Cedar Lodge Nursing Home provides accommodation, nursing care and respite care for a maximum of 60 older people. The home was well maintained, bright, welcoming and had a pleasant, quiet atmosphere. The common rooms were well equipped with furniture; there was a piano and television.
Care and support are provided over two floors. Access to the first floor is by passenger lift or stairs. Modifications have been made to the home to meet the needs of people that live here. At the time of our visit 51 people lived here, some with living with dementia. People were free to access all areas of the home. The front door was locked and operated by a button release so that people were kept safe.
The inspection took place on 22 July 2015 and was unannounced.
Overall there was positive very feedback about the home and staff from the people and their relatives. However there was one particular area of concern they told us about - the quality and choice of the meals. This concern had been raised at previous residents' meetings and was commented on during the day by people and relatives. Their concerns were borne out by our observations and discussions on the day.
Everyone we spoke with praised the care and support they received from the staff and the registered manager. When asked if they would recommend the home one relative said, “I already have done so as my second relative is now here.” Another said, “Absolutely."
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.
Where people did not have the capacity to understand or consent to a decision the provider had not always followed the requirements of the Mental Capacity Act (2005). Decisions had been made for people without an appropriate assessment and review being completed. People told us that staff did ask their permission before they provided care. One person said that "They ask us and involve us, they don't just take over".
Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards to ensure the person’s rights were protected.
People told us that the quality of the food was variable and could be improved. The menu had little variation and was repeated on a four week cycle. Very little fresh produce was used, and people did not have input in the menu planning. People had enough to eat and drink. The hydration of people was high on staff’s priority as they understood how this could affect people’s health.
People were safe at Cedar Lodge. Risks to people’s health and safety had been identified and managed by the staff.
Staff had a good knowledge of their responsibilities for keeping people safe from abuse. The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received training to support the individual needs of people in a safe way.
People received their medicines when they needed them, and staff managed the medicines in a safe way. Staff were trained in the safe administration of medicines, however they had not had competency checks in line with best practice.
Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. People told us that they had been included in the development of their care plans, and involved in reviews.
The staff were kind and caring and treated people with dignity and respect. One person said, “The girls are fabulous, they really are. I’m more than happy with everything.”
There were enough staff to meet the needs of the people that live here. People were very positive about the staffing levels and said they received support quickly when they needed it. One person said, “There’s always someone around if I need them.” A relative said, “Staffing levels are good, nothing is too much trouble for them.”
People were supported to maintain good health as they have access to relevant healthcare professionals when they needed them.
People had activities that met their needs. The home had a dedicated activities room so that those who did not want to take part were not disturbed. The equipment and environment was personalised to the people that used it. The staff knew the people they cared for as individuals.
People knew how to make a complaint. Feedback from people was that the registered manager and staff would do their best to put things right if they ever needed to complain.
People and staff had the opportunity to be involved in how the home was managed, and the management generally listened and acted on what was said. The registered manager carried out a number of audits to check that a good quality service was being provided.
We identified one breach of the regulations. You can see what action we told the provider to take at the back of the full version of this report.