Care Home: Cedar Lodge Nursing And Residential Home

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What the care home does well Service users have access to healthcare and remedial services. Staff makes sure that those who are fit and well enough are encouraged to be independent, have regular appointments and visit local healthcare services. The healthcare needs of service users unable to leave the home are managed by visits from local healthcare services. Service users have the aids and equipment they need and these are well maintained to support them and staff in daily living. The home has a good and clear care plan in place for service users and this includes appropriate risks assessments. Which forms the basis for care based on the agreed care needs of the service users and demonstrated that trained staff met service users` health and personal care needs. The home`s medication policy on receiving, storing and administering of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults` policies are in place to protect the service users from abuse. What has improved since the last inspection? The home has undertaken a complete overhaul of the care planning process, to include a minimum of ten care plans that are audited each month. The dinning room has been refurbished and is now awaiting the arrival of the new furniture. What the care home could do better: Care staff must ensure that the work they document as completed in the service users daily notes reflect the identified assessed needs of the service user they are caring for. The acting manager must chase up her CRB application results to ensure progress is made toward registration as manager for the home. CARE HOMES FOR OLDER PEOPLE Cedar Lodge Nursing And Residential Home St Catherine`s Road Frimley Green Camberley Surrey GU16 6PY Lead Inspector Mavis Clahar Unannounced Inspection 9th April 2008 09:20 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 Lodge Nursing And Residential Home DS0000017597.V361075.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 Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar Lodge Nursing And Residential Home Address St Catherine`s Road Frimley Green Camberley Surrey GU16 6PY 01252 837019 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) cedarlodge@forestcare.co.uk Forest Care Ltd vacant post Care Home 63 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (62) of places Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to four (4) service users falling within the category DE(E) Dementia over 65 - may be accommodated. Up to 56 of the 63 beds may be used for the provision of nursing care for older people from the age of 60 years. 19th April 2007 Date of last inspection Brief Description of the Service: Cedar Lodge is a purpose built nursing and residential home, set in its own landscaped gardens. The home is surrounded by woodland, which creates an atmosphere of peace and tranquillity. The home is privately owned and managed by Forest Care Ltd. Accommodation is mainly in single rooms with en-suite facilities, although there is capacity to accommodate couples in shared bedrooms. The home is situated on the outskirts of Frimley Green in a quiet location, with ample car parking facilities. All around the home there is excellent access to the garden for wheelchair users. At Cedar Lodge there is a home manager and a clinical nurse manager. At the moment there is not a registered manager at the home, but the manager’s registration is being processed. The fees for this service range from £675-£750 per week. There is an additional cost for hairdressing, chiropody and dry cleaning. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 2stars. This means the people who use this service experience good quality outcomes. This unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection, (CSCI) was undertaken by Mrs Mavis Clahar on the 9th April 2008 and lasted for seven hours and fifty minutes; commencing at 09:20 hours and concluding at 17:30 hours. The CSCI Inspecting for Better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by CSCI (us) and is referred to throughout the report. The registered manager of the home has resigned and a new management structure is now in place. The proposed manager of the home is not a Registered nurse and the company has employed a Registered nurse as head of clinical care to support the manager in the running of the home. This person is responsible for the clinical guidance and supervision of all trained nursing staff and carers. She is also responsible for the pre assessment of proposed service users wishing to enter the home. There is also a new Responsible Individual (RI) who is in daily contact with the home and supports the team. On the day of the inspection the RI with assistance from the manager assisted us with the inspection. The majority of the service users spoken to were able to express their thoughts and feelings about the care they receive. The information contained in this report was gathered mainly from observation by the inspector, speaking with a number of service users, relatives, and friends of service users and with care staff and from information contained within the AQAA. Further information was gathered from records kept at the home. The first part of the inspection was spent discussing and agreeing the inspection process with the RI and manager followed by a tour of the home, which included time spent in discussion with service users, care workers, Head of clinical care, relatives and friend of service users, the laundress and the Chef. The manager and staff are aware of the Laws regarding equality and diversity and Equal opportunities and this was reflected in the staff mix. All service users in this home are Caucasian and reflect the population of the area in which the home is situated. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 6 All records sampled were up to date with care plans being signed by the service users or by relatives. One requirement was issued on this visit Please see Health and Personal Care outcomes for full disclosure. The final part of the inspection was spent giving feedback to the RI and manager about the findings of this visit. The inspector would like to thank all the service users; visitors to the home and care staff that, made the visit so productive and pleasant on the day. What the service does well: What has improved since the last inspection? The home has undertaken a complete overhaul of the care planning process, to include a minimum of ten care plans that are audited each month. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 7 The dinning room has been refurbished and is now awaiting the arrival of the new furniture. 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 Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 8 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 Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 9 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): 3 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Prospective service users and their relatives have the information needed to choose a home, which will meet their needs and service users are being assessed to ensure the home is capable to meet the needs of the service users prior to being admitted into the home. EVIDENCE: Review of service users documents and identified policies demonstrated the home has a policy and procedure on admission and discharge of service users. Within the admission policy all service users must have an assessment prior to being admitted into the home. The Head of Care who is trained in the principles of assessment of service users’ needs based on what the care the Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 10 home says it will provide carries out all pre admission assessments of service users prior to them being admitted into the home. Review of a random sample of service user’s files including one recently admitted service user, demonstrated that pre admission assessments are being carried out and relatives were being involved in the assessment process. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 11 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 10 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home has a good and clear care plan in place for service users and this includes appropriate risks assessments. Which forms the basis for care based on the agreed care needs of the service users and demonstrated that trained staff met service users’ health and personal care needs. The home’s medication policy on receiving, storing and administering of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. EVIDENCE: The randomly selected care plans were clear and easy to read, identifying risks to service users and detailing how these risks would be managed. The daily Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 12 work sheet did not demonstrate service users’ needs were being met according to the agreed care plans. A requirement was made on this standard to ensure accurate documentation of care given to service users is recorded. However in discussion with service users and care workers it was demonstrated that service users care needs are fully met. The service user or relative signed the care plans to indicate their involvement in deciding what care they received. It was evidenced that care staff undertaking the development and monthly review of the care plans also signed and dated them. In discussions with service users on the day of the visit they confirmed they were involved in the planning of their daily care. In discussion with the Head of care we were told “on the residential side, the service we provide enable service users to benefit from the involvement of our team of community nurses”. Information contained in the home’s Annual Quality Assurance Assessment (AQAA) states “service users to benefit from the involvement of our specialist health professionals who supports us in meeting the needs of our service users”. All service users are registered with a local General Practitioner (GP) of their choice and visits are recorded, with access to specialist healthcare professionals through their GP practice as required such as sight and hearing tests which are carried out on a regular basis; and these visits are also recorded in the service user’s folder. Service users are offered access to chiropody service and weekly hairdressing facilities are available at a cost to the service users. In discussion with the registered nurse and care workers they were extremely proud of the high standard of care they provided to all service users in the home. We were told on the day of the visit that no service user at present was risked assess as capable to self medicate. However, the home had a policy on selfmedication should it become necessary. The AQAA states “Qualified and senior care staff have all received training in the receipt, recording, storage handling and administration and disposal of medicines. All medicines are administered from a lockable drugs trolley, which is stored in a locked medication room when not in use”. In discussion with the Registered Nurse we were told, “we keep a controlled drugs register and record fridge and medication room temperatures daily”. We evidenced this as correct during a tour of the home. Care staff identified as capable to administer medication are requested to leave a sample of their signature, which is dated in the medication trolley. All service users have a recent photograph included in their personal folder and medication record, to reduce the risk of mistakes happening during medication administration. We observed that care workers wore name badges to enable visitors and service users with memory impairment to be sure of whom they are speaking with; and we also observed Service users being treated in a friendly but respectful manner by care workers. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 13 In discussion with service users who were able to understand the questions, they told us that they are treated with respect and dignity, and that they are able to make their own choice. One service user told us “I am very happy here. Everything is so nice. I have my own room; I can have as much privacy as I want”. Another service user said “We have good staff here; they do not ill treat me”. “I have help to choose my own clothing every day.” Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 14 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 15 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The home employs a full time activity-co-ordinator who provides a range of activities based on the individual assessed and agreed needs, including their preferences, cultural beliefs and customs. We were told that wherever possible relatives are encouraged to participate in the planning and carrying out of service users’ activities. The AQAA states, “ This enables clients to have a varied activities programme that includes exercise, sing-a-longs, and quizzes Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 15 for example.” We observed the activities programme displayed in the reception area of the home, in all the three lounges used by the service users and in the dinning areas. In discussion with the Responsible Individual, we were told the home has purchased a flat screen TV and it has been decided to purchase some adoptive assisted games, which can be used with the TV for the use of the service users. The TV was due to be delivered the day after the inspection. The C/E Vicar holds regular services at the home, and those service users who are able attends. We were told by service users that they are able to have their friends and relatives visit any time it is convenient for them to visit. We spoke with a number of visitors to the home who all expressed their satisfaction with the level of care their relatives were receiving, and they also spoke highly of the dedication and caring attitude of the staff towards them. They also told us staff keeps them informed of any changes in the condition of their relatives. Five of the service users spoken to said they had choice in their clothing and sometimes they receive help from their key worker. On the day of inspection all service users were dressed appropriately for the weather. The AQAA states “All the meals at Cedar Lodge are prepared fresh on site. Service users have a choice daily and can eat in either the dining room or their bedrooms”. We observed they have created a very attractive and welcoming dinning room; with tables being dressed with freshly laundered and colour coordinated table linen. We were told fresh linen is used every day and daily menus that include two alternative choices to the main courses are displayed for the use of our service users. We observed bowls of fruit were placed in the lounges whilst service users were present, and staff was seen offering drinks to service users. We observed a marked improvement in the décor of all the dining areas, and in discussion with service users they said they were very pleased with the redecorations. The inspector did not sample the lunch, but service users said the food was very good, tasty and the right amount. The inspector observed the presentation of the food was done in a way to stimulate appetite. Some service users had supplements as ordered by their GP or dietician, to maintain body weight or increase appetite. Fruit juices were served with lunch, which was served in the dinning room unless a service user requested to have their meals in their bedrooms. We observed care workers interacting in a friendly but dignified manner with service users during the lunch time, sitting down beside service users and speaking to them whilst helping them with their lunches. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 16 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 18 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults’ policies are in place to protect the service users from abuse. EVIDENCE: CSCI received two concerns about the home, which were referred to Surrey Safeguarding Adults. One has been dealt with satisfactorily as the records demonstrated on the day of the visit, and the other is being investigated The AQAA stated the home received five complaints in the last year four of which were dealt with within the home’s time frame for dealing with complaints, all four were upheld. One complaint is currently being investigated. This was verified on the day of the visit by reviewing their complaints records. The Acting manager told us that she is in touch with service users on a daily basis and issues raised are dealt with immediately; this reduces the incidents of formal complaints. Service users spoken to said they know how to complain Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 17 and will do so if they are not happy. Their complaint is always dealt with immediately and they were satisfied with the outcomes. It was noted that the home received a number of compliments from relatives of service users commending the staff on their kindness and understanding and for the high quality of work they perform. A copy of the most recent CSCI report was made available for visitors to the home on top of the piano and a recommendation was made to find a more suitable place to display the report where it is easily seen. In discussion with care workers, it was apparent they are aware of the homes’ policy and procedure on Safeguarding Adults and felt secure in the knowledge that if they had to use the whistle blowing procedure the manager and the Owners of the home would support them. During discussion with care workers it became apparent they did not have a full knowledge on Equality and Diversity issues relating to the service users they were responsible for. A recommendation was made to provide training in this area and to include training in Mental Capacity Act 2005. A random sample of care workers training records demonstrated that care workers are being trained to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 18 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 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables service users to live in a safe, well- maintained and comfortable environment, which encourages independence, and protect their privacy and dignity. EVIDENCE: The manager told us that the management and staff encourage service users to see the home as their own home. It presents as a comfortable, attractive home, which has all the specialist adaptations needed to meet the service users needs and were serviced and records kept verifying this. The home has attractive gardens, which are well maintained and there is good access to the gardens from various parts of the home. The home employs a gardener to maintain the grounds and garden in perfect condition for the use of the service users. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 19 It was noted that service users were able to personalise their bedrooms with small items of furniture, paintings on the wall and many family photographs. Generally, the home presents as clean, safe, pleasant, hygienic and tidy and free from offensive odours. Random review of care workers training records demonstrated they have had training in infection control and this was evident in the storage of waste. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 20 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 30 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of the service users. EVIDENCE: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was sufficient to meet the assessed care needs of the service users. The home has a programme of planned training in place and we were told all members of staff have an individual training record this was verified by the randomly reviewed staff folder audited. The Manager told us “over 50 of care workers have obtained the National Vocation Qualification at Level 2 (NVQ L2)”, and in discussion with care workers on the day of the visit they all said they had NVQ L2 qualification or were in the process of doing the course and this was evidenced in the random sample of files reviewed. Care workers are encouraged and enabled to undertake developmental training as well as the mandatory training according to the AQAA and this was verified Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 21 during review of the home’s training records and care workers files reviewed. All newly appointed staff undertakes an induction programme as recorded and documented in their personal files. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and from review of care workers training records Random sampling of care workers file demonstrated the homes recruitment processes are in line with the Care Homes Regulations 2001 Schedule 2 whereby all care workers are Criminal Records Bureau, (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and two written satisfactory references are obtained. Staff files sampled contained the required work history. Care workers are in receipt of terms and conditions of employment as evidenced in their randomly selected files. A review of all Registered Nurses Personal Identification Numbers verified current registration with the Nursing and Midwifery council. We were told that supervision records were up to date and this was verified during random sampling of care workers files. In discussion with care workers some were able to give examples of how the home applied equality and diversity to the different needs and wishes of the service users in their care, and also within the diverse staff group. Staff files contained their up to date training records and it was noted that Equality and Diversity training was not done. In discussion with the manager she provided evidence that this aspect of training was itemised for discussion with the Company Trainer. A recommendation was made to include Mental Capacity Act training as well See recommendations under Complaints and Protection Outcomes. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 22 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 33 35 38 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The acting manager supported by the Clinical Head of Care manages the home and works to continuously improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home. The views of service users and their relatives are actively sought in the running of the home and The service provides training on health and safety issues for all staff and service users are involved in the running of the home. Service users financial interests are safeguarded EVIDENCE: Cedar Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 23 The acting manager is not a registered nurse; however, the company has appointed a Registered nurse with long managerial experience in the NHS and has been a manager for another home as Head of clinical care who also supports the acting manager. The Head of clinical care has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. In discussion, it was evident she was knowledgeable about the training needs of the care workers to meet identified needs of the service users. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection were aware of their role and responsibilities. We were told that regular residents meetings are arranged and minutes of the meetings are passed to the owners who will action requests as soon as possible. The home does not become involved in service users finances except for service users spending money, which the home oversees. Receipts are kept and logged for all transaction carried out on behalf of service users. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, water temperature fridge and freezer recordings were regularly checked. Random sample of care workers’ training files demonstrated that up to date and relevant training were carried out by care workers to protect service users’ health, welfare and safety. In discussion with care workers they discussed their understanding and implementation of appropriate procedures to safeguard service users. Further more they spoke about their understanding of promoting safe working practices based on their health and safety training. The AQAA stated that equipment necessary for the care of service users are serviced and records kept. In discussion with the acting managers she was able to evidence this. Cedar Lodge Nursing And Residential Home DS0000017597.V361075.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 X X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cedar Lodge Nursing And Residential Home DS0000017597.V361075.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 OP7 Regulation 18 (1) © Requirement Ensure that persons employed by the Registered person to work at the home receive training in accurately documenting the work they do with service users in the daily work sheet Timescale for action 15/07/08 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 Lodge Nursing And Residential Home DS0000017597.V361075.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Lodge Nursing And Residential Home DS0000017597.V361075.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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