Inspection on 12/05/05 for The Cedars Nursing Home

This inspection was carried out on 12th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Cedars Nursing Home 06/03/07

The Cedars Nursing Home 03/11/05

The Cedars Nursing Home 04/11/04

The Cedars Nursing Home 06/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE THE CEDARS Cedar Park Road Enfield Redditch B97 6HP Lead Inspector Christine Potter FINAL - Unannounced 12 May 2005 9:00 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 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 E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Cedars Address Cedar Park Road Enfield Redditch B97 6HP 01527 63038 01527 63038 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) Mr Robert Delaney Mrs Denise Hodson CRH 40 Dementia - over 65 Old age Physical disability Physical disability - over 65 Terminally ill 3 40 4 40 4 Category(ies) of DE(E) registration, with number OP of places PD PD(E) TI THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4 November 2004 Brief Description of the Service: The Cedars nursing home is a late Victorian manor house that is located on the outskirts of Redditch town centre. The home is registered to accommodate forty older residents requiring twenty four hour nursing care.The home is owned by Mr R Delaney who is the sole provider, who visits the home frequently and inputs into the day-to-day management of the home. Mr Delaney employs an administrator who manages the business and financial side of the business. The registered manager is Mrs Hodson who is a first level registered nurse. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over six hours on the 12th May 2005. The inspection was unannounced and part of the planned program of inspections. A tour of the home was completed, care plans and records were examined. Three residents were spoken to during the time of the visit. There have been no complaints made to the CSCI about the service since the last inspection. What the service does well: What has improved since the last inspection? The home has developed a formal staff supervision program for all staff. A record of the supervision is maintained within the staff’s personal file. Care plans have further developed since the last inspection. The home has provided ramps to assist with mobilising residents on the second floor. The home has also purchased a wheelchair that is able to go up and down stairs to further assist with mobilising residents on the second floor. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 standard(s) 3 and 4 Attention is paid to ensure that all the relevant information is gathered prior to any person being admitted to the home. EVIDENCE: The manager visits the potential resident prior to their admission to the home. This is conducted in either the resident’s own home, hospital or other care home. The manager undertakes a care needs assessment to ensure the home is able to meet those needs. This pre-admission assessment then forms the basis of the residents care plan. Residents spoken to at the time of the visit complimented the staff and stated how hard working they are. A new resident complimented the homes entertainment program and how welcoming the staff had been. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 standard(s) 7,8,9,10 and 11 The care planning process in the home has improved since the last inspection, although some care plans still require further development to ensure they are reviewed and updated more frequently. EVIDENCE: Three care plans were reviewed during the inspection, and some improvement from the last inspection was noted. Care plans require further development to ensure they clearly reflect the residents care needs, and how those needs can be met. Risk assessments should be reviewed more frequently. One care plan showed that the waterlow assessment had not been reviewed from June 2004 to April 2005. All other appropriate risk assessments had been completed for the residents. Staff demonstrated a good knowledge and understanding of the residents needs. Staff was observed being respectful to the residents, and residents spoken to confirmed this. Since the last inspection the home has changed its pharmacy arrangements. They have changed the supplier and relocated the storage of medication to a THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 10 more suitable room. All nurses have attended a refresher course on the administration of medication. The medication administration records were examined during the visit and these highlighted gaps on some resident’s records. It is necessary to ensure all nurses sign and date for the medication administered or record a code as to why the medication was omitted. It was also noted that not all nurses were recording if one or two tablets had been administered to the resident on their record chart, this needs to be addressed. Where possible the home has recorded in the residents care plan their wishes following their death. The manager confirmed that it is not always possible and depends on each individual resident. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 standard(s) 13,14 and 15 Social activities are well planned and organised, and provide a daily variation for people living in the home. EVIDENCE: Visitors are welcome to visit the home at anytime of the day, residents spoken to confirmed this during the visit. Staff advised the inspector that residents could either see their visitors in the lounges or in the privacy of their bedroom. Some residents have had a telephone line installed into their bedrooms, and others have purchased a mobile phone to assist them in maintaining contact with family and friends. Since the last inspection the home has employed two activities co ordinators THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 standard(s) 16 and 18 Complaints are reviewed thoroughly and residents are confident that their concerns will be taken seriously. A vulnerable adults procedure has been developed to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The complaints records were examined during the visit. Since the last inspection neither the home or CSCI have received no complaints. The records demonstrated that the home had followed their complaints policy, and the outcome was recorded. A copy of the complaints procedure had been given to all residents, and was available for the relatives and visitors. A procedure for responding to allegations of abuse is available. All staff receive training to assist them in recognising the different types of abuse. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 standard(s) 19,20,21,23 and 26 The home is maintained to a high standard and provides a safe, warm, comfortable home for the residents. EVIDENCE: The home is conveniently located near to Redditch town centre providing easy access for visitors. All areas of the home are in good decorative order, with attractive fittings and furnishings. The home employs a maintenance operative to attend to day-to-day issues and the gardens. The gardens are maintained to a high standard providing a pleasant outlook and pleasant areas to sit out in when the weather permits. Residents confirmed that the home was comfortable and they liked their bedrooms. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 14 All areas of the home were observed to be clean and tidy and the management of odours was commended. Hot water temperatures have been risk assessed and had been regulated to prevent people being accidentally scalded when they have a bath. Records examined showed that health and safety checks had been carried out. Since the last inspection the home has purchased a special wheelchair designed for going up and down stairs. This has helped the home address the access to several bedrooms on the second floor. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Staffing levels are appropriate to the number of residents in the home. EVIDENCE: Staff rotas reviewed that the home allocate two registered nurses and six care staff for the day duty, and one registered nurse and three care staff on night duty. The manager has three supernumerary days. In addition to nursing and care staff, there was also activities co-ordinators, catering, domestic, laundry and maintenance staff working in the home. Residents commented that the staff were very good and hard working. Staff training records evidenced that all staff were up to date with their moving and handling training, and fire training. Two of the registered nurses have attended a wound care update. All of the registered nurses have completed a medication update since the last inspection. Other relevant training courses have been booked and the dates of these were available. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36,37 and 38 There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The registered manager is appropriately qualified and completed the registered manager’s award. Staff and residents confirmed that the manager was approachable and showed clear leadership. Since the last inspection the home has developed a formal staff supervision program for all staff. Records were available at the time of the inspection. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 17 All appropriate maintenance records and certificates were available and up to date at the time of the inspection. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 4 3 x x x 3 3 3 THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 19 yes 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 7 Regulation 15 Requirement The care plans must be evaluated and updated on a monthly basis. When the residents medication is not administered, the registered nurse must ensure that an identifiable code is entered detailing the reason for nonadministration. The registered nurse must record must record accurately the number of tablets administered where 1 or 2 tablets are prescribed. The menu should be reveiwed to ensure the residents have a choice of meals. Timescale for action Immediate from the time of the inspection. Immediate from the time of the inspection Immediate from the time of the inspection. July 2005 2. 9 13 3. 9 13 4. 15 23 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. Refer to Standard 15 Good Practice Recommendations The menu should be reveiwed and changed depending on the seasonal changes. THE CEDARS E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 20 Commission for Social Care Inspection The Coach House Droitwich Road Worcester WR3 7NW 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 E52 S4102 The Cedars V215639 120505.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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