Care Home: The Cedars Christian Residential Home

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What the care home does well Information is available to help people decide if the service provides what they want. They have opportunities to try things out for themselves before making their minds up. People`s needs are thoroughly assessed so that their care and support can be planned properly. People have care plans that are sufficiently detailed to ensure they get the support they need. Plans are reviewed regularly, so that important information is kept up to date. Risk assessments are in place to ensure they get the support they need to stay safe. People`s personal and healthcare needs are generally well met. They get the support they need from staff and a range of other professionals to help them stay healthy and well. People are supported to do things they value and enjoy, and keep in touch with the people who are important to them. Mealtimes are relaxed and unhurried so that people can enjoy the good quality food that the home provides. Staff work hard to ensure that people enjoy the benefits of living in an environment that is comfortable, homely, safe and clean. The service provides sufficient staff to ensure that people get the support they need. Recruitment and selection procedures are robust, to ensure that people are fit for their jobs. Staff are generally well trained and supervised to ensure that they have the knowledge and skills and get the support they need to do their jobs well. The home has a strong management team. It is generally very well run, for the benefit of people using the service. People`s opinions are actively sought, so they can be confident their views are listened to and taken seriously. Regular maintenance and checking of important equipment helps to ensure that people living and working at the home stay safe. People living in the home continue to enjoy excellent outcomes. What the care home could do better: No requirements were made following this inspection. Some good practice recommendations were made, and these can be found at the end of this report. Random inspection report Care homes for older people Name: Address: The Cedars Christian Residential Home 22 Redlake Road The Cedars Pedmore Stourbridge West Midlands DY9 0SA three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Gerard Hammond Date: 0 2 0 6 2 0 1 0 Information about the care home Name of care home: Address: The Cedars Christian Residential Home 22 Redlake Road The Cedars Pedmore Stourbridge West Midlands DY9 0SA 01562882299 01562882299 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Carol Onley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Carole Jenkins care home 22 Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 22 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other categories (OP) 22 Date of last inspection Brief description of the care home The Cedars is a large Victorian property built in 1902 and registered as a care home in 1984 by the owner. The property is located in a residential area of Pedmore close to Care Homes for Older People Page 2 of 11 Brief description of the care home the town of Stourbridge. It has easy access to a main bus route, shops and other amenities. The home is registered to provide accommodation and support for up to 22 people . There are 20 single bedrooms and one double bedroom. 15 of these rooms have en-suite facilities and two have a shower. Accommodation is provided on three floors, all of which can be accessed by a passenger lift. There are bathrooms with assisted baths on the ground and first floors. The home has three lounges and a dining room, all of which are tastefully decorated and furnished to a high standard.There are generous gardens to the front and rear, providing well maintained and attractive outdoor spaces for people to enjoy. Car parking is available at the front of the home. Care Homes for Older People Page 3 of 11 What we found: This services last key inspection was on 07 August 2009, when its quality rating was 3 stars. This means that people using the service experienced excellent outcomes. The purpose of this inspection was to monitor compliance with essential standards of quality and safety against current National Minimum Standards. The Manager sent us an Annual Quality Assurance Assessment. We made a visit to the home and met people who use the service, the management team and members of staff. We also received written responses to questionnaires we sent to people who use the service, members of their families, and staff at the home. We looked at records including personal files, care plans, staff records, previous inspection reports, safety records, and other documents. We looked at peoples personal records to check that the home had made sure their needs had been properly assessed. All of the files we looked at contained an initial assessment that included necessary details of peoples abilities and support needs. This forms a sound basis on which to plan their future care and support. The Annual Quality Assurance Assessment (AQAA) shows that people are encouraged to come and visit the home and we saw that written information about what the service provides is also available. This helps to ensure that people have the information they need to see if the service is what they are looking for. We looked at personal records to see how peoples care and support is planned and managed. All of the files we saw contained a care plan, and these had been kept under regular review. This ensures that important information is kept up to date. Records showed that peoples health care needs are met through staff support and the involvement of other professionals as required. We saw records of regular appointments with peoples GPs, dentist, optician, and chiropodist, and hospital or clinic visits. One person is currently receiving daily support from the district nurse for pressure area care. We saw that a detailed care plan is in place for this, and that appropriate equipment to promote recovery has been obtained. This person has also recently been diagnosed as suffering from coeliacs disease. We talked to her and the Manager about this, and saw that appropriate arrangements have been put in place to ensure that she has a glutenfree diet. There was information on her file about this. Other care plans were in place for personal care, oral hygiene, continence, nutrition and weight monitoring. We saw that plans were supported with risk assessments, so that people get the support they need to stay safe. The Manager showed us some examples of work currently being undertaken to develop care plans to make them more detailed and person-centred. This is a work in progress. We were able to observe interactions between staff and residents. We saw that support was given with warmth and friendliness, and peoples rights to privacy and dignity were respected. We were able to meet one person with her relatives who were visiting. They said the staff here are very kind and friendly. They make sure that (N) gets the care and attention she needs and get the doctor in if required. We are very happy with the care she receives. We saw that arrangements for storage, handling and administration of medication are generally satisfactory. Records of audits by the local pharmacist showed no major Care Homes for Older People Page 4 of 11 problems. However, we recommended that the Manager review all PRN (as required) medication to ensure that written protocols are in place for all such medicines currently prescribed. This is to ensure that staff have clear guidance about the precise circumstances in which such medication should be give. If possible, these should be countersigned by the prescribing doctor. We also recommended that a copy of the protocols are filed with each persons Medication Administration Record. The Manager told us of some recent initiatives being developed in the home to improve peoples lifestyles and activity choices. These include friendship groups where families get to know and support each other. Also Age UK (formerly Age Concern / Help the Aged) Good Neighbourhood Scheme was recently launched at the home by the Mayor. A gardening group is being set up, as well as a knitting circle. There are film nights planned and a summer garden party. The Manager said that staff seek to put on at least one activity each day, in consultation with the residents. We saw the activity planner which showed these have included exercise sessions (music and movement), bingo, word games (very popular), craft, local news, chat sessions, knitting, gardening, films music and cookery. Also Remember When (reminiscence), quizzes, singing and supping, music and poetry. and using the homes minibus to take people out. The home provides a relaxed environment for visitors, and we saw people come and go through the day. The Annual Quality Assurance Assessment (AQAA) shows that people are encouraged and supported to maintain the community links they had before coming to live at the Cedars, including local churches, WI and day centres. We saw people being asked about what they wanted to do, to take part in activities, and also saw that people made positive choices to go to their rooms and relax, watch TV or read. We recommend that opportunities for residents to do things on an individual basis are explored and developed further. We saw residents taking lunch, the main meal of the day. This was a three course cooked meal. The food was well presented: the dining room area is very nicely laid out and people can enjoy their meals in relaxed and comfortable surroundings. The home operates a four week rolling menu, drawn up in consultation with the residents. Feedback about the quality of food and mealtimes was very positive. One person wrote that The food is excellent. A relative commented the dining tables are always laid nicely . Another resident told us the food here is very good, I have things I like and the staff always serve it up nicely. As reported above, one resident now requires a gluten free diet. Staff are now exploring the best range of options available for meeting this need and providing enjoyable alternatives. We looked at the homes complaints records which provided evidence of an open complaints culture and an eagerness to encourage people to voice their opinions. Peoples concerns were appropriately recorded, with notes of the action subsequently taken. All of the people we spoke to said they knew how to raise concerns and who they would talk to. The Annual Quality Assurance Assessment (AQAA) shows that the home has not made any safeguarding referrals in the past 12 months. We have not received or made any referrals about this service during that time either. Training information shows all staff have done safeguarding training. Staff we spoke to were able to identify different forms that abuse can take, recognise potential indicators and say what they would do in the event of witnessing or suspecting abuse. Staff files provided evidence of robust recruitment procedures including checks with the Criminal Records Bureau. These things show the home takes positive action to ensure residents are protected and that their concerns are taken seriously and acted upon. Care Homes for Older People Page 5 of 11 We looked around the home in company of the Manager. We saw that peoples rooms are generally well furnished and decorated and individual in style representling the personality of the occupant. Personal possessions including pictures, ornaments and family photographs were in evidence. It is clear that there is a rolling programme of redecoration, maintenance and refurbishment. We saw that there are sufficient bathing and toilet facilities on all floors. The home includes a range of comfortably furnished shared spaces providing people with a number of options other than their rooms, and places to receive visitors. Staff work hard to keep the home clean fresh and tidy. There are attractive outside spaces available for people to enjoy when the weather permits. We saw that the laundry area was clean, tidy and well organised, with good infection control practices in place. We looked at staff records to see how recruitment and selection is managed. Files we looked at contained completed applications with full employment histories, written references and (as reported above) checks with the Criminal Records Bureau (CRB). This shows that the home takes positive action to ensure that people employed to work at the home are fit for their jobs. We looked at the staff training and development plan and saw that statutory training is generally up to date. Over half of the staff team hold qualifications at NVQ level 2 or above: it is recommended that action be taken to improve this further. We also noted that the plan shows that most people have done training in dementia care but only one person has received training in diabetes. We recommend that, as this is a condition common among elderly people, that all of the staff team should receive this training. The home has had a new registered manager since the last inspection. She is appropriately qualified to NVQ level 4 and has many years experience in the field. She is supported by the homes proprietor as well as the General Manager, both of whom live next to the Cedars. The General Manager is also qualified to NVQ level 4. Roles are clearly defined and understood, which contributes to a stong management team. Staff said that the style of management in the home is open and inclusive, and they feel comfortable raising any matters of concern. We saw that systems are in place for quality assurance and monitoring of the service, including seeking residents opinions directly. We recommend that information gathered in this process be collated and analysed, with a report produced of the findings. This should be shared with all interested parties, so that it can be clearly seen how peoples views have guided the review and development of the service. In replying to surveys we sent them, staff told us that they meet with their Manager regularly or often. The Manager told us that she is seeking to delegate some responsibility for supervision to senior staff, to ensure this takes place on a more frequent basis and provide a development opportunity for staff involved. We sample checked records relating to health and safety in the home and saw that essential maintenance and checks on equipment take place regularly, to ensure that people living and working at the home get the support they need to stay safe. What the care home does well: Care Homes for Older People Page 6 of 11 Information is available to help people decide if the service provides what they want. They have opportunities to try things out for themselves before making their minds up. Peoples needs are thoroughly assessed so that their care and support can be planned properly. People have care plans that are sufficiently detailed to ensure they get the support they need. Plans are reviewed regularly, so that important information is kept up to date. Risk assessments are in place to ensure they get the support they need to stay safe. Peoples personal and healthcare needs are generally well met. They get the support they need from staff and a range of other professionals to help them stay healthy and well. People are supported to do things they value and enjoy, and keep in touch with the people who are important to them. Mealtimes are relaxed and unhurried so that people can enjoy the good quality food that the home provides. Staff work hard to ensure that people enjoy the benefits of living in an environment that is comfortable, homely, safe and clean. The service provides sufficient staff to ensure that people get the support they need. Recruitment and selection procedures are robust, to ensure that people are fit for their jobs. Staff are generally well trained and supervised to ensure that they have the knowledge and skills and get the support they need to do their jobs well. The home has a strong management team. It is generally very well run, for the benefit of people using the service. Peoples opinions are actively sought, so they can be confident their views are listened to and taken seriously. Regular maintenance and checking of important equipment helps to ensure that people living and working at the home stay safe. People living in the home continue to enjoy excellent outcomes. 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 2. Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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, 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 7 Continue with care plan development, so that these become more person-centred. This will help to ensure people get the support they need in ways that suit them best. Review protocols for all PRN (as required) medication to ensure these are current and provide staff with clear guidance about the circumstances in which medicines should be given Develop opportunities for people to do activities on an individual basis, so they get the support they need to do things they value. Improve the numbers of staff holding qualifications at NVQ level 2 or above. This is to ensure that staff have all the knowledge and skills they need to do their jobs well. Provide training for all staff in diabetes care, to develop their knowledge of common conditions affecting elderly people. Collate and analyse information from quality assurance and monitoring activity. Produce a report of the findings and Page 9 of 11 2 9 3 12 4 28 5 30 6 33 Care Homes for Older People 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 make this available to all interested parties. This is to show how peoples views underpin the review and development of the service. Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 11 of 11 - 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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