Inspection on 19/07/05 for The Cedars Rest Home Limited

This inspection was carried out on 19th July 2005.

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 11/01/06

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 19th July 2005 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 Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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 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) The Cedars Rest Home Ltd Responsible Individual - Mr Keith Symms Ms Christina King CRH Care home PC Care home only 34 Dementia Mental disorder Old age Physical disability Category(ies) of DE registration, with number MD of places OP PD The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 8 December 2005 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, where 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 F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s first annual unannounced visit for the year, which took place over 1 1/2 hours during the afternoon on a weekday in July. 5 residents were met of which two were consulted over their experiences of life at the home. 4 staff were on duty plus the manager. The main focus of the inspection was to review the care of residents, care planning and management systems operated within the home. The users of the service and the staff were consulted over the term of address preferred in writing this report regarding the users of the service. It was indicated that the preferred address was “residents”. 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 had since their last inspection shared information with the Commission for Social Care Inspection on their findings of their Quality Assurance Review and the outcomes of the providers internal monitoring of the home. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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 F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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 Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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, 4, 5 The process of admission resulted in the home being well informed about prospective residents needs and the prospective resident informed about the terms and conditions of residency. EVIDENCE: The initial assessment of needs were completed by the manager (or deputy in the absence of the manager). The manager explained wherever possible a pre admission visit to the prospective resident’s home/hospital was completed by herself and another senior member of staff. From the outcome of the assessment an initial care plan was completed which helped to determine the suitability of the placement. One resident spoken with confirmed their relatives visited the home prior to making any decision about the resident taking a place. The resident said they were given information about the home. An initial assessment seen showed that the home had undertaken a detailed assessment that provided information on the degree of personal care, mental health, social considerations, healthcare, diet and mobility of the resident. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 9 This was then supported by associated risk assessments that evaluated the dependency of the residents and formatted the main care plan. The assessment forms were particularly well designed which enabled staff to access essential information without the need for searching. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 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. EVIDENCE: A sample of care plans were seen. These were well designed for monitoring and promoting residents health. They indicated that residents were supported by the home to access primary health care as required. When residents were poorly, additional health care plans were written that instructed staff on the level of support/care required, including action plans. The manager maintained good communication with health professionals to obtain additional aids and advice on meeting the health needs of the residents. All communication made with professionals was recorded in the care plan. The plan was seen to be reviewed on a monthly basis, and updated when changes in a residents needs were identified. The families were consulted over the care plan including asking them to help The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 11 by providing details about the history of the residents’ life “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 had been added to the care planning system, which staff completed for all hospital admission / treatments. This provided all essential information. A record of prescribed medication including details on changes was included in the care plan. A record of all administered medication was maintained, patient leaflets on all prescribed medication were added to each residents medication records that helped staff reference if concerns over the medication were raised. All staff who undertook the duties of administering medication had received appropriate basic training in the care of medication. However, the senior team had completed more advanced training. A resident described their experience of the home as positive, with the staff respecting their rights and privacy. They spoke about being able to make decisions over how they spent their day and having a choice over times they retired to bed. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 12 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) 12 & 14 A range of meaningful activities were offered that reflected social, cultural and recreational interests and needs of residents. EVIDENCE: From talking to residents and staff information on the range of activities was confirmed. An annual fun day was described as being a good day and enjoyable. Pictures of the fun day were up on display. Other activities included Physiotherapy, Occupational Therapy, art and crafts which were offered to residents’ on a regular basis. Also more informal activities were seen to be going on where staff either sat and talked with residents or completed recreational arts and crafts. In addition staff were running small group activities were they debated over current affairs. Birthdays were celebrated and Local trips organised in small groups. The manager detailed a planned trip to the seaside in the forthcoming weeks. This was planned after consulting with the residents and their relatives and risk assessments completed. The home was found to be working closely with relatives to keep them informed about the health needs of their relatives. The manager had made up an information pack that give families advice on the health conditions affecting the relatives. Positive feedback had been received from using this approach. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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 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 F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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 standard(s) 19 & 26 The standard of the environment within the home was good providing residents with an attractive and homely place to live. EVIDENCE: Over the past 12 months the home had undergone a major redecoration programme, upgrading bedrooms and the communal areas of the home. Some final work was still outstanding including carpeting. However, the communal areas seen were found to be of a good standard. One resident said how lovely and well maintained the home was and particularly loved the open view into the Cheshire countyside from the lounge. The areas seen during the inspection were all found to be clean pleasant and maintained to a good standard of hygiene. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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 & 30 Staff morale and training were high resulting in a skilled, competent, and enthusiastic workforce. EVIDENCE: The training of staff was very high with nearly all staff holding a NVQ award in care. The level of staff with the award was well above the current level expected by the National Minimum Standard. The manager provided details of the range of courses covered by staff in the past 12 months and planned training. The courses ranged from key training such as moving and handling to more specific training including dementia care, challenging behaviour and mental health. The manager had completed the instructor / assessors training course in safe moving and handling. From talking with the manager and reviewing the training matrix evidence could be seen that training was given a high degree of importance on meeting the needs of residents the home supported. All new staff were receiving structured induction training of which the manager and a senior member of staff had attended. This enabled them to assess and support new staff in the various aspects of their duties, responsibilities and principles of care. At the time of the inspection 4 care staff were on duty supported by house keeping and catering services. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 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) 33 & 38 The residents benefited from a well run 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 that meant 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 older people. The manager was committed to staff development and encouraged staff to develop skills. The home had a health & safety-monitoring book that checked fire safety, water temperature and other safety checks. This was well maintained and easy to audit. The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 17 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 3 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 x 14 3 15 x COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 18 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 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 Good Practice Recommendations The Cedars Rest Home Limited F55 F05 s5600 the cedars v235500 060705 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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. 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