Care Home: The Cedars and Larches Care Home

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What the care home does well The Registered Providers had provided a statement of purpose and Residents Guide to the Home, and all new Residents applying to the Home would be appropriately assessed by the Manager before an admission was arranged. The senior staff and care staff were found to be very attentive and supportive of people staying in the Home, and completed a satisfactory level of administration to support this level of care. The people spoken with also said how helpful staff were to them, which was observed during this visit to the Home. Residents were found to be appropriately protected by the Complaints procedure and the Safeguarding Adults procedure in the Home. The Home was found to be well maintained throughout. All of the administrative arrangements to ensure that the Home met the standards set by law were found to be in place. What has improved since the last inspection? The last inspection took place in October 2007. Improvements have been made to the Home in the following areas: Those staying in the Home, or their representative, now had the right to see their records and comment upon them. The administration of the recruitment of staff had been improved. Supervision was now provided for all care staff. Mandatory had been provided in Fire Safety and Infection Control. What the care home could do better: The Registered Providers needed to repair the guttering to protect the building in The Cedars wing of the Home. Mandatory training needed to be provided for all care staff on First Aid. CARE HOMES FOR OLDER PEOPLE The Cedars and Larches Care Home 16 Queens Drive Ilkeston Derbyshire DE7 5GR Lead Inspector Steve Smith Unannounced Inspection 5th September 2008 09:35 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 The Cedars and Larches Care Home DS0000002129.V371438.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. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cedars and Larches Care Home Address 16 Queens Drive Ilkeston Derbyshire DE7 5GR 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) 0115 9440166 Exceler Healthcare Services Limited Mrs Janina Ann Wright Care Home 69 Category(ies) of Old age, not falling within any other category registration, with number (69) of places The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd October 2007 Brief Description of the Service: The Cedars and Larches is registered to provide nursing and personal care for up to 69 people over the age of 65. The Home is situated close to the centre of the town of Ilkeston, in a quiet but accessible location. The Home is on one site, but in two distinct wings, all but joined in the middle. One wing is called The Cedars and provides residential care, and The Larches provides nursing care. Each wing is very similar, although The Larches has wider corridors, due to providing a nursing service. Each wing provides a main lounge and dining area on the ground floor, with smaller lounges on the first floor. The Home also has one passenger lift and staircase in each wing, providing access to the first floor facilities. In the main, the Home provides single bedrooms, although a small number of double bedrooms are available. No ensuite facilities are provided, but there are sufficient toilet and hygiene facilities available throughout the Home. All bedrooms are equipped with a link to the call system. People are encouraged to personalise their bedrooms with small items of furniture and mementoes, if they so wish. Support services are in place, with a choice of General Practitioners, and chiropody, dental, optician and other services arranged as appropriate. A visiting hairdressing service is provided. An Activities Coordinator is employed, for five days of the week. There is a garden beside the home, which has been designed to be accessible to all those staying in the Home. The Home has open visiting arrangements. The charges made for a room at The Cedars and Larches range from £390.00 to £465.00 a week, dependent on the size of room, the facilities provided, whether the room is a double or single room, and whether residential or nursing care is required. Details of previous inspection reports can be found at the Home, or on the Commission for Social Care Inspection’s website: www.csci.org.uk The Cedars and Larches Care Home DS0000002129.V371438.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 2 Star. This means that people who use the service experience Good quality outcomes. The focus of inspections, undertaken by the Commission for Social Care Inspection (CSCI), is upon outcomes for people and their views of the service provided. This process considers the Home’s capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that needs further development. This inspection visit was unannounced and took place over a period of approximately 8.5 hours. In order to prepare for this visit we looked at all of the information that we have received, or asked for, since the last key inspection of the Home, which took place on 23 October 2007. This included: The ‘Annual Quality Assurance Assessment’ (AQAA). This is a document completed by the Registered Providers of the Home that focuses on how well outcomes are being met for people using the service. What the service has told us about things that have happened in the service. These are called ‘notifications’ and are legal requirements. The previous ‘Key Inspection Report’, and the results of any Other Visits that we have made to the service in the last 12 months. Relevant information from Other Organisations, and what Other People have told us about the service. Surveys returned to us by people using the service, from the relatives of those staying in the Home, and from the staff working in the Home. For this inspection of the service the Commission’s Residents questionnaire (a ‘survey’ mentioned above) was sent to 10 people staying in the Home, 10 people staying in the Home were asked if their relatives could complete a questionnaire, and 10 questionnaires were also sent to staff. However, no questionnaires were available to the Inspector when completing this report. During this visit to the Home ‘case tracking’ was used as a system to look at the quality of the care provided. This involved the sampling of a total of four peoples records, being a cross-section of people staying in the Home. Their The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 6 care plans and care records were examined, and their private bedrooms and the Home’s communal facilities were seen. Discussions were held with people, if they were able about the care and services the Home provided. In addition, discussions were held between the Inspector and the Manager of the Home about its general operation. Discussions were also held with staff about the arrangements for peoples care, and also about the staffs recruitment, induction, deployment, training and supervision. What the service does well: What has improved since the last inspection? What they could do better: The Registered Providers needed to repair the guttering to protect the building in The Cedars wing of the Home. Mandatory training needed to be provided for all care staff on First Aid. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 7 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. The Cedars and Larches Care Home DS0000002129.V371438.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 The Cedars and Larches Care Home DS0000002129.V371438.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): Standards 1, 2, 3 & 6. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. All new people moving to the Home were appropriately assessed prior to their admission, so that they were reassured that their needs would be met. EVIDENCE: The Registered Providers had provided a good statement of purpose for the Home together with a Resident’s Guide, which informed people staying in the Home, and their relatives, of what the Home provided. The Guide was well completed, and included information from those staying in the Home on what life was like in the Home. The Residents Guide also contained information on how, if necessary, people staying could contact the Commission, the local Social Services Dept and the local Health Authority. In the Annual Quality Assurance Assessment, completed by the Manager, she had written – ‘(We send out) brochures (to potential Residents) outlining what is offered in the home. (The) Service Users Guide and Statement of Purpose The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 10 are available at the reception area and (in peoples) bedrooms. (We conduct) pre-assessment (on all potential new Residents) and extensive care planning (is carried out) with everyone involved. (Information is made available on the) levels of service fees and any extra requirements. Fees are discussed before admission. Time is spent with relatives who are actively encouraged to visit and help with activities.’ The records of four people staying in the Home were examined during this visit and a copy of the statement of terms and conditions of residency or a contract, if purchasing their care privately, were available to examine. This ensured that peoples legal rights were protected. When new people were admitted to the Home, the Manager was provided with a summary of the needs of each person, completed by the Social Services Dept Care Manager supporting each person, copies of which were seen. The Manager also assessed all people sponsored by Social Services Depts. If the person was self-funding from the outset, the Manager completed her own summary of needs, which were also seen during this visit. Standard 6 does not apply to this Home. The Cedars and Larches Care Home DS0000002129.V371438.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): Standards 7, 8, 9 & 10. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. Peoples health and personal care needs were being met, as demonstrated within care plans, and by comments made by those staying in the Home. EVIDENCE: Four records of people staying in the Home were examined, or case tracked, to ensure that suitable records were being maintained. Satisfactory initial assessment records were made by the manager, during her first visit to the potential new people in their own homes. This was found to be followed up by very detailed individual plans of care and risk assessments for each person whose files were looked at. Choices and preferences of each person were also recorded, and included such issues as the preference for a bath or a shower, as well as information about peoples wishes about meals. Formal six monthly reviews of care were found in all of the four records examined. Satisfactory daily records were maintained by the Home’s staff and in general peoples care files were well organised, with different sections. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 12 The signatures of relatives were seen in the record for their relative in the Home. The files also had detailed monthly summaries contained within them. Staff were observed talking and assisting people in the lounges and dining rooms. This was seen to be done very positively, with a relaxed atmosphere, which was enjoyed by the people staying in the Home. The records of peoples health needs were observed and a good record was found to be maintained. All medication and the method of distributing it to people staying in the Home was examined. This showed that a well maintained record was kept, in both The Cedars and The Larches sections of the Home. Discussion was held with people staying in the Home. They said that staff were very good at listening to their views on how they liked to be cared for and staff would carry out their wishes. They also said that their care needs were always met with dignity and respect. As a result, they felt very safe in the Home, and had a strong sense of well being. One Resident said - ‘Oh yes, if I ask them to do something they do it my way, I cannot fault them’ – another persons said – ‘Staff are very good, if I mention something they would try and do it for me.’ All staff were observed to be very caring in their dealing with people in the Home, and spoke to them in a caring manner. In the Annual Quality Assurance Assessment, completed by the Manager, she had written – ‘We try to maintain a warm, caring environment to meet the individual Service Users needs, aiming to ensure their privacy and dignity is maintained at all times. … The Manager meets with relatives once a month, and their comments are recorded and followed up. … A monthly news letter is provided.’ The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 & 15. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. Peoples preferred lifestyles were respected by the Home, and people were given a wholesome and appealing diet in pleasant surroundings, that enhanced their well being. EVIDENCE: People staying in the Home were asked about the activities provided. Those spoken with said that regular activities took place. They said that such activities as bingo, skittles and an organ player calls at intervals. One person said that they had been invited to go on an outing to Skegness. Staff were also asked about the activities provided, and in addition to those already listed they said that ‘play your cards right’ was played, gardening was done, and that trips out to the town were organised. They said that this was all organised by the Activities Coordinator, who they said worked in the Home five days a week. In the Annual Quality Assurance Assessment the Manager had written – ‘The Activities Coordinator has training skills updated to ensure a varied programme of activities are available. The home (is in a) local market town and is in easy walking/wheelchair distance of the local weekly market. We ensure religious The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 14 needs are met with visit to the Home (of vicars/ministers) or externally when possible.’ People staying in the Home said that they decided when they got up and went to bed. One person said - ‘I choose the time I get up. At night time, after getting me ready for bed, they leave me in the chair for me to decide when I actually go to bed.’ Another person said – ‘I have one bath a week, although before I came here I had a bath or a shower almost every day.’ The Manager said that all people staying were able to have two baths a week, if they chose to do so. Relatives and friends of people staying in the Home were able to visit at any time, and could always be seen in private. One person said – ‘Oh yes, if I want to I can see them in my room, but I see both my children almost daily’ – another person said – ‘Yes, I can see them in private if I want to. I get quite a few coming to see me, and I can see them in my bedroom or the lounge.’ Staff spoken with confirmed this, saying that people could see their visitors in their bedrooms or in the lounge, as it was each person’s choice. People staying in the Home were able to say that the Home provided good meals – ‘The choice at breakfast is good. I have cereal and a cooked breakfast most mornings. Then there is a choice at dinner time, and at tea time. You can have sandwiches if you like, and there is always a good choice’ – another person said – ‘Someone comes around and asks what you want for breakfast, then again at dinner time and at tea time.’ Staff also confirmed this. Staff were also seen going around and asking what people wanted for dinner. People and staff said that drinks and snacks were always provided between meals, and that people could also ask for additional drinks at anytime. Mealtimes were never rushed, which was witnessed during this visit to the Home. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. Complaints made to the Manager were addressed to meet peoples needs. The protection policies and procedures provided, and staff skills meant that people staying in the Home were well protected. EVIDENCE: People spoken to said that if they had a complaint to make they would tell the Manager or a senior member of staff - ‘I would tell the Manager, but I have not had to do this’ – another said – ‘I would tell a person-in-charge.’ The Commission had not received any notice of complaint since the last visit to the Home, in October 2007. Since that visit, in October 2007, the Manager had recorded 4 concerns or complaints. Those concerns/complaints were examined and a good system was found to operate. Good procedures were seen for both written and verbal complaints. The Registered Providers complaints procedure detailed that all complaints would be responded to by the Manager within at least 28 days. In the Annual Quality Assurance Assessment the Manager had written – ‘The home has a robust complaints policy and procedure. They are documented and made available to all in the Service Users Guide. Other formats are also available. When relatives visit, the complaints procedure is explained to them, and they are shown … who they can refer to, with a comprehensive list of The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 16 telephone numbers. All complaints are dealt with promptly, and used in meeting for training and self-improvement.’ The Registered Provider had a Safeguarding Adults procedure that included a ‘Whistle Blowing’ policy, about which staff spoken with said they had received training. This meant that a procedure was in place to allow staff to inform the Manager of any inappropriate actions by other staff. The Manager had copies of the Public Interest Disclosure Act of 1998, and of the Dept of Health’s policy called ‘No Secrets’. The Manager confirmed that all allegations and incidents of abuse would be promptly followed up and that all actions taken would be recorded. Staff said that they understood that people staying in the Home might, on occasion, show anger and aggression, and described the training received on the best way to resolve these situations. The Manager said that a policy was available to staff stating that they could not benefit from peoples wills, which was also understood by the staff spoken with. In the Annual Quality Assurance Assessment, completed by the Manager, she had written – ‘(We) use complaints in a positive manner. A new company initiative has started with the home managers having training with the ‘Charity to Stop Elder Abuse’… This will role out a completely confidential telephone number to the ‘Charity’ for Whistle Blowing and Service Users and their relatives to use. This will feed back directly to the Operational Team and Mangers as a safeguard for our vulnerable adults who use the service.’ The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 22, 23, 24, 25, & 26. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. The Home was well maintained throughout, providing all people staying in the Home with a safe, comfortable environment in which to live. EVIDENCE: A tour was made of the public areas of the Home, and included a number of bedrooms of people staying in the Home. The Home was most pleasantly decorated throughout, and the lounges and dining rooms was pleasant to sit in. The bedrooms seen provided sufficient space and provision for each person staying in the Home. The Registered Providers had also provided appropriate furnishings in all locations seen during this visit. Bedrooms were also very pleasantly decorated, by each person, with pictures of their lives prior to moving to the Home. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 18 Toilets were easily available to everyone, were clearly marked, and were provided with handrails where necessary. A call system was also available throughout the Home. All radiators were appropriately guarded, and could be controlled within each bedroom. The Home had appropriate sluicing facilities, and laundry was washed at appropriate temperatures. In the Annual Quality Assurance Assessment, completed by the Manager, she had written – ‘There is a rolling decoration plan to ensure the home recognises and improves the environment. Service Users are given a choice of bedroom, and we encourage them to personalise their rooms. Doors to each bedroom have their own name and door knocker to try to make the rooms look like the Service Users own front door. The maintenance services are reviewed and actioned as required.’ However, the following two issues needed attention: Outside of The Cedars wing, opposite the office, the guttering was seen to be very badly leaking and needing attention. In the majority of bedrooms and lounges plastic upholstered chairs were provided. When sat on these chairs caused considerable perspiration and discomfort. When rising from the chair clothing was found to be damp. Staff also commented that the seats were unpleasant to sit on. Alternative seating covers should be provided. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. A good level of care staffing was provided to meet the needs of people staying in the Home. Recruitment practices were always followed when recruiting new staff, so that Residents welfare was always safeguarded. EVIDENCE: Levels of nursing and care staffing were examined for the 3 weeks beginning 11 August 2008. This showed that a good level of staffing was being provided. At the time of this visit to the Home it was found that over 50 of care staff had a qualification of at least NVQ level 2 in Care; 20 out of a total of 34 staff, 59 . A further four staff were found to be studying for an NVQ level 2 in Care. In the Annual Quality Assurance Assessment, completed by the Manager, she had written - ‘Over 75 of staff have an NVQ level 2 and some have NVQ level 3, some of the staff are now registered to do NVQ level 4.’ The records of two new staff employed during the past 12 months were examined to see whether the Manager had obtained all relevant information about them. It was found that all necessary information had been obtained. Care staff spoken with were able to confirm that they had been given copies of the General Social Care Council’s code of conduct and practice. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 20 The Manager said that all new staff were provided with induction and foundation training, which was confirmed by staff. She also said that all care staff were provided with at least three paid days training a year, which again was confirmed by staff spoken with. All staff also had an individual training and development assessment and profile. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 & 38. The quality in this outcome area was Good. This judgement was made using available evidence including a visit to this service. Management arrangements at the Home were in place to ensure that Residents care was maintained at a positive standard. EVIDENCE: The Manager was appropriately qualified to manage the Home, having an NVQ level 4 qualification in Management; she also held a nursing qualification. A senior manager was found to be inspecting the Home on a monthly basis, so ensuring that peoples care, and the maintenance of the Home itself was satisfactory. The Manager was able to show the annual development plan for the Home, which was adjusted on a monthly basis. This development plan reflected the aims and outcomes for people staying in the Home. Surveys had been The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 22 undertaken with people staying in the Home on their opinions of the operation of the Home, and these had been published and added to news letters which were sent to those staying and their relatives. Regular 3 monthly Residents Meetings were held, and the Manager had set aside a special time, once a week, to talk with relatives and those staying, via appointment, on subjects of their choosing. The opinions of peoples families and friends, and of GPs and District Nurses had also been surveyed for them to comment on how well they thought the Home was achieving goals for those staying. The results of these surveys were also published. The Home held a number of accounts for peoples money, with the Registered Providers ensuring that interest was paid on the money held. It was seen that this was managed effectively for those staying in the Home. Two members of the care staff was asked about the supervision they received from the Manager or other senior staff in the Home. They said that this was done approximately twice a year. The Manager showed a record of the supervisions held by her senior nursing staff, which showed that some staff had only had two supervision sessions since January 2008, while the majority had received three sessions. The training required by the Regulations was examined. This showed that training in Moving and Handling, Fire Safety, Food Hygiene and Infection Control were all up to date. This was also confirmed by staff spoken with. However, the records showed that 8 care staff were still awaiting their training in Basic First Aid. In addition to the above areas of mandatory training, the Manager said that training was provided to various staff in Bedrail Management, Dementia Awareness, Pressure Care, Customer Care, Care Planning, Challenging Behaviour, Continence training, Safeguarding Adults, Medication training and other training. The Manager was able to show that all accidents, injuries and incidents of illness or communicable disease were recorded and reported to the relevant government bodies. With the assistance of the Fire Service, fire safety notices were also posted in relevant places around the Home. The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 3 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 3 X 2 The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 24 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 OP19 Regulation Reg 23(2)(b) Requirement The guttering, to the right of the office in The Cedars wing, must be repaired to prevent the considerable leaking of water when it is raining. This will improve the outlook and noise during heavy rain for those staying in the Home. Mandatory training must be provide for all members of staff requiring First Aid training. This training is needed to ensure that all staff have the knowledge to meet the needs of people staying in the Home, and to ensure that the Home is run to satisfactory standards. Timescale for action 31/10/08 2 OP38 Reg. 18(1)(c) 31/12/08 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 Good Practice Recommendations DS0000002129.V371438.R01.S.doc Version 5.2 Page 25 The Cedars and Larches Care Home 1. Standard OP19 The plastic upholstered chairs should be changed for chairs with a more modern and appropriate covering to increase comfort for those staying in the Home. Supervision should be provided for all care staff in the home on at least a two monthly basis. 2 OP36 The Cedars and Larches Care Home DS0000002129.V371438.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Cedars and Larches Care Home DS0000002129.V371438.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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