Care Home: Cedar Lawn Nursing Home

Similar services:

• Flint House
• St Vincents
• The Cotswold Home
• Fairways
• Winton House
• Treloar College
• Rush Court

What the care home does well Residents said that they liked living at the home. Comments included ` I am very happy here` and `I can`t think of anything that needs improving`. Residents also said that they felt safe living at the home. The matron completes a care needs assessment for all prospective residents to ensure the home can meet their care needs and prospective residents and their relatives are able to visit the home to meet staff and residents before making a decision about taking a place there. The home looked clean and welcoming. Residents said that they liked their rooms, which they had personalised with items of furniture, pictures and ornaments. Communal rooms provided space for social activities and for quiet areas where residents could entertain visitors if they wished. Residents were involved in their care planning and said that their wishes were taken into account and their plans were discussed with them regularly. The care plans provided clear information for staff on the assessed needs of the residents and the support required to meet those needs. Residents said that they enjoyed the varied and interesting programme of activities provided but staff respected their wishes when they did not want to join in. A choice of food was offered for each meal and residents said that they enjoyed the food provided. Residents and relatives said that communication with staff was good. Staff said that they were encouraged to attend training sessions and records seenindicated that staff were receiving the training required to provide them with the skills to fully support the residents. What has improved since the last inspection? At the time of the last inspection not all staff records contained up to date photographs of the staff member. This has been addressed and records seen contained photographs. A deputy matron has been appointed to support the matron. Clear lines of responsibility were in place and the deputy and matron said that there was good communication between them regarding the running of the home. The home has recently employed an activities co-ordinator who is improving the activities programme and a new mini bus driver has been employed by the organisation giving residents increased opportunities to go out on trips. What the care home could do better: The registered manager runs the home in the best interests of the residents and no requirements were made at this inspection. CARE HOMES FOR OLDER PEOPLE Cedar Lawn Nursing Home Woodley Court Braishfield Romsey Hampshire SO51 7PA Lead Inspector Marilyn Lewis Unannounced Inspection 20th November 2007 10:00 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 Cedar Lawn Nursing Home DS0000011416.V349456.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 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. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Lawn Nursing Home Address Woodley Court Braishfield Romsey Hampshire SO51 7PA 01794 523300 01794 518820 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) www.sentinel-healthcare.co.uk Sentinel Health Care Limited Mrs Sheila Hewitt Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (6), Physical disability of places over 65 years of age (30), Terminally ill (6), Terminally ill over 65 years of age (30) Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only six service users in the categories of PD and TI between the ages of 50 - 64 shall be accommodated at any one time. 22nd March 2007 Date of last inspection Brief Description of the Service: Cedar Lawn Nursing Home is one of four homes in Hampshire owned by Sentinel Health Care Limited. The home is located in a quiet close on the outskirts of Romsey, a small market town. A former manor house converted for use as a care home, the building has been tastefully refurbished and extended and is set in pleasant and well-maintained gardens. The bedroom accommodation is on 2 floors and comprises 22 single and 4 shared rooms; 22 rooms have en-suite facilities. The home’s communal/shared areas comprise, three lounge areas, one of which includes a dining area. Other facilities include a passenger lift, assisted baths, a laundry service and full board. Fees range between £550 and £800 per week depending on the needs of the resident. The matron provided this information in November 2007. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information provided since the last inspection including the Annual Quality Assurance Assessment (AQAA), completed by the registered manager and information obtained from survey questionnaires for residents, relatives and staff was taken into account when completing this report. Information was also obtained during an unannounced visit to the home, which took place on the 20th November 2007. During the visit the inspector met with residents, visitors, staff, the deputy manager, registered manager and the organisation’s director of care. The registered manager is known to the residents as the matron and has been addressed in this manner in the report. What the service does well: Residents said that they liked living at the home. Comments included ‘ I am very happy here’ and ‘I can’t think of anything that needs improving’. Residents also said that they felt safe living at the home. The matron completes a care needs assessment for all prospective residents to ensure the home can meet their care needs and prospective residents and their relatives are able to visit the home to meet staff and residents before making a decision about taking a place there. The home looked clean and welcoming. Residents said that they liked their rooms, which they had personalised with items of furniture, pictures and ornaments. Communal rooms provided space for social activities and for quiet areas where residents could entertain visitors if they wished. Residents were involved in their care planning and said that their wishes were taken into account and their plans were discussed with them regularly. The care plans provided clear information for staff on the assessed needs of the residents and the support required to meet those needs. Residents said that they enjoyed the varied and interesting programme of activities provided but staff respected their wishes when they did not want to join in. A choice of food was offered for each meal and residents said that they enjoyed the food provided. Residents and relatives said that communication with staff was good. Staff said that they were encouraged to attend training sessions and records seen Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 6 indicated that staff were receiving the training required to provide them with the skills to fully support the residents. 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 Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 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 Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No one is admitted without a full care needs assessment to ensure the home can meet their care needs. The home does not provide intermediate care. EVIDENCE: Three residents spoken with said that they had received good information about the home and two of the residents said that they had visited prior to making a decision about taking a place. One resident who had returned a survey questionnaire said that her relatives had visited the home on her behalf. The matron stated in the AQAA information that arrangements were being made for prospective residents to spend a half-day at the home so that they could meet the residents and join them for a meal. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 9 The matron said that when a prospective resident or their relatives enquire about a place at the home they are invited to visit to see the home and arrangements are made for the matron to visit their home to complete a care needs assessment. Assessment forms seen for three residents contained information on all care needs including personal and social care, medication and mobility. Information from relatives, care managers and health professionals was included in the completed assessment report. Details such as whether the person wished to have their name on their room door and how they would like to be addressed were also included. The matron said that if the home was able to meet the assessed needs of the person and a suitable room was available then a trial place would be offered. The three residents confirmed that the matron had visited them prior to their admission. The home admits residents for respite care but does not provide intermediate care. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in their care planning and their health care needs are being met. Residents are protected by staff adhering to the home’s clear procedures for dealing with medication. EVIDENCE: Care plans were seen for four residents with differing care needs. The care plans had been developed from the information provided in the care needs assessment. The wishes of the residents were included in the plans with comments such as ‘does not wish to be disturbed at night’ and ‘would like to be checked at 7am’’. The residents said that they knew what was in the care plans and had signed to confirm that they agreed with them. The plans seen showed evidence of Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 11 monthly review and the residents said that staff sat with them and discussed the documents. Visits by GPs and other health professionals were documented in the care plans and residents said that they were able to see their GP as they needed. One resident spoken with said that he was going to an outpatient appointment that morning and a staff member was accompanying him. The matron said that a system of routinely completing a urinalysis testing, monthly for each resident had picked up some urine infections when there were no symptoms yet detected. This had enabled treatment to be given promptly and had helped residents remain continent. Staff were seen to interact with residents in a very caring and friendly manner and they supported the residents to maintain their independence. One resident said that when she had left hospital to live at the home her mobility had been very poor. Staff had the ‘patience’ to spend time encouraging her to walk a little way at a time and she said she now enjoyed being able to walk short distances. Risk assessments were in place for all daily living activities including nutrition, falls and pressure areas. Assessments were also completed for the use of bed rails which had been signed by the resident or if appropriate their relatives, the GP and the matron. The home has clear procedures in place for dealing with medication. A trained nurse was well aware of the procedures when she discussed medication with the inspector. Records seen had been completed appropriately and medication was stored securely. Consent had been obtained from the GP and Pharmacist for a table to be crushed for one resident. Records seen indicated that this was being done, as the resident would not take the medication in tablet or liquid form. Temazepan was stored as a controlled drug and records seen matched the stock held. Up to date information on current medication was readily available for staff. The trained nurse said that staff had received training in administering medication including the use of the syringe driver and records seen confirmed this. Residents spoken with said that staff treated them with respect at all times. Staff were seen to knock on doors and wait before entering rooms and room doors were kept closed when assistance with personal care was being given. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents said that their cultural and religious needs were being met, they looked forward to the varied and interesting activities provided and enjoyed the meals served. EVIDENCE: Residents’ interests and hobbies were included in their care plans plus their wishes to attend religious services. A communion service was held at the home monthly for those who wished to attend. A resident said that they enjoyed the communion service and that staff would contact their vicar or minister if they wished to see them between services. At the time of the visit there were no residents from a different ethnic group. The matron said that the cultural and religious needs of the residents were discussed with the residents or their relatives and information gained would be used to provide for the residents needs. The activities co-ordinator said that the organisation also organised theme days such as Mexican and Indian days where meals were offered that reflected Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 13 the theme. A St Andrews Day was due to be held at the end of the month when Scottish music and a special tea were to be provided. The activities co-ordinator said that she hoped to arrange days for the nationality of staff who were from the Philippines and South Africa to provide an event of interest to staff and residents and to help in cultural understanding. The home has recently appointed the activities co-ordinator who has started to develop and improve the programme of activities for residents. The coordinator discussed the programme and her ideas for future events with the inspector. Residents said that since the co-ordinator had been appointed the activities had improved and they were enjoying the sessions, particularly the armchair exercises, where sessions had been increased due to popular demand, from one a week to two or three. One resident said that he had not participated in activities in the past but was enjoying them now. The programme included group sessions for games such as dominoes, whist, bingo and one to one sessions for letter writing, crosswords and book reading. Arrangements had been made for entertainers such as musicians to visit the home and a recent fund raising event had raised money for Children in Need. A new mini bus driver has been employed providing residents with increased opportunities for trips out. Outings are arranged to places of interest and for pub lunches. One resident who went on visits and the lunches, was not able to participate in meals out and therefore was not able to fully enjoy the outing. The co-ordinator had discussed with the resident what his preferred outing would be and arrangements were in place for a visit to the cinema, his choice. One resident said that they were looking forward to plant spring bulbs later in the week as they enjoyed gardening and another said that she was going to the cake baking session. On the day of the inspection visit the activities session in the morning was exercises and in the afternoon residents were engaged in making greetings cards. Two residents said that they liked to spend time in their own rooms and staff respected their wishes. The residents said that they were told what activities were to take place and were able to decide for themselves whether to join them. The activities co-ordinator said that she had spoken to the person responsible for the activities programmes in the other homes owned by the company to gain ideas for future activities. The matron said that she was investigating training courses in providing activities for people in care homes, as the coordinator had requested she be able to attend a course to provide her with more skills and ideas for the future. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 14 Residents said that they liked the food provided and that choice was always available. On the day of the visit residents had chosen to have different meals for their lunch, with the main choice chicken with potatoes, cabbage and broccoli, while others opted for vegetable couscous or omelette. All but one of the residents said that their meals were very good. The one resident said that she had changed her mind and didn’t want the meal she had chosen and staff immediately asked her what she would like and the alternative was provided quickly. Pudding was a choice of spotted dick and custard, rice pudding or fresh fruit salad. The cook said that residents were offered two or three main choices at lunch and other alternatives were always available. The residents had chosen their meals for supper and again there were different choices made, with some opting for cream of vegetable soup, some jacket potatoes, one had requested a cheese omelette and another cheese scones and brie. The main pudding was crème caramel and fresh fruit, yoghurts and ice cream were also on offer. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt safe living at the home and thought any complaints would be dealt with quickly. EVIDENCE: Residents said that if they had any complaints they would talk with the matron or the deputy. They said that they felt any issues would be dealt with quickly but all said that they had not had any cause to complain. The home’s complaints procedures were provided for each resident on admission and copies were included in the Statement of Purpose and Service User Guide available for all residents and visitors in the reception area. The matron and a staff member spoken with knew the procedures to follow should abuse be suspected. The home has clear policies and procedures in place for the protection of vulnerable adults. Three residents asked said that they felt safe living at the home. An incident had occurred in August 2007 when £5 was missing from a resident’s money. Records seen indicated that the appropriate actions were taken for the protection of vulnerable adults with adult services, the commission and the police informed. Following the investigation the police officer involved in the incident arranged to visit the home to home to talk with the residents about ‘modern day policing’. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 16 Staff said that they had received training in the prevention of abuse and records seen confirmed this. In the AQAA information the matron states that with the introduction of the Mental Capacity Act, the home may need to look for Independent Mental Capacity Advocates for those residents who lack capacity and do not have a relative or friend to consult. The home was looking at how to raise awareness of the changes and implement them. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, safe and welcoming environment for all who live and visit there. EVIDENCE: The home is a large detached property situated in a quiet residential area on the outskirts of Romsey. The home has been extended over the years to provide accommodation for thirty residents, in twenty-two single and four shared rooms. Potential residents know whether the room they are to occupy is single or shared before they make the decision to move in. A husband and wife, who share a room, said that they were very pleased to be able to be together. Residents in the other shared rooms said that they liked sharing a room. The registered manager said that the room available is taken into Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 18 account when offering a place to potential residents, as a shared room would not be suitable in some instances. Accommodation is provided over two floors with a passenger lift and stairs providing access to each floor. The top floor of the home is used as staff offices, rest room, training room and laundry. This floor is not accessible to residents. Personal items of clothing are laundered at the home while large items such as sheets and towels are sent to a laundry company. The home looked clean, welcoming and well maintained. Residents have access to three lounge areas, one of which includes a dining area. One lounge is large and is used for social activities, while the other lounge areas are used as quite areas. Two residents said that they liked to entertain their visitors in one of the quiet lounge areas. Residents said that they liked their rooms and the communal areas. Four residents said that they were very pleased they were able to bring items of furniture and other personal articles such as pictures and ornaments with them to the home. The home has assisted baths and a shower room and residents are able to choose whether to bath or shower. Specialist equipment such as hoists, stand aids and slide sheets are provided to assist residents with poor mobility. One of the bedrooms is fitted with an overhead hoist. A call alarm is provided throughout the home and alarm call bells were seen to be available and accessible to residents. Staff said that they had received training in infection control and records seen confirmed this. Disposable gloves and aprons were available and staff were seen to use them as needed. AQAA information states that the department of health guide ‘Essential Steps’ was being used to assess the home’s infection control management. The rear landscaped garden has a decked area with seats, tables and shades provided, an ornamental pond and lawns and is accessible to all residents including those who use wheelchairs. A Gazebo is being erected in the front garden to provide additional seating area for residents. All visitors to the home are admitted by a staff member and are asked to sign the visitors’ register. Records seen indicated that maintenance checks on the home are undertaken regularly. The temperature of the hot water was being monitored and recorded to ensure it was at the appropriate safe level. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust procedures are used for the recruitment of staff and staff are provided with the training they require to do their job. EVIDENCE: The home employs seven trained nurses, eight senior carers, fourteen carers and an activities co-ordinator plus the deputy and matron. Survey information received from two relatives and three staff members stated that they felt at times there was a shortage of staff on duty. Residents asked during the visit said that usually they did not have to wait long when they asked for assistance but there were times such as lunchtime when they might wait longer. This was discussed with the matron who said that she would investigate the concerns and take action as needed to resolve the issue. The matron said that residents take lunch in two sittings, with nearly all staff sometimes required to assist residents during one of the sittings, which may result in other residents with a shortage of staff for assistance such as to the toilet. Staffing levels are two trained nurses and four carers in the morning, one or two trained nurses and three or four carers in the afternoon and one trained nurse and two carers at night. Separate staff are employed for catering and domestic duties. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 20 The matron said that agency staff were employed to cover staff sickness and holidays. The matron said if at all possible the same staff were employed so that they knew the residents and were able to meet their care needs. Staff said that they were encouraged to attend training sessions. All the senior carers hold NVQ or the equivalent and three of the carers are currently undertaking level 2 NVQ and three level 3, giving them the skills to fully support the residents. Records seen indicated that staff were attending mandatory training including moving and handling, adult protection, infection control and food hygiene. All new staff completed an Induction training programme that covered all aspects of care provision. Trained nurses attended sessions in wound care and optical awareness and the nurses and senior carers were due to commence training with the Macmillan nurses in Palliative Care. The matron said that training and development was included in each supervision session with staff and staff confirmed this. Records were seen for two staff members recruited since the last inspection. The records contained all the information required including two written references and confirmation that Protection of Vulnerable Adult (POVA) and Criminal Records Bureau (CRB) checks were undertaken before the staff members started work at the home, minimising the risks to the safety of residents. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The matron runs the home well and in the best interests of the residents. EVIDENCE: The matron, Sheila Hewitt is a trained nurse who has managed the home for nine years. Residents said that they felt able to talk easily with Mrs Hewitt and staff said that they received very good support. It was evident during the visit that the matron had a very good rapport with residents, visitors and staff. Since the last inspection a deputy matron has been appointed to assist the matron in the management of the home. The matron and deputy said that they felt they worked well together and there were clear lines of responsibility in place to ensure the smooth running of the home. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 22 The home has systems in place to monitor the quality of the care provided. Relatives spoken with said that they are able to meet with the matron as they wish and communication is good. Residents said that some months they are asked to complete questionnaires on an area of care such as the meals. The matron said that each month six to eight residents are asked to complete a survey on one topic of care. An annual survey is also undertaken for residents and staff and the results are included in the Service User Guide, copies of which were available in the reception area of the home. Resident and relatives meetings are held twice a year and records of the meetings are made available to those unable to attend. Staff meetings are held every three months. A staff member said that she found the meetings useful. Minutes are taken at the meetings and the matron said that staff who have not attended the meeting are asked to read the minutes and discuss them with her to ensure they understand any changes taking place. The organisations’ director of care undertakes unannounced checks on the quality of care provided at the home on a monthly basis and also visits the home frequently to offer advice and support. The matron said that relatives deal with the financial affairs for all residents bar one. The organisation holds money for one resident at its’ head office. The organisation has one account for residents’ money and money from residents of the four homes is pooled into the one account. Records are kept of each person’s account but is not made available to the resident and was not available at the home for inspection. Following the visit the organisations director of care confirmed with the commission that the financial records were available for the residents and to ensure there is no confusion a duplicate ledger will be held in the home for each resident for whom money is held. Staff said that they received regular supervision and records seen confirmed this. Each month the organisation provides learning material in the form of a video on topics relevant to the provision of care at the home, such as nutrition. Staff said that they are asked to view the video and the information is then discussed during supervision. Supervision session also covered personal development; performance and residents’ care issues. The home has procedures in place for health and safety and notices were displayed around the home. Staff received training in health and safety issues, including infection control and during the visit were seen to use safe working practices. Fire records indicated that checks were made on fire safety equipment and fire drills were taking place. Records seen showed that electrical equipment and specialist equipment such as hoists were checked as necessary. Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 23 The kitchen looked clean and food was stored appropriately. The temperatures of the fridges and freezers were monitored and recorded to ensure food was stored at the appropriate temperature. Cedar Lawn Nursing Home DS0000011416.V349456.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 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 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Cedar Lawn Nursing Home DS0000011416.V349456.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. 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. Refer to Standard Good Practice Recommendations Cedar Lawn Nursing Home DS0000011416.V349456.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection 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 Lawn Nursing Home DS0000011416.V349456.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!