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Inspection Summary


Overall summary & rating

Good

Updated 15 June 2018

Cedar Grange is a care home which offers nursing care and support for up to 60 predominantly older people. At the time of the inspection there were 52 people living at the service. Some of these people were living with dementia. The service occupies a large purpose built detached house over two floors. The service is divided in to four separate units.

This unannounced comprehensive inspection took place on 22 May 2018. The last comprehensive inspection took place on the 14 and 17 March 2017 when the service was not meeting the legal requirements. The service was rated as Requires Improvement at that time. People's safety was not always protected. We identified issues in the recording and management of risks to some people. People who were vulnerable due to not being physically mobile, were not protected against the risk of other people entering their bedrooms and engaging in activities which were harmful. We took enforcement action against the service due to the concerns found at that inspection. We returned to carry out a focused inspection on 9 August 2017 to check on the action taken by the provider to meet the requirements of the regulations. At the focused inspection we found the service had made improvements and was no longer in breach of the regulations. However, the service rating of Requires Improvement was not changed at that inspection, as we required to see that changes were sustained over time. At this comprehensive inspection we found the service had sustained the changes made and had continued to make further improvements. The service is now rated as Good.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is required to have a registered manager and at the time of the 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 and associated Regulations about how the service is run.

We spent time in the communal areas of the service. Staff were kind and respectful in their approach. They knew people well and had an understanding of their needs and preferences. People were treated with kindness, compassion and respect. The service was comfortable and appeared clean with no odours. People’s bedrooms were personalised to reflect their individual tastes.

The premises were well maintained. The service was registered for dementia care. There was little pictorial signage at the service to support people who were living at the service with dementia, who may require additional support with recognising their surroundings. The décor of three of the units did not identify places easily for people. We have made a recommendation about this in the Effective section of the report.

The premises were regularly checked and maintained by the provider. Equipment and services used at Cedar Grange were regularly checked by competent people to ensure they were safe to use.

Care plans were well organised and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs were recorded. Daily notes were completed by staff. Risks in relation to people’s daily lives were identified, assessed and planned to minimise the risk of harm whilst helping people to be as independent as possible.

The service had identified the minimum number of staff required to meet people’s needs and these were being met. The service had a number of staff vacancies at the time of this inspection and these posts were being filled by agency staff. The service was facing challenges in recruiting new staff. We were told this was due to businesses in the local ar

Inspection areas

Safe

Good

Updated 15 June 2018

The service was safe. Staff knew how to recognise and report the signs of abuse. They knew the correct procedures to follow if they thought someone was being abused.

There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service. A high number of agency staff were being used to cover vacant posts. However, many of these staff were regularly used and were familiar with the service.

Care plans recorded risks that had been identified in relation to people�s care and these were appropriately managed.

People received their medicines as prescribed.

Effective

Good

Updated 15 June 2018

The service was effective. Staff were well trained and supported with regular supervision and appraisals.

People had access to a varied and nutritious diet.

The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. However, information in some care plans could mislead staff about which family members held power of attorney for particular areas.

Caring

Good

Updated 15 June 2018

The service was caring. People who used the service and relatives were positive about the service and the way staff treated the people they supported.

Staff were kind and compassionate and treated people with dignity and respect.

Staff respected people�s wishes and provided care and support in line with those wishes.

Responsive

Good

Updated 15 June 2018

The service was responsive. People received personalised care and support which was responsive to their changing needs. Care plans were well organised, up to date and relevant.

People were able to make choices and have control over the care and support they received.

People knew how to make a complaint and were confident if they raised any concerns these would be listened to.

People had access to activities.

Well-led

Good

Updated 15 June 2018

The service was well-led. There were clear lines of responsibility and accountability at the service. Staff morale was good and staff felt well supported

There were systems in place to assess, monitor and improve the quality of the service provided

People were asked for their views on the service.