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Inspection Summary


Overall summary & rating

Good

Updated 14 April 2018

Cedar House is registered to provide two regulated activities; accommodation for persons who require nursing or personal care and personal care. The service has a care home and also provides a domiciliary care service to people living in supported living schemes.

The care home was last inspected in December 2015; however, this was the first comprehensive inspection of the domiciliary care service.

We have written our report under the headings Care Home and Domiciliary Care Service to ensure that our specific findings for both services are clear.

Care Home

This inspection took place on 22 and 23 February 2018 and was unannounced.

Cedar House is a residential care home for six people with enduring mental health conditions, learning disabilities and complex healthcare needs. On the day of our inspection there were five people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People told us that they felt safe living at Cedar House. Care staff demonstrated a clear understanding of what it meant to protect people and the steps they would take to keep people safe and free from harm.

Risk assessments identified people’s individual risks and provided detailed guidance for care staff on how to mitigate or minimise risk in order to keep people safe.

The provider followed robust recruitment processes to ensure that only care staff assessed as safe to work with vulnerable people were employed.

People received their medicines safely, on time and as prescribed. The provider had systems in place to ensure the safe management of medicines.

Accidents and incidents were recorded, monitored and analysed in order to support further learning and improvement.

Care staff received regular support and development through training supervision and annual appraisals in order to effectively carry out their role.

At the last inspection we found that some people using the service may have had their liberty restricted without the appropriate authorisations in place. At this inspection we found that this had been addressed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We observed kind and caring interactions between people and care staff, where people had built positive relationships with the care staff that supported them.

People and relatives knew who to speak with if they had a complaint or concern and were confident that their concerns would be dealt with appropriately.

Care plans were detailed and person centred and provided clear information about the person, their likes, dislikes, choices and preferences on how they wished to be supported.

Appropriate management oversight systems in place ensured that there was continuous monitoring of the care and support people received. Where issues or gaps were identified processes in place supported learning and improvement to allow the delivery of high quality care.

Further information is in the detailed findings below

Domiciliary Care Service

This inspection took place on 22 and 23 February 2018 and was unannounced.

This is the first comprehensive inspection of this service. Cedar House provides the regulated activity of personal care. This service provides care and support to people living in a number of ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used f

Inspection areas

Safe

Good

Updated 14 April 2018

Care Home

The service remains Good.

Domiciliary Care Service

The service was safe. Safeguarding policies in place were clearly understood by care staff and care staff knew what to do to address suspected abuse.

Risk assessments in place provided detailed information and guidance to care staff on how to mitigate or reduce risks in order to keep people safe and free from harm.

People received their medicines safely and as prescribed. Robust systems and processes in place supported the safe management of medicines.

Sufficient numbers of staff were observed throughout the inspection. Safe recruitment processes had been followed in order to ensure appropriate recruitment of staff.

Accidents and incidents were recorded, monitored and analysed to support further learning and improvement to service provision.

Effective

Good

Updated 14 April 2018

Care Home

The service was effective. Where people using the service may have had their liberty restricted, appropriate authorisations were in place in order to ensure people were supported in line with current legislation.

Domiciliary Care Service

The service was effective. People�s care and support needs were comprehensively assessed so that a package of care was developed which met people�s identified needs effectively.

Care staff received regular support and guidance through training, supervision and annual appraisals.

Care staff understood the key principles of the MCA 2005 and were able to explain how the principles were applied when delivering care and support.

People were supported with their nutritional and hydration needs in a way which maintained a healthy and balanced diet.

People were supported with their healthcare needs where required. Referrals were made to appropriate healthcare professionals where a specific need was identified.

Caring

Good

Updated 14 April 2018

Care Home

The service remains Good.

Domiciliary Care Service

The service was caring. We observed kind and caring interactions between people and care staff. We observed that people had established positive relationships with care staff that were based on mutual trust and respect.

People were always involved in every aspect of their care, support and treatment. People�s choice, likes, dislikes and preferences had been recorded and was always integral to the delivery of care.

People and relatives told us that their privacy and dignity was always respected and that they were supported to be independent as far as practicably possible.

Responsive

Good

Updated 14 April 2018

Care Home

The service remains Good.

Domiciliary Care Service

The service was responsive. Care plans were detailed and person centred and provided clear information and guidance which was responsive to the person�s needs.

People and relatives confirmed that they knew who to speak with if they had a complaint or concern and were confident that any concerns would be dealt with promptly and appropriately.

Well-led

Good

Updated 14 April 2018

Care Home

The service remains Good.

Domiciliary Care Service

The service was well-led. People and relatives knew the management team well and told us that they were always approachable.

A number of systems and processes were in place to allow the service to monitor and oversee the quality of care being delivered. This allowed for learning, development and improvement to take place.

People, relatives and various other stakeholders were asked to give feedback, comments, ideas and suggestions on the quality of care and where improvements could be made.

The service worked in partnership with a variety of external agencies including day centres, leisure centres and advocacy services so that people had access to a variety of wider social care services.