Care Home: The Cedars

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What the care home does well The home`s philosophy is to help people feel that they are living "at home" rather than "in a home." There is a relaxed caring and inviting atmosphere in the home with lots of conversation and laughter. People and their relatives say "It looks smells and feels like your own home" "I think we have been extremely fortunate to find such a caring home for my mum...The carers treat her with love and respect and she is very happy. "The level of care in this home is excellent" "There is always discussion and support. Any queries are followed up and responded to" "I`ve found the Cedars to be clean and tidy at all times and the proprietors Nada and Tommy and all the staff whom I`ve met to be caring helpful and attentive at all times." "The Cedars is a very well presented extremely clean home. The staff and owners are very friendly and always there to help. Everyone is very well looked after." Staff say, "Mrs Green is always giving us support and praising me and other staff. We have a friendly and understanding caring staff" "Because we are a small home 12 residents and our boss is so lovely it feels like home to staff as well as residents. Also correct care is given, food is excellent and presented well. The home is spotless and smells lovely. The atmosphere is lovely music playing all day. Visitors are offered a drink always and if there at mealtimes offered food as well" "I wont work in another care home I worked in one before the Cedars this is the best home" The home is fitted and decorated to a high standard and very well maintained What has improved since the last inspection? All medication records are now checked to make sure that records show that people have been given their medication as prescribed. A dishwasher has been purchased which helps the home make sure that care staff continue to concentrate on care duties. The home now has a washing machine with a sluice cycle. This means that the risk of passing on infection is reduced. Staff have continued to update their training and have had training that helps them to look after people with specific medical conditions such as diabetes. The hard wiring at the home was tested in March 2007 and a certificate was seen at this inspection. This helps to make sure that people live in a safe environment. What the care home could do better: There are no requirements and recommendations made in this report. People we spoke to said they could not think of anything the home could do better. The manager said she intends to introduce a questionnaire asking people if the admission process could be improved further. As it is a small home many of the conversations between staff and the manager are informal and the manager has said she may record in writing some of the significant discussions. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Cedars 23/25 Threshfield Road Baildon Bradford West Yorkshire BD17 6QA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sughra Nazir     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Cedars 23/25 Threshfield Road Baildon Bradford West Yorkshire BD17 6QA 01274531125 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): thecedars1@hotmail.co.uk Mrs Nada Green Name of registered manager (if applicable) Mrs Nada Green Type of registration: Number of places registered: 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: Date of last inspection Brief description of the care home The Cedars is a large terrace property. It is on the main road about half a mile from the centre of Baildon. It is registered to look after twelve older people. There are two double and eight single bedrooms. Three of the single rooms have ensuite facilities. There is one lounge and dining room on the ground floor and this opens out to a decked seating area in an enclosed garden. There are toilets and bathrooms to both floors. Access to the first floor is by staircase only,there is no passenger lift. The home is on a direct bus route between Bradford and Baildon. There is a bus stop directly outside the home. The fee level at the last inspection was between 344 and 394 Care Homes for Older People Page 4 of 26 care home 12 Over 65 1 9 2 0 0 0 Brief description of the care home pounds per week. For current fees please contact the home direct. Additional charges are made for hairdressing and private chiropody treatment. Care Homes for Older People Page 5 of 26 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: three star excellent 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: We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assurance assessment and sent surveys to staff and people living in the home. On an unannounced visit to the home we talked to people, their relatives, staff and the manager. We also checked some of the records, policies and procedures the home has to keep. We concentrated on the key standards and what the outcomes are for people living in the home, as well as issues which were raised at the last inspection. Care Homes for Older People Page 6 of 26 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? All medication records are now checked to make sure that records show that people have been given their medication as prescribed. A dishwasher has been purchased which helps the home make sure that care staff continue to concentrate on care duties. The home now has a washing machine with a sluice cycle. This means that the risk of passing on infection is reduced. Staff have continued to update their training and have had training that helps them to look after people with specific medical conditions such as diabetes. The hard wiring at the home was tested in March 2007 and a certificate was seen at this inspection. This helps to make sure that people live in a safe environment. Care Homes for Older People Page 8 of 26 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to decide whether the service is right for them. By carrying out a thorough assessment the home can be sure that staff will be able to meet peoples needs. Evidence: People who want to come to live at the home get very clear information telling them about the services, the accommodation, qualifications and experience of staff and how to make a complaint. The files we looked at showed detailed assessments of peoples needs are carried out before people move in. This helps the home make sure that they will be able to provide care to meet those needs. People or their relatives are always involved in the assessment process. Before people move in they are supported by a member of staff who follows a checklist to make sure the move goes as smoothly as possible. This member of staff helps the person settle in and unpack etc. This is good practice. One Care Homes for Older People Page 11 of 26 Evidence: person told us they had visits for tea were introduced to other residents had a tour around the residence and found it very informative. Care Homes for Older People Page 12 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Staff know how to look after people properly because they have detailed information that tells them about the persons background their abilities and their needs and how to meet them Evidence: We looked at three care files. They were very detailed and uptodate. Individual needs are recorded and there is good detail showing exactly how care is to be provided. For example care plans state whether people prefer one pillow or two. The files tell staff what people can do for themselves and what they need help with. This means that staff know what they need to do to meet individual peoples needs in a consistent way and helps maintain peoples independence. Relatives are invited to complete a summary of peoples likes, dislikes and preferences. They are also sent a care plan to agree every year. Care Homes for Older People Page 13 of 26 Evidence: All the files we looked at had information about what risks there might be looking after that person and what staff should do to keep them safe. People are encouraged to keep their own GP and receive visits in private. We saw a medical summary that lists key events such as falls, symptoms, changes to medication from admission to date. This can be shown to health professionals in the event of ill health and gives a clear picture of the persons health. This is excellent practice. The home has put together a clear medication policy that staff see and understand. We saw that medication records are fully completed, contain required entries and are signed by appropriately trained staff. Every persons medication record has a summary sheet which lists what medication they are on, what it is prescribed for and what the side effects could be. This gives staff an at a glance guide to medication and is excellent practice. Care Homes for Older People Page 14 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to nutritious food and drink and stimulating activities that meet their individual needs and preferences. Evidence: The home provides activities such as painting, quizzes, exercises, music and movement entertainment and spelling games. People go on outings to have coffee in the village or local pubs and restaurants. They have the choice of a hairdresser who comes to the home or can use the hairdresser in the local community. On most days staff accompany people on walks. When we visited the home there was music playing, there was an exercise group and a quiz in the afternoon. One person had their nails done and another was going out to a day centre. People told us about going to the church and having church services at the home. This tells us that people are supported to maintain a varied social life through a wide range of in house and community activities. This is excellent practice. One visitor we spoke to said that they are always made welcome, offered a drink or a meal if its mealtime. She said everyone wants to put their name down. Care Homes for Older People Page 15 of 26 Evidence: Meals are served in a warm, comfortable dining area. There is a 4 week planned menu on the notice board and meal choices are not repetitive. The home caters for special diets including people with diabetes and will take advice from speech and language therapists if someone has any particular difficulties. Where people need help this is provided discretely. We saw that staff make mealtimes relaxed and sociable with lots of conversation. We asked people about the food. They said, Good variety, fantastic and super. Were well looked after and Its always nice. Care Homes for Older People Page 16 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their views will be listened to and acted upon. They are protected by robust policies procedures and trained staff. Evidence: There had been no complaints since 2004 either to the home directly or to Commission for Social Care Inspection. People said they knew how to complain and who they could talk to if they felt unhappy. Informal discussions are regular and help the home pick up on any concerns or issues. All staff have had some training on adult protection. Some staff are due to go on further training to make sure they know what to do if they suspect abuse. Care Homes for Older People Page 17 of 26 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 excellent 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 warm, clean and very well maintained environment. Evidence: The home is maintained to an excellent standard and the standards of decor and furnishings are good. People are involved and asked for their opinions when the home is being redecorated. One part of the main lounge has patio doors that open out onto a decked area with a small enclosed garden. There are bathrooms and toilets on both floors. Peoples bedrooms are individually decorated and furnished with some of their own belongings. This helps them feel at home. One person said, It looks, smells and feels like your own home Relatives told us Ive found the Cedars to be clean and tidy at all times The Cedars is a very well presented extremely clean home Its spotless All areas of the home we saw were very clean and tidy and smelt fresh. Staff work together to achieve this and were seen to be well organised and committed. After the last inspection the home acquired a washing machine with a sluice cycle this reduces the risk of infections being passed on. The home received 4 out of 5 stars in a Care Homes for Older People Page 18 of 26 Evidence: recent Environmental health inspection. This tells us they have robust policies and procedures to keep the home safe and clean. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after by caring committed and well trained staff. Evidence: We saw that staff helped to create a family atmosphere at the home. They were very friendly and welcoming and showed a very good understanding of each persons needs. Staff who returned surveys said, Mrs Green is always giving us support and praising me and other staff. We have a friendly and understanding, caring staff I wont work in another care home I worked in one before the Cedars this is the best home People told us, The level of care in this home is excellent staff exceptional,very caring very caring and supportive We looked at two staff files and they showed that the required checks are carried out to make sure that the people the home employs are safe to work with older people. A number of staff already hold the National Vocational Qualifications at the required level and more staff are enrolling. Induction is thorough. We saw a training a programme showing training on adult protection, first aid, medication diet and Care Homes for Older People Page 20 of 26 Evidence: nutrition. One relative told us that staff have undergone medical training in order to accommodate my mums needs as a diabetic. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect has effective quality assurance systems developed by a qualified competent manager. Evidence: we sent the manager a document called an annual quality assurance assessment. This was completed in a lot of detail and gave us lots of evidence to show that the home is providing very good standards of care. The manager/owner has 30 years experience of care and lives on the premises. This gives people and their relatives added reassurance about care provided. All the requirements and recommendations made in the last inspection were acted upon. This shows that the manager takes her responsibility seriously and works with us to improve standards. The manager told us that they use a number of ways to keep checking the quality of Care Homes for Older People Page 22 of 26 Evidence: their care. This includes annual quality assurance surveys, food and drink questionnaires and agreeing care plans with relatives as they are developed and again annually. A relative told us , There is always discussion and support. Any queries are followed up and responded to The home has a policy of not handling peoples money. The hairdresser and chiropody service invoice relatives direct with any charges for their services. We looked at some records to check if safety checks are up-to-date and found that recordkeeping is of a consistently high standard. All policies and procedures are regularly updated. We saw that a hard wiring certificate is in place showing checks carried out in March 2007. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!