We carried out a review of the data available to us about The Cedars on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Cedars, you can give feedback on this service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. 11 people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.
People were positive about the service. One person told us, “I am very happy here it took me a while to get used to the other people and sometimes they annoy me but you can’t get on with everyone. The staff are all great.”
We recommend the registered provider reviewed how they explore and record people’s preferences and choices in relation to end of life care.
People were supported to have their medicines correctly and staff had been trained. Medication audits were carried out. Systems and processes were in place to safeguard people from the risk of abuse. Staff knew how to prevent the spread of infection.
Assessments were in place which detailed people’s needs and choices. Staff had been trained and were given regular supervision. People were supported to eat and drink in line with their assessed needs. 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.
Care plans were individual and contained information about how people preferred to communicate and their ability to make decisions.
People were encouraged to take part in activities that they enjoyed, and were supported to keep in contact with family members. When needed, they were supported to see health professionals and referrals were put through to ensure they had the appropriate care and treatment.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Relatives and staff were complimentary about the management of the service. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.
The management team had systems in place to monitor the quality and safety of the service provided. Regular surveys were carried out with a range of people, relatives, staff and professionals. Information was used to make improvements to the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was Good (21 October 2016)
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information may inspect sooner.
The Cedars provides accommodation and personal care for up to 13 people who have mental health needs. The service does not provide nursing care. At the time of our inspection there were 12 people using the service.
There was a registered manager in post at the service. 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. The registered manager was supported to manage the service by regular input from the provider.
People were safe because the management team and staff understood their responsibilities identifying abuse. People received safe care that met their assessed needs.
People were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively.
There were sufficient staff who had been recruited safely and who had the correct skills and knowledge to safely meet people’s needs.
The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.
People’s health and social needs were managed effectively with input from relevant health care professionals and people had sufficient food and drink that met their individual needs.
The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider was following the MCA code of practice.
The registered manager and the provider supported staff to provide care that was centred on the person and staff understood their responsibility to treat people as individuals.
People were treated with kindness and respect by staff who knew them well. Staff respected people’s choices and took their preferences into account when providing support. People were encouraged to enjoy pastimes and interests of their choice and accessed the community so that they were not socially isolated.
Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected.
There was an open culture and the management team encouraged and supported staff to provide care that was centred on the individual.
The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.
The provider had systems in place so that people could raise concerns and there were opportunities available for people or their representatives to give their feedback about the service.
The registered manager was visible and actively involved in supporting people and staff. Staff were positive about their roles and their views were valued by the manager and the provider.
People told us that they had been given the opportunity to visit the service prior to admission and their consent had been obtained before any care or treatment had been given.
We saw that staff were knowledgeable about the needs and preferences of the people who lived at the home and promoted people's independence and choices. We saw evidence from our observations and the records we looked at that people received the support they needed to maintain their independence.
There were policies and procedures, records and monitoring systems in place for the protection of people who used the service. Staff told us about the training they had received to enable them to carry out their roles in supporting people. We were also told by staff they felt supported by the manager.
We found that the provider had systems in place to monitor and respond to any complaints received about the home.
People told us that they were satisfied with the level of care and support they received at The Cedars. One person told us "I get looked after very well here."
People said they could choose whether or not to join in activities and could spend time alone in their room pursuing their own interests or going out if they preferred.
People told us when we visited that they liked the home and that they liked living there.
People also told us that they liked their rooms and found them comfortable and were happy at the home and liked the way it was presented.
One person explained to us they were involved in the choice of decoration for their room and had been able to bring personal possessions and photographs into the home.
People told us that they felt well looked after by the staff at The Cedars. One person we spoke with said "The staff are very good. They are friendly and I get on with them all."
People told us that they felt comfortable talking to the staff about any issues that they had and that the manager was also always available for them to talk to.
One person said, in relation to personal care, 'I can do most things myself but if I need help I can ask for it' and another person said 'I am away on holiday next week and chose where I wanted to go.'
People told us that they were satisfied with the level of care and support they received at The Cedars. One person with whom we spoke told us "The care is very good here and the staff are lovely."
One person with whom we spoke said "The staff are very good here. They are very friendly and I always get all the help I need."
Where people were unable to provide a verbal response or tell us their experiences, for example as a result of their limited verbal communication or poor cognitive ability, we noted their non verbal cues and these indicated that people were generally relaxed and comfortable and found their experience at the Cedars to be positive.