Care Home: Cedarwood Nursing Home

What the care home does well Residents care needs are assessed in detail, with a number of areas documented to ensure their safety and that of the staff assisting them. Residents feel they are treated with respect and their privacy and dignity are recognised. Comments received with regard to what the home did well included The care staff contact me immediately any concern happens, they are very attentive regarding thisto which I am very happy". "I am most impressed with the skill and care provided, and evident with "hands on care", and the certificates on display of care courses attended". "The care that A (resident) receives I believe is is second to none", (the staff)"are good at keeping relatives informed". Residents have a number of choices and variety of activities based around their individual needs, and promoting people`s independence, choice and decision making. Residents are encouraged and assisted to keep in contact with relatives, and the greater community. Comments received with regard to what the home did well included "General care, different activities and staff addressing people by their first names" "Mother is always met with a cheerful smiling face and is always engaged with and by the staff in the home". "Food! Nice home cooked meal, with consideration given to dislikes". "Whole home events, organised by the Activities Co-ordinator" and the "pampering of female residents", Regular visits by the hairdresser and manicures carried out by care staff. Residents have Quality Assurance questionnaires circulated periodically, these and formal meetings are used to discuss issues such as meals and menus, pastimes and outings. Decisions that the residents make are recorded in the daily notes. Staff operate a safe and secure process when administering medication. Complaints information is displayed throughout the home, and is also available in the paperwork issued prior to moving in to the home. Staff are aware of how the complaints procedures work, and how to recognise and report on safeguarding issues. One relative stated, "I was concerned about an incident my relative told me about. When I mentioned this to a member of staff, they took my concerns seriously and investigated the incident. I received a written report of their findings, within a couple of days, and the Manager and Nurse Manager met with me to ensure that I was satisfied. I was most impressed and reassured by the way my concerns were handled". Staff employed in the home have an extensive process to go through prior to being allowed to work at the home. This process includes police and Criminal Record Bureau (CRB) checks. Nursing staff are confirmed on the appropriate register. Supervision, which is where the manager oversees the staff working and theoretical practices. This continues on a one to one basis, and helps toward care planning, and the planning of staff training events. What has improved since the last inspection? The storage of some equipment has improved and this is now stored safely around the home.The assessment process and paperwork used prior to people move into the home, has improved with more detailed information now being requested by the staff. The care planning has also improved, again with more detail being introduced into the plans. Staff have also been trained on how to complete the paperwork. Menus have been revised and the manager has enrolled with NAPA. The National Association for Provider Activities, which provides a specialised point of contact when planning activities for the residents. What the care home could do better: The recording of safety information could improve, and all records be kept up to date. Regular medication audits must take place to ensure people are receiving the correct amounts of medication. To assist in this process, any medication carried over from one month to another could be recorded in the new months medication. The manager has recognised that the assessment of people with Dementia needs to be extended to ensure the best quality service possible. A list of alternatives to the main meal could be produced. This would enable staff to offer a consistent choice for residents. Of the relative comment cards received, people felt the care home could improve by "The facilities could do with being modernised, or freshened up" another commented "Standards are good keep it up" Key inspection report Care homes for older people Name: Address: Cedarwood Nursing Home 492 Kettering Road Spinney Hill Northampton Northants NN3 6QP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Williamson     Date: 3 0 0 4 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Cedarwood Nursing Home 492 Kettering Road Spinney Hill Northampton Northants NN3 6QP 01604643114 01604719606 sarah@cedarwoodnursing.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cedarwood Nursing Homes Limited care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia aged 50 years of age and over - Code DE Old Age, not falling within any other category - Code OP Physical Disability - aged 50 years of age and over - Code PD Date of last inspection Brief description of the care home Cedarwood Nursing Home provides nursing and personal care for up to 32 Service Users within the categories of old age, dementia, physical disability and terminal illness. The home is situated in a residential area within the suburbs of Northampton and has good access to local facilities and amenities. The accommodation offers 12 Care Homes for Older People Page 4 of 24 32 0 32 Over 65 0 32 0 Brief description of the care home single rooms and 10 shared rooms with three lounge areas and a dining room. The business is family run and the service users and their families are encouraged to be involved within the home. Fees range from £345 to £550 according to assessed needs. Information about the home can be obtained from the Registered Manager in the form of the Statement of Purpose and Service Users Guide. A copy of the latest CQC report is also available from the office. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspection is on outcomes for residents and their views of the service provided. The main method of Inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, and looking at their records and accommodation, in this case three people were chosen. This visit took place over one day, commencing at 9.30am and took six hours to complete. An opportunity was taken to talk with residents, manager and staff, look around the home, view records, policies and care plans. Residents and their relatives made a number of comments, both on the day and through the questionnaires that were sent prior to the visit. Some of those comments have been included in this report. Information was obtained from the Annual Quality Assurance Assessment, which gives information about the home, and is filled in by the registered manager. A copy of the last Care Quality Commission (formerly the CSCI Commission For Social Care Inspection) report is displayed at the homes office, and copies of this report are available from the registered manager. The quality rating for Care Homes for Older People Page 6 of 24 this service is 2 star. This means the people who use this service experience good quality outcomes. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? The storage of some equipment has improved and this is now stored safely around the home. Care Homes for Older People Page 8 of 24 The assessment process and paperwork used prior to people move into the home, has improved with more detailed information now being requested by the staff. The care planning has also improved, again with more detail being introduced into the plans. Staff have also been trained on how to complete the paperwork. Menus have been revised and the manager has enrolled with NAPA. The National Association for Provider Activities, which provides a specialised point of contact when planning activities for the residents. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can be confident that their needs will be assessed, and that they will be given good information to enable them to make an informed choice about the home. Evidence: The staff have developed a comprehensive Statement of Purpose and Service User Guide, these documents are used to give information about the service to people considering a move into the home. The information included gives people the latest Quality Assurance feedback. This is information collected from completed questionnaires by people living in the home, their relatives and other interested parties such as General Practitioners and District Nurses. All of the peoples files included a signed contract or terms and conditions, a copy of which was also included in the Service User Guide. Pre admission assessments were completed, and additional information was gathered from the relatives of the people concerned. This is a recent addition to the admission process, and gives more detail and information for the staff to complete the care plan. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care are sufficient to ensure people are safely cared for. Evidence: The care plans for residents are well written and include detailed daily records, these record peoples care on a daily basis. There are photographs on all the care and medication records, which increases the security for everyone in the home. The hand written care plan is made up from a number of documents that cover in detail the care needed by the person. Risk assessments are in place, though these could be more detailed. This would enable staff to have specific instruction when giving PRN or occasional doses of medication. Residents healthcare is good with evidence of recent health checks with the General Practitioner, and detailed records of those and other health care workers visits. Medication is well administered, with accurate recording of medicines received and disposed off. The records around medication that is kept from one month to another needs to be made more detailed. This would enable staff to ensure the correct medication had been given, when a medication audit is undertaken. Residents when Care Homes for Older People Page 12 of 24 Evidence: spoken with agreed the staff recognised their privacy, by indicating staff knocked and waited prior to entering private areas of the home. Of the relative comment cards received, people felt the care home did well in The care staff contact me immediately any concern happens, they are very attentive regarding this- to which I am very happy. I am most impressed with the skill and care provided, and evident with hands on care, and the certificates on display of care courses attended. The care that A (resident) receives I beleive is is second to none, (the staff)are good at keeping relatives informed. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The employment of an activities organiser enhances the personal choices of those in the home. Evidence: A variety of activities are provided on a regular basis. The home employs an activities person who assists in producing an activities plan so people know what is on offer on any particular day. There is considerable written evidence of activities being completed with people on an individual and small in groups. People agreed they have a number of choices in the home, and indicated flexibility in times of rising and going to bed, meals and activities. There is only one choice of main course at lunch time. This does not cause any concern to residents as alternatives are on offer. To ensure a consistent choice, a specific list of alternative meal choices would give people a fair and equitable choice. Of the relative comment cards received, people felt the care home did well in General care, different activities and staff addressing people by their first names Mother is always met with a cheerful smiling face and is always engaged with and by the staff in the home. Food! Nice home cooked meal, with consideration given to dislikes. Care Homes for Older People Page 14 of 24 Evidence: Whole home events, organised by the Activities Co-ordinator and the pampering of female residents, Regular visits by the hairdresser and manicures carried out by care staff. And when asked on how they could improve.. Standards are good keep it up Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that their concerns will be dealt with promptly, and feel safe in the home. Evidence: The home has a complaints policy that people are aware of. This is posted in the foyer of the home as well as information being given to people prior to admission. This results in people being confident that any concerns would be dealt with appropraitely. There have been one complaint since the last visit, being recorded and dealt appropriately within set timescales. There have been no safeguarding issues forwarded to the CQC (Care Quality Commission formerly known as the CSCI, Commission of Social Care Inspection). Staff are aware what to do and who to report onto, issues around safety of the people in the home. The staff group were aware of what action to take in view of a complaint or safeguarding issue became apparent. Comments received with regard to what the home did well included I was concerned about an incident my relative told me about. When I mentioned this to a member of staff, they took my concerns seriously and investigated the incident. I received a written report of their findings, within a couple of days, and the Manager Care Homes for Older People Page 16 of 24 Evidence: and Nurse Manager met with me to ensure that I was satisfied. I was most impressed and reassured by the way my concerns were handled. Care Homes for Older People Page 17 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable, and homely environment. Evidence: The decor in the in the home is of a good standard. There is a plan in place to refurbish or replace worn items of furniture, fixtures and fittings. Improvements are done on a planned basis, and shows the responsible person has the needs of the people in the home at the as a priority. The staff are aware of cross contamination issues, and are supplied with the appropriate protective clothing to assist in protecting residents. The laundry is well appointed with surfaces that guard against the transfer of contaminants, though the redecoration of the walls has recently been added to the refurbishment plan. Of the relative comment cards received, people felt the care home could improve by The facilities could do with being modernised, or freshened up Care Homes for Older People Page 18 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes recruitment practices, and training programme. Evidence: Staff are employed in adequate numbers to provide care for the people in the home. Staff are provided with a training programme that commences with their induction, and other periodic training updates in health and safety, fire and evacuation and other statutory training which is required by law. Some of the staff have undertaken an NVQ in care. The NVQ (National Vocational Qualification) is a nationally recognised training qualification. The recruitment process is good with staff going through a standard process of application form and references being obtained prior to interview. Successful applicants then have povafirst and CRB (Criminal Records Bureau) clearances prior to starting work. These are required by law, and obtained to increase the security of employing staff to work with vulnerable people. Of the relative comment cards received, people felt the care home did well in Staff work well as a team, there is good staff contnuity Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The poor recording around health and safety detracts from the overall safe environment of the home. Evidence: The current manager has many years of experience in the care industry, though has not yet applied to be the registered manager at the home. The quality assurance for the home is ongoing with questionnaires given to residents, their relatives and others who have an interest in the home, on an annual basis. The complaints procedure is well displayed in the home and is included in many of the documents distributed to people considering a stay in the home. There are residents and staff meetings, which also adds to the overall quality assurance within the home. Staff supervision is regularly undertaken by the staff. This assists in the planning of staff training courses, as well as discussing residents care planning issues. Most of the health and safety checks are undertaken periodically, though the recording of these is not up to date. This is not good as these are undertakn to ensure the safety of those Care Homes for Older People Page 20 of 24 Evidence: in the home. Staff assist in the process by assisting with the tests in a number of areas, with fire alarm and monthly emergency lighting tests. The fire risk assessment was noted to be in date. It was noted at the last visit that some equipment was not stored safely, this was not an issue at this visit, so is seen as having improved. We asked to check the monies that the home held on behalf of the people, this was accurate and agreed with the paper records held. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Staff could ensure that medication carried over from one medication period to another is detailed enough to ensure people have received the correct dose of medication. A list of alternatives to the main meal could be produced. This would enable staff to offer a consistent choice for residents. 2 15 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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