Archived: The Cedars

The Cedars is a 30 bedded short term rehabilitation service. A range of services is offered, including support after surgery for fractures and support to increase independence and confidence in daily living skills. The aim is to help people with a safe return to their home. There were 29 people receiving rehabilitation and support at the service on the day of the inspection.

There was a registered manager in place. 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.

Although the service was clean and tidy, overall, we found the premises generally in need of an update. The décor was dated and there was limited specialist signage in place to support people who may have had issues with their memory or those who may be living with dementia.

People told us they felt safe and well cared for and staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe.

Accidents and incidents were recorded and monitored and risks had been assessed. Actions had been completed to reduce the likelihood of risks occurring.

People were cared for by staff that demonstrated knowledge of the different types of potential abuse to people and how to respond to actual or suspected abuse.

Medicines were safely managed and people received them as they were required. Temperature checks were required to ensure that medicines were suitably stored.

People told us their needs were met promptly and staff confirmed sufficient staff numbers enabled them to meet people’s needs and perform their roles effectively.

Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. We found the provider was complying with their legal requirements.

People were positive was about the food they received. People accessed other healthcare professionals such as GP’s, occupational therapists and physiotherapists to aid their rehabilitation.

People using the service were positive in their feedback about the service. People were involved in making decisions about their care and treatment and said their privacy and dignity was maintained. We made observations which supported this.

People received care which met their individual needs. They were encouraged to express their views and give feedback about their time at the service. People said staff listened to them and they felt confident they could raise any issues should the need arise.

Staff spoke highly of the management team and felt supported. Staff and external health professionals told us the culture of the service was positive and spoke well of the teamwork within the service. The quality of service provision and care was continually monitored and actions taken where required.

We considered all the evidence we had gathered under the regulations we inspected. We used the information to answer the five 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 a summary of what we have found.

Is the service safe?

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We saw people were safe and protected from abuse. Staff demonstrated to us an understanding of the types of abuse and how they should be reported. All staff had received training in the safeguarding of vulnerable adults and whistleblowing.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw policies and procedures were in place and the manager and deputy manager had received training in the Mental Capacity Act 2005 (MCA) and DoLS.

We saw there were sufficient members of suitably qualified and experienced staff on duty to meet people's needs.

Is the service effective?

People who used the service were asked about the support they received and if they understood their rights. People we spoke to were aware of their rights and what to do if there were any problems.

Is the service caring?

People were treated with respect and dignity.

People had care plans in place to provide staff with the correct guidance on how to meet people's needs.

People's preferences, interests and needs were recorded in people's care records. Staff were able to give examples of these when we spoke to them and displayed a good knowledge of the people staying at the home and what their likes or dislikes were.

Is the service responsive?

There was an effective system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.

We saw evidence that care staff identified changes in people's needs and acted to make sure they received the care they needed. For example, there was evidence that where one person's health had declined an immediate referral was made to the correct medical professional for advice and support.

Is the service well led?

The staff we spoke with were aware of the complaints, safeguarding and whistle blowing procedures. Staff told us they would immediately report any concerns they had about poor practice and were confident these would be addressed.

There was a manager in post at the service who was registered with the Commission in line with legal requirements.

The service had a quality assurance system in place that included the use of surveys from people who used the service.

We found that people were provided with a choice of suitable and nutritious food to meet their individual needs. People said, "I'm very pleased with the food" and "I've enjoyed it, I couldn't eat any more."

Appropriate measures were in place to ensure the premises were well maintained throughout to provide people with a suitable place to stay.

There were enough staff on duty who were qualified and competent to meet the needs of the people who used the service.

The service had an appropriate procedure in place to deal with complaints and people were provided with information about how to make a complaint if they needed to.

We spoke with nine people at The Cedars. They told us they were able to express their views freely and were involved in making decisions about their care. They said their consent was sought before they received care or treatment. One person said, 'They check if I'm happy with male staff to attend.' Another noted 'They don't step in if they're not needed, but if needed help is given.' Staff documented people's choices, preferences and decisions when they had sought consent. This included consent with medicines.

We found people received the care they needed. People made positive comments about the care received. One comment was, 'I'm much impressed with the care, the food too is excellent and plenty of it.' Another person said, 'Very happy, the staff, the food, I'd like to stay.' We observed people being cared for with dignity and respect. Staff promoted people's independence. The atmosphere in the service was calm and relaxed.

We saw staff provided help with medicines in a safe way, with clear records kept.

People told us they were happy with the staff who worked with them. One person told us, 'The staff are marvellous.' Another person commented about the staff, 'Not discourteous, very good, very helpful.'