We carried out a review of the data available to us about Cedar Court Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cedar Court Nursing Home, you can give feedback on this service.
Cedar Court Nursing Home is a care home providing personal and nursing care to 25 people aged 65 and over at the time of the inspection. The service can support up to 25 people in 1 adapted building. The service provides support to older people, people with dementia and people with an eating disorder.
People’s experience of using this service and what we found
New staff to the service had a series of checks carried out on them during their recruitment to try to ensure they were suitable to be working at the service. Enough skilled and suitable staff had been safely recruited. Staff had received the required training, competency checks, supervisions and appraisals. Ongoing support was given to help staff maintain and improve their skills to fulfil their role and responsibilities.
Staff used their training and knowledge to safeguard people wherever possible and support people to keep them safe. If staff had any concerns about people, they knew where to report this both inside and outside of the service. People received their medicines as prescribed and staff ensured they followed infection prevention guidance and good practice. Staff encouraged people to eat healthily and drink enough. They supported people’s individual dietary requirements and choices. Staff listened to and respected people’s choices. Communication was good.
Staff knew people’s individual needs, wishes and preferences well. They also knew people’s assessed risks and these risks were monitored by staff. Staff were responsive to people’s changing care and support needs. Care plans were reviewed and updated when changes occurred.
The building had been adapted to meet people’s needs. The building was also undergoing refurbishment and a lot of this work had been completed. People’s rooms were personalised and signage to help people orientate themselves around the building was in place.
The governance systems in place monitored the service provided and was effective in identifying and driving improvements. The registered manager and the staff team took on board learning when incidents happened. The registered manager and staff team worked well with other organisations, health and social care professionals to provide people with joined up care. The registered manager was aware of all the incidents they were legally obliged to notify the CQC of.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 09 February 2018).
Why we inspected
The inspection was prompted in part due to concerns received that included concerns about staffing levels, staff recruitment, staff training, incident reporting and governance, lack of choice around food, personal care concerns around a lack of hot water and maintenance and lack of bedding/ towels. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well-led sections of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cedar Court Nursing Home on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Cedar Court Nursing Home is a care home providing personal and nursing care to 25 people aged 65 and over at the time of the inspection. The service can support up to 25 people.
People’s experience of using this service and what we found
People were happy with the care home and the staff that provided their care.
People felt safe living at the home and staff knew how to report possible harm. Staff assessed and reduced risks as much as possible, equipment was in place to help people remain as independent as possible and this was stored appropriately. Kitchen staff received the training needed to enable them to reduce risks to people. Staff used protective equipment, such as masks, gloves and aprons, the service was clean and measures had been taken to reduce the risk of transmission of infection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 9 February 2018).
Why we inspected
We undertook this targeted inspection to check on a specific concern we had about falls, fire safety, training for kitchen staff and access to dining and lounge tables and seating. The overall rating for the service has not changed following this targeted inspection and remains Good.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
The service had donning and doffing stations, one of these was separate from the main building and allowed staff and visitors to put on and take off personal protective equipment (PPE). This ensured staff had a place to change into their uniforms and PPE. There was a designated entrance that contained a screened off area for visitors to meet with their families. Visitors and staff were required to have their temperature checked and wash their hands.
All staff wore a face mask and a face visor as part of their PPE. The provider felt this was a safer way to prevent the spread of infection as this created a double barrier. This was to protect both staff and people who lived at the service. At the time of our inspection no service users had tested positive for COVID-19.
Two staff had tested positive on a Lateral Flow Test (LFT). They were then required to complete a polymerase chain reaction (PCR) test. This is a more accurate test that confirmed a negative result. The provider requested both staff to isolated for 14 Days to ensure there was no risk of spreading infection.
The building looked clean and free from clutter. Appropriate cleaning products were used, to ensure good infection control was maintained. All high touch points were cleaned regularly. For example, door handles. The registered manager ensured regular infection control audit checks were completed, this included staff practice and use of PPE.
The registered manager told us that they were working collaboratively with colleagues from the Local Authority and CCG (Clinical Commissioning Group) and received good support and advice. They were part of the Peterborough and Cambridgeshire care association; this is where providers supported each other and shared best practices.
Cedar Court Nursing Home accommodates 25 people in one adapted building. At the time of our unannounced inspection there were 17 older people, some of whom were living with dementia, living at the service.
This inspection took place on the 16 January 2018 and was unannounced. At the last comprehensive inspection on 13 January 2017 we rated the service as requires improvement. At this inspection the necessary improvements had been made and we rated the service as good.
Why the service is rated good.
The Care Quality Commission (CQC) records showed that the service had a registered manager. 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.
Staff had an understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff knew how to report any suspicions of harm and poor care practice. Information and guidance about how to report concerns, together with relevant contact telephone numbers were available as a prompt for staff to refer to.
People were assisted to take their medication as prescribed. Processes were in place and followed by staff members to ensure that infection prevention and control was promoted and the risk of cross contamination was reduced as far as possible.
There were building adaptations in place to help people with limited mobility. This meant that people could access all of the services internal areas and the garden.
Staff assisted people in a caring, patient and respectful way. People’s privacy and dignity was maintained and promoted by the staff members supporting them.
People and their relatives were given the opportunity to be involved in the setting up and review of their individual support and care plans. Staff encouraged people to take part in activities and maintain links with the local community to promote social inclusion. People’s friends and family were encouraged by staff to visit the service and were made to feel welcome.
People were supported by staff to have enough to eat and drink. People were assisted to access a range of external health care professionals and were supported by staff to maintain their health and well-being.
People were supported by staff and external health care professionals, when required, at the end of their life, to have a comfortable and as dignified a death as possible.
People had individualised care and support plans in place which documented their needs. These plans informed and prompted staff on how a person would like their care and support to be given, in line with external health care professional guidance.
Individual risks to people were identified and monitored by staff. Plans were put into place to minimise people’s risks as far as possible to allow them to live as safe and independent a life as practicable.
The registered manager had a recruitment process in place and staff were only employed within the service after all essential safety checks had been suitably completed. Staff were trained to be able to provide care which met people’s individual needs. The standard of staff members’ work performance was reviewed by the registered manager through supervisions and appraisals. This meant that the staff felt supported to carry out their role.
Compliments about the care and support provided had been received and the positive feedback shared with staff. Complaints were investigated and action taken to make any necessary improvements and to resolve to the complainants satisfaction wherever possible.
The registered manager sought feedback about the quality of the service provided from people, their relatives, visiting health and social care professionals, and staff. There was an on-going quality monitoring process in place to identify areas of improvement needed within the service.
Records showed that the CQC was informed of incidents that the provider was legally obliged to notify us of.
Further information is in the detailed findings below.
This inspection was unannounced and took place on 13 January 2017. The previous inspection took place on 17 June 2015 and overall was rated as good. However, we had received concerning information about the care that was being provided to the people living at Cedar Court Nursing Home and as a result of this we brought the date of this inspection forward.
The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Staff had received training and had an understanding to ensure that where people lacked the capacity to make decisions they were supported to make decisions that were in their best interests. People were only deprived of their liberty when this was lawful.
People’s dignity was not always respected. People privacy was protected and staff sought, and obtained, permission before entering people’s rooms to provide personal care.
The provider had a recruitment process in place and staff were only employed within the home after all essential safety checks had been satisfactorily completed.
Staffing numbers were adequate to ensure people’s care needs were met. However staff were task led and had little time for social interaction.
Care plans provided detailed information on how people’s care needs need to be met and had been reviewed on a regular basis. Wherever possible people or their families were involved in the planning of the care people received.
People’s health, care and nutritional needs were met. People were provided with a varied, balanced diet and staff were aware of people’s dietary needs. Staff referred people appropriately to healthcare professionals when this was needed. People received their prescribed medicines and medicines were stored in a safe way.
The provider had an effective complaints process in place which was accessible to people, relatives and others who used or visited the service.
Cedar Court Nursing Home is registered to provide accommodation and nursing care for up to 25 older people There were various communal rooms for people to use. The home is a single storey building. There were 23 people living at the home at the time of our inspection.
This unannounced inspection took place on 17 June 2015. At our previous inspection on 28 April 2014 we found the provider was not meeting all the regulations that we looked at. We found concerns in relation to care and welfare of people. The provider sent us an action plan detailing when the improvements would be made by. During this inspection we found that improvements had been made.
At the time of this inspection the home did not have a registered manager. 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 and associated Regulations about how the service is run.
We found that staff treated people in a way that they liked and that there were sufficient numbers of staff to safely meet people’s needs. People received care which had maintained their health and well-being. Relatives were very happy with the care provided.
Medicines were stored correctly and records showed that people had received their medicines as prescribed. Staff had received appropriate training for their role in medicine management.
Staff supported each person according to their needs. This included people at risk of malnutrition or dehydration who were being supported to receive sufficient quantities to eat and drink.
Staff respected people’s privacy and dignity. They knocked on people’s bedroom doors and waited for a response before entering. People told us that staff ensured doors were shut when they were assisting them with their personal care.
People’s needs were clearly recorded in their plans of care so that staff had the information they needed to provide care in a consistent way. Care plans were regularly reviewed to ensure they accurately reflected people’s current needs.
People confirmed they were offered a variety of hobbies and interests to take part in and people were able to change their minds if they did not wish to take part in these.
People’s views were sought and used to improve the lives of people. Quality assurance systems were in place to monitor the home although these were not all effective. The management were unable to provide evidence of all documents requested during this inspection. We asked for these to be sent to us but we have not received them.
We considered out inspection findings to answer questions we always ask; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
This is the summary of what we found:-
Is the service safe?
We found that staff had received appropriate training to carry out their roles. Staff we spoke with understood their responsibilities in reporting any concerns in regards to safeguarding vulnerable adults. We saw that people's moving and handling hoists and fire equipment had been serviced regularly to ensure peoples safety.
Is the service effective?
People had their health monitored and saw a range of health care professionals to maintain their wellbeing. Staff were well supported and had the required training to do their jobs well. Staff were knowledgeable about people's care and support requirements. Not all the care records reflected people's current needs and this could put people at risk of not receiving the appropriate care with their identified needs.
Is the service caring?
We spoke with ten people who use the service and four visitors and most were complimentary about the staff and felt they or their relatives were well cared for. We saw that people were given time to perform differing tasks which allowed them to be as independent as possible.
Is the service responsive?
People's needs were assessed but not all care records had been updated to reflect their current needs. People were given the opportunities to join in activities and visitors were able to visit the home at any time. People and their families were given the opportunities to express their views about the running of the home through relative meetings.
Is the service well led?
The manager has been in post since August 2013 and has recently applied to register with the Care Quality Commission. Quality assurance systems were being further developed to ensure that all aspects of the service were monitored and improvements made where necessary.
We spoke with three people who used the service and with two relatives. They gave us positive feedback about the service. A person said, 'The staff are very kind to me and they help me a lot.'
People had safely received all of the nursing and personal care they needed.
There were effective infection control arrangements to ensure that good standards of cleanliness and hygiene were maintained.
There were reliable arrangements for managing medication so that people reliably received all of the medicines that had been prescribed for them.
There were enough qualified, skilled and experienced staff to enable people's needs for care to be met. This included staff receiving the training they needed to care for people in a safe way.
Records showed that the provider operated a robust recruitment and selection procedure.
We found there were enough qualified, skilled and experienced staff to enable people's needs for care to be met. A person said, "I like seeing the staff around because I do need help and they check on me at night too."
Records showed that the provider operated a robust recruitment and selection procedure. This included completing security checks on new staff to help ensure that they were suitable to care for vulnerable people.
Having enough staff on duty and making sure that they were trustworthy supported the provider's ability to safely care for people.
Documents and records gave a clear and up to date account of the care provided for each person. We saw that safe, reliable and responsive support had been provided to ensure that people ate and drank enough. We also noted that people had been helped to keep their skin healthy by reducing the pressure and friction that can cause ulcers.
We found that care and ancillary staff had the necessary knowledge and skills to provide people with the care they needed. However, records showed that they had not received all of the training which the provider considered to be necessary.
People had access to advice and treatment of health care professionals, such as dieticians and district nurses.
The service provided a four week rotating menu cycle, which included an alternative meal option. All main and alternative meals included a source of protein, which ensured all meals were nutritionally balanced. A mix of fresh and frozen vegetables was available, as was fresh fruit.
We found that people who needed help to eat and drink were provided with this help. They were helped to sit in appropriate positions and support from aids was provided for people who needed help to eat independently.
Drinks were offered at the lunch time meal and a further three times before the next meal. Water jugs were available in people's rooms and one person confirmed that staff members would be around to refill their glass when they had time.
Not all records about people were written as quickly as they should have been and some had only started to be kept after concerns had been identified. For example, when pressure relieving mattresses were found to be too hard for the person using them.
People said that they were well cared for and were able to decide how to spend their time. Visitors we spoke with also commented that they were happy with the care their relatives received. Staff members spent time with people who could not easily communicate and encouraged them to be involved in their surroundings. They communicated well with people and supported people who were anxious.
People confirmed they would be able to make a complaint if they were not happy with anything, but that they could not think they would ever have to do this. People's relatives also felt they could raise any concerns and have them dealt with.