varied and nutritious in content, are based on a four-week rota and are checked by a dietician for nutritional balance. The. Service users are offered an alternative to the main meal on offer. One of the service users has Diabetes’s and is on a low fat/low cholesterol diet. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 20. The homes policies and procedures for handling medicines ensure the service users are so far as reasonably practicable protected from harm and/or abuse. EVIDENCE: The home has the support of a local pharmacist for advice on medication. Medication is stored in a locked cupboard in the dining room. Medication administration records checked on the day of the inspection were up to date and accurate. The administration system includes a service user medication profile and a service user photograph. There are guidelines for staff to follow prior to administering as required medication. Each service user has a signed “consent to medicate” form. The home has a medication policy and procedure. The Surrey and Borders NHS Trust provides accredited training in the administration of medication in line with the policy. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The home has appropriate complaints and adult protection procedures procedure in place. EVIDENCE: The home has a book for recording complaints and all complaints. All relevant documentation includes details of the Commission for Social Care Inspection. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30. The overall impression when visiting this home is that it is clean and hygienic however attention should be paid to the homes décor in particular the downstairs hallway and the bathrooms thus ensuring the service users live in a more homely and comfortable environment. 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. Each service user has a single room, which is decorated and personalised to reflect their individual taste. The home has three toilets and two baths. Bathrooms are in need of refurbishment, the panel on the downstairs bath is coming away from the bath and skirting boards are beginning to rot due to surface water. The flooring in the upstairs bathroom is badly water marked and is coming away from the walls and the edge of the bath. The home manager must ensure that both the homes bathrooms are refurbished. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 17 It has been noted in the last three inspection reports that the bottom corner of a wall in the downstairs hallway is chipped, and recommendations were set that the home manager protect the corners with plastic covers however despite assurances from the previous home manager at the inspection in October 2004 this work has never been completed. The paintwork on the wall outside one of the service users bedrooms in this hallway has also deteriorated. The home manager must ensure that the downstairs hallway is redecorated. The home was clean, tidy and free from offensive odours at the time of the inspection. The home has appropriate laundry facilities. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 36. Staff supervision sessions have increased thus offering staff the appropriate support they need to carry out their jobs. Arrangements should be made for Criminal Records Bureau Checks to be inspected by the Commission For Social Care Inspection. EVIDENCE: The new home manager was not present on the day of the inspection however staff on shift ably supported the inspection process. Staff contacted the homes service managers to inform them that the inspection was taking place however both service managers had prior engagements and could not attend the inspection. It was therefore not possible to access staffing information. Previous requirements that the manager ensure that all staff Criminal Record Bureau Checks is available in the home for inspection and that each member of staff completes an annual appraisal could not be fully assessed. Although the deputy manager arranged for some staff Criminal Records Bureau Checks to be inspected after the last inspection not all were seen. Staff said that some staff are still awaiting Criminal Records Bureau clearance. The new home manager must 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) DS0000025845.V250508.R01.S.doc Version 5.0 Page 19 A requirment was set at the last inspection that all staff receive regular supervision at least eight times a year or once every six weeks. Both staff on shift said that the frequency of supervision has increased and they receive regular monthly or six weekly supervision. The homes staffing rota now indicates when staff are due to be supervised. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. In general the home appears to be well run and well managed. The management approach of the home creates an open, positive and inclusive atmosphere. The health and safety of the service users could be compromised if regular weekly checks of homes the fire alarm system is not carried out. EVIDENCE: Since the last inspection the home has a new manager, he has applied to the Commission for Social Care Inspection to become the registered manager for the home. The home has self-monitoring systems in place such as internal audits and regulation 26 visits. Service users hold regular meetings and it was very evident from the minutes that service users are given an opportunity to express their wishes and concerns at these meetings. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 21 Service users spoken to on the day of the inspection said that they feel that staff and managers in the home listen to them and generally comply with their requests. During the inspection in October 2004 evidence was seen of a newly devised service user, service user relatives and visitors questionnaire/survey the previous home manager had plans to employ this in the home. There was no evidence to suggest that these questionnaires had been completed. It is recommended that the new home manager employ’s a service user, service user relatives and visitors questionnaire/survey in the home. It was required at the last inspection that the fire alarm system is checked on a weekly basis. Fire records examined indicated gaps of two weeks and three weeks in July and August this year were checks were not carried out and recorded. Therefore the requirement that home manager ensures that the fire alarm system is checked on a regular weekly basis has not been met. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 22 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 X 3 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X 2 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Cedars (Geoffrey Harris House) Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000025845.V250508.R01.S.doc Version 5.0 Page 23 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. 2 3. Standard 27. 24. 34. Regulation 23(2) b. 23(2) d. 19(1) b. Requirement The home manager must ensure that both the homes bathrooms are refurbished. The home manager must ensure that the downstairs hallway is redecorated. The home manager must contact the Commission for Social Care Inspection to arrange a time for staff Criminal Records Bureau Checks to be inspected. The acting home manager must ensure that each member of staff completes an annual Appraisal. Previous requirement, not able to assess on the day of the inspection. The acting home manager must ensure that the fire alarm system is checked on a regular weekly basis. Previous requirement not met. Timescale for action 31/01/06 31/01/06 21/10/05 4. 35. 18(1) c. 31/01/06 5. 42. 23(4) a. 21/09/05 The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 24 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 39. 3. Good Practice Recommendations It is recommended that the new home manager employ’s a service user, service user relatives and visitors questionnaire/survey in the home. The home should request that the diabetic nurse attends a team meeting to advise staff on diabetes. The Cedars (Geoffrey Harris House) DS0000025845.V250508.R01.S.doc Version 5.0 Page 25 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) DS0000025845.V250508.R01.S.doc Version 5.0 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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