Care Home: Cedar House Pitsea

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What the care home does well This home has a warm, friendly and comfortable atmosphere. The home is light, bright and airy and is decorated and furnished to a good standard. Staff on duty were knowledgeable about service users care needs. The staff team work together well and were enthusiastic about their work.Service users are involved (as appropriate) in the day-to-day planning of their own care and in the way the home is managed on a daily basis. There was a natural rapport between staff and service users. The way the meal times is managed is good. The home enables residents to enjoy a wide variety of leisure and social activities. What has improved since the last inspection? The Statement of Purpose had been reviewed and updated to reflect current practice. The process by which care plans, risk assessments and all other associated documentation is managed had also been reviewed, so that the care plan documentation is current. The lounge had new furniture and curtains, and had also been redecorated. What the care home could do better: Evidence needs to be available for inspection to confirm that sufficient numbers of staff are trained in first aid, to ensure that at least one trained first aider is on duty at all times. Regular fire drills need to take place, and these need to be recorded. --------------------- CARE HOME ADULTS 18-65 Cedar House Pitsea London Road Pitsea Basildon Essex SS13 2BY Lead Inspector A Thompson Unannounced Inspection 24th April 2008 10:15 Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 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 Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 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. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar House Pitsea Address London Road Pitsea Basildon Essex SS13 2BY 01268 458266 01268 455 103 kingswood@donna-higby.freeserve.co.uk 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) Kingswood Care Services Limited Manager post vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2007 Brief Description of the Service: Cedar House is a five bed-roomed house located in Pitsea, close to the local town, bus route and shops. The home is within walking distance of Pitsea Centre, shops, pubs and medical centres. All bedrooms have ensuite or adjacent bath/shower facilities. Four bedrooms are on the first floor and one is on the ground floor. The home has a main lounge, kitchen/diner, sitting room, laundry, staff office and a staff toilet. The home has a well-maintained rear garden/decking area. The front of the property has off road parking. Regular community access is provided to residents by the use of two vehicles based at the home. The current weekly fees range between £1600.00 - £2183.00. Fees need to be discussed on an individual basis with the home as the exact amount will depend on assessed individual care needs. CSCI inspection reports can be obtained from the home, or via the CSCI internet website. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced key inspection took place on Thursday 24th April. The content of this report reflects the inspector’s findings on the day of the inspection along with information provided by the service and feedback by service users, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions were entered into with service users, the manager, area manager and staff on duty. CSCI survey questionnaires were also provided to service users and staff. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. Written and verbal comments received from service users included: ‘I think this is a really nice place and I like it (here)’. ‘The staff are lovely’. ‘The food is good and there is lots to do here, I like all the staff’. ‘I like my room’. ‘If I don’t like something I will talk to staff and they try to help me’. Written and verbal comments from staff included confirmation that they felt trained for their roles and were well supported by the management of the home. They said they were happy working at Cedar House and the manager was ‘approachable’ and ‘very good’ at supporting them. There were no visitors available to speak with during this inspection, however CSCI questionnaires were sent to the home so that relatives and visitors had the opportunity to make their views on the service known directly to the Commission. At the time of writing this report none had been returned. Twenty four standards were looked at, and the outcomes for service users against twenty three of these were good, with one adequate. As a result this report includes two statutory requirements for action. What the service does well: This home has a warm, friendly and comfortable atmosphere. The home is light, bright and airy and is decorated and furnished to a good standard. Staff on duty were knowledgeable about service users care needs. The staff team work together well and were enthusiastic about their work. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 6 Service users are involved (as appropriate) in the day-to-day planning of their own care and in the way the home is managed on a daily basis. There was a natural rapport between staff and service users. The way the meal times is managed is good. The home enables residents to enjoy a wide variety of leisure and social activities. What has improved since the last inspection? 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 summary of this inspection report can be made available in other formats on request. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 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 Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. People considering moving into the home can be confident that the admission processes ensure that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s updated Statement of Purpose was seen, and included the information needed to help new services users make an informed choice when considering moving into Cedar House. The current service users are placed and funded by local authorities. Records confirmed that these organisations had provided a full assessment of needs to the home before admission. In addition to this the manager at Cedar House undertakes a written assessment of needs for all prospective residents prior to admission. No new service users had moved into the home since the last inspection and so a file was looked at for a person admitted prior to 2007. Included was information on the individual’s previous lifestyle, likes and dislikes around routines, choices and preferences. The assessment of need included headings of background information, emotional need, physical health and wellbeing, self care ability and needs and any other identified issues. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 9 The manager advised that prospective new service users are able to visit the home prior to making any decision on admission. She said that frequent ‘transition visits’ are enabled to try to ensure that the new service user’s needs can be met by staff. Existing service users views/needs are included in this process. Service users spoken with at the inspection said that they had visited the home prior to moving in. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. Service users had a plan of care which included their current needs. Service users were supported in making decisions and improving independence, this is because staff promote their rights and choices whilst taking account of perceived and identified risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two individual support/care plan files were inspected. These had comprehensive risk assessments with guidelines for staff on methods to minimise risk. Risk assessments had been reviewed regularly. There were also physical intervention plans and behaviour plans, with detailed guidance for staff on how to mange incidents and aggression. The manager said that since the last inspection all staff had received training on responding too and managing aggression. Staff spoken with confirmed this. Daily assessed needs were listed under individual headings including lifeskills, personal care, medication, communication, use of community facilities and activity plans. Each area of need showed an aim and course of action relating to the daily care provided. All care plans had been regularly reviewed with a Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 11 daily record completed by staff on their perception as to the effectiveness of each care plan strategy, with particular regard to service users behaviours whilst accessing community facilities. Healthcare issues were seen to be recorded, including visits to medical professionals, social workers, hospital visits, GP consultations, dentists, opticians and chiropodists. Also seen recorded were notes of full reviews of placements, undertaken with the placing authority and the service user. The manager confirmed that service users meetings take place regularly. Minutes of a meeting that took place in April 2008 included evidence of discussion on holidays, interests, daily routines, shopping and community access. Service user views and opinions were included. Service users spoken with who were willing or able to express an opinion, (some did not engage in conversation with the inspector), confirmed that they regard that they are fully included in day to day decision making within the home, with staff offering choices around routines and events. Care plan notes recorded that their views and opinions are sought, and staff spoken with confirmed that they liaise closely with service users regarding preferences. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. A range of activities within the community mean that service users have various options to participate in social, educational and leisure opportunities. Meals and mealtimes are flexible and meet with the lifestyle of service users living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that none of the service users living in Cedar House is currently in any form of paid or voluntary employment. Past work experience had included a service user working in a shop. However the service user chose to stop doing this. College courses are available at a local further education facility. Two service users attend on a full or part time basis. Courses include expression, French cooking and computers. Staff support service users to attend these classes on a 1-1 basis. None of the remaining service users attend college. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 13 Staff continue to fully support all service users in accessing the local and wider community and its facilities. Records had been kept of daily activities offered and participated in, these included pub trips, swimming, bowling, use of local library, massage, shopping trips, drives out and eating out. Service users spoken with confirmed that they regularly attend many of these activities, with staff support. One said they liked eating out and going shopping. They also spoke about holidays they have taken, these included Spain, Texas and Cornwall, and weekend trips to London Theatres and other destinations. The company owning Cedar House provides two vehicles based at the home for the benefit of service users, enabling ease of community access with full staff support. Evidence was seen that at least three service users have an interest in politics and vote in elections (with staff support to access the polling station). Service users see their families regularly with staff offering to drive the service user home to ensure regular contact is supported. Contact includes regular visits home, including overnight stays. Staff enter bedrooms only with the individual’s permission, unless the welfare or well being of the service user is in question. Service users are offered keys to their private bedrooms. Currently only one chooses to lock the room and retain the key. Throughout this inspection staff were observed to interact appropriately with service users and appeared to always use the individual’s preferred form of address. Discussions were seen to take place about events and routines, and the atmosphere in the home was supportive. Nutrition records were inspected and evidenced a varied and balanced diet. Service users eat in the dining room or at the dining table in the kitchen. Breakfast and lunch are taken at times according to service users choices and their daily routines. The main daily meal is in the evening, when all service users eat together. Menus are decided week by week with service user involvement. Service users accompany staff on food shopping trips and will sometimes choose the meal, purchase the ingredients and then prepare and cook the food to eat. Service user meetings included discussion on the food, and the manager confirmed that service users food preferences and likes/dislikes form the basis of menu planning. The manager also advised that all service users assist staff with cooking on a rota basis. This was confirmed by service users spoken with. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. Service users in Cedar House can expect to receive support in an appropriate and dignified way that meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records and discussion with service users and staff confirm that service users are fully supported in making their own choices around clothing styles, hairstyles and general appearance. Assessment records included preferences around rising and retiring times and full details of the levels of personal care support required was also seen to be documented. Service users spoken with who were able or willing, when asked, to fully express a view as to the support provided them by staff, did confirm that they liked the staff and were satisfied with the care provided them in the home. Care plans contained assessment of healthcare needs. The current service user group require staff support and guidance in recognition of their individual healthcare needs. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 15 Service users regularly visit community based healthcare services including consultant psychiatrists and dentists (with staff support). One service user uses a visiting dentist the others go to dentists in the local community. Service users healthcare needs were recorded within individual care plans and updated in the daily care notes. All service users accommodated were receiving full staff support with their medication needs. Service user files included a signed form consenting to staff providing this support. Some of the current service users, in the opinion of the inspector, did not appear to have a full understanding or awareness of the medical reasons for medication regimes prescribed to them. The manager confirmed that if service users refused medication then advice and encouragement is offered to them to understand the reason for the prescribed dosage. The home’s written medication procedure/policy clarified policies on homely remedies, side effects of the medicines prescribed, the storage of medicines and of administering prescribed dosages. Records were seen relating to the re-ordering and returns of unused medication. A random sample of medication administration records and stocks of current medication were inspected. One error was seen (dosage not signed for). The manager undertook to look into this oversight and remind staff to complete these records. Training records seen included evidence that in-house medication training had been provided to staff who deal with residents medication. The homes pharmacist had also provided training to staff on the medication system used (monitored dosage system). Certificates were seen to evidence this. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Practices in the home safeguard service users and ensure that concerns are listened to and addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints procedure in place, which clarified the complaints process and the timescales that the manager should respond to the complainant. There was a pictorial style complaints procedure in the home. Some service users would not have the ability to follow any written procedure, but the document displayed clearly indicates to service users that they have a right to ‘feel sad’ or ‘feel unhappy’ and that they should tell somebody. The inspector spoke to service users about their understanding of this and they were clear that they would tell their key worker or ‘somebody else’. All service users have active involvement with their respective families and/or regular contact with external health/social care professionals. The home has active links with the local advocacy service and have been able to demonstrate that this service is used as appropriate to ensure that service users wellbeing is paramount to any given situation. There was a set template form for recoding complaints and a complaints record book. There had not been any formal complaints received since the last inspection. Also seen in the home was a copy of the safeguarding adults policy and procedure produced by the registered provider. This included guidelines for staff on the adult protection procedures and on types of abuse that may occur. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 17 Staff have safeguarding adult abuse training during their induction and also a further training course as part of their professional development programme. Staff files inspected included certificates evidencing that abuse awareness training had been provided. Staff spoken with understood what was meant by ‘safeguarding adults from harm’ and said that if they suspected an issue then they would contact the Manager or ‘on call’ manager. Also seen was a ‘whistleblowing’ policy which clarified staffs responsibility to report any suspected abuse. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. People living in Cedar House could be confident they will be provided with a comfortable, clean and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection a partial tour of the home was made accompanied by the manager. The home was clean, bright, homely and was well maintained, furnished and decorated. Since the last inspection new lounge furniture had been installed and this room had new curtains and had been redecorated. Communal areas of the home had been tastefully decorated and furnished and were comfortable and warm. Measures were in place to ensure that the laundry and kitchen area were safe. The home had an attractive safe rear garden with a decking and BBQ area and garden tables/chairs. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 19 At the back of the garden there is an office that is used by the area manager and also for staff training purposes. Staff come from other establishments owned by the registered provider. The manager said that the use of this facility does not impact on service users privacy and facilities within the home are not used. Access to this office is via a secure side gate. Cleary this arrangement has been in place for some considerable time and there has been no reported problem. Service users are provided full opportunities to personalise their rooms to their own tastes and requirements, and rooms inspected included various items of personal possessions according to individual choices. The manager reported that four rooms had en-suite wc and bathing facilities (two have showers and two have baths), with the service user in the fifth room having private use of an adjacent wc and bathroom. Cedar House has a pay phone and the manager said that all service users have their own mobile telephones. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 & 36 Quality in this outcome area is good. Service users benefit from being supported by an experienced staff team who had received training. The recruitment procedure in the home provides the safeguards to ensure that appropriate staff are employed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A clear organised staff rota was available for inspection. On the day of the inspection four service users were living at Cedar House and there was one vacancy. Current daytime shifts were a minimum of four staff on duty and at night there is one ‘sleeping in’ member of staff and one ‘awake’. Staffing levels reflect service users who require 1:1 or 2:1 service user/staff ratios. In addition, individual service users enjoy going out and staffing levels reflect that staff are available to facilitate this, with evidence seen that many daytime shifts have a fifth carer on duty. The manager confirmed that staff meetings take place approximately every 6 weeks, and minutes of these were seen. Discussion had included service user issues, job roles, quality assurance and rotas. The most recent meeting before this inspection was on 7/4/08. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 21 Staff records seen for new employees taken on since the last inspection included an application form, proof of ID, photo, a CRB check, two references and contract of employment. New staff are subject to a probationary period during which time they receive in-house induction training covering the home’s aims and objectives, safety, medication, COSHH, food hygiene, health & safety, risks, fire and challenging behaviours. After completing this they move on to the Skills for Care Common Induction standards for social care workers. Evidence of this was seen. New workers are encouraged to commence NVQ training (level 2) after one year of service. Staff spoken with confirmed this. Staff training records had been kept in files, with individual personal development profiles and an overall record of training provided. These recorded that staff had been trained in induction, conflict management, abuse, key worker roles, food hygiene, NVQ, health & safety, fire safety, inclusive communication, infection control, epilepsy, restraint and challenging behaviours. Evidence was not available to confirm that sufficient numbers of staff had received first aid training to ensure that a trained first aider was on duty at all times. Staff confirmed they were were well supported by the management team. They also said that they had been offered good training opportunities appropriate to their roles. Staff spoken with were open, friendly and demonstrated sound care values. All had a good understanding of work practices and routines and the observed rapport between staff and service users was warm, friendly and supportive. Regular staff supervision meetings had taken place, with records kept of the agenda discussions and actions. Areas included had been work role, responsibilities, key worker role, performance and training needs. The home’s written supervision policy provided clear guidance to staff on the reasons for regular 1-1 meetings. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good. The home had been run effectively, with service users opinions included when the home develops and reviews their practice. The environment was safe but staff training provided did not include sufficient evidence of training for first aiders. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post for since before the last inspection and advised that she had now begun the process of applying for registration as manager with the Commission. The manager’s previous experience includes 10 years in care work with three years in a management role. Her qualifications include the Registered Manager Award (NVQ level 4). The registered provider’s policy on quality management was available for inspection. Service users views had been sought by sending them survey questionairre forms for completion. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 23 Evidence of this process taking in 2007 was seen along with an annual developemnt plan compiled from the feedback and findings. Random samples of records required to be kept by regulation were inspected. These included: the statement of purpose, regulation 26 reports (monthly registered person report), staff rota, visitor book, nutrition records, accidents/incidents, cash held for safekeeping, assessments, care plans, staff recruitment, complaints, medication records and fire procedures. Evidence to confirm that regular fire drills had taken place were not available. Staff had received training in fire safety (but not including regular drills), health & safety and food safety, but evidence of first aid training was not all available. Service records were seen to show that the home’s fire alarms, fire equipment, emergency lights, gas systems, the electrical installation supply and portable electrical appliances had all been tested/serviced within recommended timescales. The manager confirmed that hot water supply is regulated at or near 43 degress celcuis, and that weekly checks on this take place. Records of this were seen. The home’s fire, premises and safe working practices risk assessment formats were seen. These were regarded as comprehensively compiled documents. Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 YA42 Regulation 13 (4) Requirement Evidence needs to be available for inspection to confirm that sufficient numbers of staff are trained in first aid to ensure that at least one trained first aider is on duty at all times. Regular fire drills need to take place, and these need to be recorded. This is to provide staff with the training they need to ensure they follow the home’s fire procedures when called for. Timescale for action 31/07/08 2. YA42 23(4)(e) 31/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Cedar House Pitsea DS0000061931.V363074.R01.S.doc Version 5.2 Page 27 - 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. 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