Inspection on 11/01/06 for The Cedars Rest Home Limited

This inspection was carried out on 11th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Rest Home Limited 19/06/06

The Cedars Rest Home Limited 19/07/05

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE The Cedars Rest Home Limited The Cedars 23 Langham Road Bowdon Altrincham Cheshire WA14 2HX Lead Inspector Michelle Moss Unannounced Inspection 11th January 2006 11:30 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 Rest Home Limited DS0000005600.V275538.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 Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Cedars Rest Home Limited Address The Cedars 23 Langham Road Bowdon Altrincham Cheshire WA14 2HX 0161 928 4361 0161 929 5929 cedars@elfcare.u-net.com 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) The Cedars Rest Home Ltd Ms Christina King Care Home 34 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0), Old age, not of places falling within any other category (0), Physical disability (0) The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 34 service users will be accommodated. All service users will fall within the category of old age, but may in addition have mental disorder (excluding learning disability), dementia or physical disability. The service user accommodated in the 2nd floor bedroom must be independently mobile. If their health deteriorates a transfer to a more appropriate. Bedroom must be undertaken at the earliest opportunity. 19th July 2005 Date of last inspection Brief Description of the Service: The Cedars is a residential care home providing 24-hour personal care and accommodation for 34 older people. The Cedars is a large detached property situated in Bowdon. The main building consists of a ground floor and two upper floors. The basement of the building has been used to accommodate the kitchen and laundry facilities. A new extension has been added and this has bedroom accommodation on two levels and has been sympathetically blended into the slope of the garden area. Altrincham town centre is within easy access. The home has wheelchair access and there was provision for parking at the front of the building. The rear of the house has a terraced area, where there are two well-appointed patios, during the warmer weather residents can sit and enjoy the extensive views of the surrounding countryside. The garden area was tastefully planted, and gave a pleasant outlook for all the service users enjoying the patios. The patios are used for special events during the year such as birthday parties and other celebrations. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one weekday in January. The visit lasted approximately 2 hours. Several residents were met and two members of staff and the manager were spoken with about practices of care within the home. In addition, a selection of care plans were examined. The term of address preferred by the users of the service was confirmed as “residents”. It was felt that this best reflected the function and purpose of the service. The inspection only looked at a limited number of standards, so this report should be read together with the earlier report to get a full picture of how the home is meeting the needs of the residents living there. What the service does well: What has improved since the last inspection? The home was seen to take a proactive approach to improving the service. Two main areas picked up during the visit were training and the environment. Both these areas were found to be of benefit to the care of residents. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 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 Rest Home Limited DS0000005600.V275538.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 Rest Home Limited DS0000005600.V275538.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): 3&6 The process of admission resulted in the home being well informed about prospective residents’ needs and the prospective resident was informed about the terms and conditions of residency. EVIDENCE: The initial assessment of needs were in nearly all cases, completed by the manager. She explained that, wherever possible, a pre admission visit to the prospective resident’s home / hospital was completed. From the outcome of the assessment an initial care plan was completed which helped to determine the suitability of the placement. Samples of these assessments were examined and were found to be detailed. These included sections for reviewing the physical and mental health of the resident, social considerations, healthcare, diet and mobility. This was then supported by associated risk assessments that evaluated the dependency of the resident. The initial assessment would then be used after the resident’s admission to formulate the main care plan. The home did not provide intermediate care. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The residents’ care and health was well documented by the home in a comprehensive care planning system. This included having a well-managed system in place for medication and health conditions affecting the residents. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 10 EVIDENCE: A sample of care plans were seen. These were well designed for monitoring and promoting the health of residents. From talking with the manager, it was felt that the partnership work between the home and other health professionals was particularly good. The staff team were receiving specialised training from health professionals where the needs of residents had changed. Care plans and associated risk assessments were then formulated to reflect the additional needs of the residents. It was highlighted that the senior care workers were being trained in administering injections to one specific resident. The staff had been trained and assessed as competent by the appropriate health professional. However, it was advised that the home should draw up a policy and risk assessment regarding staff using needles. The care plan demonstrated a monthly review, which was updated when changes in a resident’s needs were identified. The families were consulted over the care plan, including asking them to help by providing details about the history of the individual resident’s life to form the “reminiscence plan.” This was seen to help staff to engage with the residents and to have sensitivity over matters that had affected the residents’ personal life. A hospital transfer plan was included in the care plan, which staff would complete when a resident was admitted to hospital. A record of prescribed medication, including details on changes, were included in the care plan. The Cedars Rest Home Limited DS0000005600.V275538.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): 12, 13 and 15 An extensive range of meaningful activities were offered that reflected social, cultural and recreational interests and needs of residents. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 12 EVIDENCE: Residents spoke about the home’s Christmas Party and described the event as being great fun. Families and friends of residents were invited and entertainment was provided. Every week a range of activities were offered to residents. These included Physiotherapy, Occupational Therapy and reminiscence sessions. These activities were provided by qualified occupational therapists. In addition, more informal activities were offered which included staff either sitting or talking with residents or completing board type games. Furthermore, the staff, with the support of an occupational therapist, would organise small group activities where they would debate matters including current affairs, or organise local trips. The residents spoken with described the meals served as being nice. The chef had a City & Guilds qualification in catering and other relevant training including food hygiene. Furthermore, the catering staff were also completing a NVQ in catering. The chef completed updated reports to the management on the catering services of the home, which included a focus on meeting the dietary needs of residents. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The complaints process in the home was good and staff were well informed on protection of vulnerable adults. EVIDENCE: The home had a good complaints process in place, with information about making complaints displayed in an easy to follow flow chart on the main residents and relatives notice board. Staff had been supported by the home to complete training on adult protection. This was covered both in induction and ongoing training provided by the home. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The standard of the environment within the home was good and provided residents with an attractive and homely place to live. EVIDENCE: Over the past 18 months the home had undergone a major redecoration programme, upgrading bedrooms and the communal areas of the home. However, due to unforeseen problems, some essential structural work has arisen which had unfortunately impacted on the improvement. The home was addressing these problems but it was noted that it would delay the final planned improvement works, including the fitting of new carpeting. Despite the noted problems affecting mainly the wall areas, the overall standard of the communal areas were seen to be of a good standard. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30 Staff morale and training were high, resulting in a skilled, competent, and enthusiastic workforce. EVIDENCE: The training of staff was very high with over 80 of all staff holding an NVQ award in care or equivalent qualification. The percentage of staff with the award was well above the current level expected set under the National Minimum Standard. The manager had completed her Registered Managers Award. The manager provided details of the range of courses completed by staff in the past 12 months. These included: - Fire safety, First Aid, Client Handling, Food Hygiene, POVA, Dementia care, Mental Health Awareness, Challenging Behaviour, Stroke Care and Care of Medicines to name just a few. The manager and two seniors care workers had completed the 5 day Moving & Handling Facilitators Course, which meant that the staff could receive training and advice on moving and handling on a day to day basis. Furthermore, the manager was planning to complete IOSH Managing safely Course and an ECDL course (European Computer Driving Licence). From talking with the manager, and reviewing the training matrix, evidence could be seen that training was given a high degree of importance to meet the needs of residents the home supported. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 16 At the time of the inspection 4 care staff were on duty supported by house keeping and catering services. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 17 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): 32, 33, 35 & 38 The residents benefited from a well ran home, with a manager who promoted health, safety and welfare of residents. EVIDENCE: The manager took the lead in care planning within the home. She maintained daily contact with staff and residents, which meant that she remained well, informed about the health and welfare matters of the residents. The manager took the main lead in completing assessments of all prospective residents and was particularly well conversant with the various conditions that affected the elderly. The manager had developed a good working relationship with health professionals to ensure that the changing health needs of residents could be met. She understood the importance of meeting individual needs and balancing the rights of residents. The manager was seen to make the right The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 18 referrals where the needs of residents were changing sufficiently to question the suitability of the placement. The home had received a visit from the fire authority within the same week of the inspection during which no safety concerns were noted. A review of the fire risk assessment was completed including the fire authority assessing the location of the oxygen cylinders used at the home and the layout of the premises. Records of all financial transactions were made by the home and these were made available for inspection by the resident, their family and CSCI upon request. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X 3 X X 3 The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action 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 OP8 Good Practice Recommendations The home should complete a risk assessment and write a policy/ procedure for staff carrying out duties which involve using needles. The Cedars Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Rest Home Limited DS0000005600.V275538.R01.S.doc Version 5.1 Page 22 - 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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