Cedar Lodge Nursing Home

Updated 3 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 7 June 2018 and was unannounced.

The inspection was carried out by three inspectors, a specialist advisor in nursing care and one expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we gathered information about the service by contacting the local and placing authorities. In addition, we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was reviewed to see if we would need to focus on any particular areas at the service.

As part of our inspection we spoke with eight people living at the home and two relatives. We spoke with seven staff members and the registered manager. We also spoke with two visiting healthcare professionals. We looked at the care plans for ten people, medicines records, accidents and incidents, complaints and safeguarding. We looked at mental capacity assessments and applications to deprive people of their liberty. We reviewed audits, surveys and looked at evidence of activities taking place at the home.

We looked at three staff recruitment files and records of staff training and supervision, appraisals, a selection of policies and procedures and health and safety audits. We also looked at minutes of staff meetings and evidence of partnership working.

Updated 3 August 2018

Cedar Lodge Nursing Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Cedar Lodge Nursing Home is registered to provide accommodation for up to 60 older people who require residential or nursing care. At the time of our inspection there were 52 people living at the home.

The inspection took place on 7 June 2018 and was unannounced.

The last inspection of Cedar Lodge Nursing Home was undertaken in November 2016 when the overall rating was Requires Improvement.

At the time of inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were safe living at Cedar Lodge Nursing Home because all staff looked after them well. People told us that the staff were very good and kind and they supported them when they needed it. Staff were knowledgeable about keeping people safe and the reporting procedures to follow if they had suspected or witnessed abuse. People were kept as safe as possible because potential risks had been identified and assessed to help maintain their independence. There were sufficient numbers of skilled staff and appropriate checks were carried out to help ensure only suitable staff were employed to work at the service. Safe procedures were followed to ensure that people were protected against the spread of infection. Medicines were safely stored and administered to people at the times as prescribed by their GPs.

People’s rights under the Mental Capacity Act 2005 were respected and staff followed the legal procedures when making decisions on behalf of people who lacked the mental capacity to do so for themselves. People’s needs and choices were assessed and care, treatment and support was delivered in line with people’s wishes. Staff had received training, supervision and appraisals that helped to ensure people received effective care from staff who had the skills, knowledge and understanding needed to carry out their roles. People’s nutritional needs and preferences were recorded in their care plans and the chef had regular discussions with them to ensure that meals provided were to their liking. People received support to keep them healthy. People lived in an environment that that was adapted to meet their needs. The environment had undergone a recent refurbishment and was brightly decorated.

People were treated with kindness and compassion in their day-to-day care by staff who were caring and respected their privacy and dignity. People were involved in making decisions about their care, support and treatment and their independence was encouraged by staff.

People received care that was personalised to their needs. Comprehensive care plans had been written and regularly reviewed with the involvement of people and their relatives that were responsive to their individual needs. Staff had got to know people well and were aware of people’s

needs. There was a varied programme of activities people could get involved in. Complaints and concerns were taken seriously and used as an opportunity to improve the service. End of life care was provided sensitively and in line with people’s needs and preferences.

Accidents and incidents were recorded and an analysis of why accidents or incidents had occurred or what action could be taken to prevent further accidents had been developed. The provider and staff undertook quality assurance audits to monitor the standard of service provided to people. An

action plan had been produced and followed for any issues identified. People, their relatives and other associated professionals had been asked for their views about the home through surveys and resident and relatives’ meetings. The provider and staff worked with other related agencies that ensured people received joined up care, treatment and support.