17 October 2019
During a routine inspection
Cedar House is a care home providing accommodation and personal care for up to 29 adults in one adapted property. At the time of the inspection, there were 18 people living at the service and two further people, registered at the service, but receiving care in hospital. People using the service were older people with varying needs.
People’s experience of using this service and what we found
People told us they felt safe and were happy living at Cedar House. However, we found processes were not consistent to ensure the effective management of some medicines and some records.
An incompatibility between a pressure mat and the alarm call system meant the system could not be used to alert staff of the risk of a person falling when they mobilised independently.
Although the shortfalls we found were addressed during our inspection, audits and quality assurance processes had not identified or acted on these issues as was their intended purpose. This was because monitoring procedures were not always effective to allow enough management oversight, which could compromise the quality and safety of the service people received.
Individual risk assessments provided the detail needed to keep people safe. People and their relatives told us they felt safe and staff knew how to keep them safe. There were enough staff to provide the support and flexibility people needed. Only suitable staff had been employed to support them, the provider had used robust recruitment practices.
The registered manager and the staff understood their responsibility about safeguarding people from abuse, staff had been appropriately trained and knew how to recognise and raise safeguarding concerns.
People were met with before they moved into the service to complete an initial assessment. This enabled the provider to make sure staff had the skills to provide people’s support. Staff received the training, support and supervision they needed to carry out their role and achieve personal development goals. People received a balanced diet.
People’s support was individual, planned and provided in a way that they preferred. People were encouraged to take part in activities they enjoyed. Staff knew people well, their likes, dislikes and what and who was important to them.
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; the policies and systems in the service supported this practice.
When people were unwell or needed extra support, they were referred to health care professionals and other external agencies. People’s end of life wishes were recorded and people were supported at the end of their lives to be comfortable and pain free.
People knew how to complain or make comments and suggestions. People were asked their views about the service at meetings and by completing surveys, suggestions had been acted upon.
There was an open culture, led by the registered manager and provider. People, relatives and staff described them as approachable and supportive. People knew the provider well and were relaxed and enjoyed their company. The provider had oversight of the service, often visiting daily.
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 24 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach in relation to quality monitoring at this inspection. However, we found no evidence during this inspection that people were at risk of harm from this concern.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.