This inspection took place on 31 August and 1 September 2016 and was unannounced. Cedar Lawn Nursing Home is an older style property which has been adapted to provide accommodation for up to 30 older people who require nursing care. The home is set over three floors with the accommodation being situated on the ground and first floors which are accessed by a lift or by stairs. Three of the rooms are for double occupancy. At the time of our inspection there were 28 people living at the home. The home does not provide specialist support for people living with dementia or those who might display behaviour which might challenge others. The service has a selection of communal sitting areas, a dining room and conservatory and a garden with outdoor seating areas. There is parking to the rear.
The manager was not currently registered with the Care Quality Commission. 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. The manager had submitted an application to register and this was currently being assessed.
Medicines were not always administered as prescribed and care plans or information within the care plans about medicines was not always complete, current or followed by staff.
Improvements were needed to ensure that there were at all times sufficient numbers of staff deployed to meet people’s needs in a responsive manner.
Recruitment practices were safe and relevant checks had been completed before staff worked unsupervised.
Staff had a good understanding of risks to people’s health and wellbeing and measures were in place to protect people from risks associated with the environment.
Staff understood the signs of abuse and neglect. They were aware of what to do if they suspected abuse was taking place.
Staff felt well supported and received an induction and on-going training which helped to perform their role effectively.
Where people lacked the mental capacity to make decisions staff had undertaken mental capacity assessments and care plans had been agreed which described the support that was to be provided in the person’s best interests.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations had been applied for or were in place.
People received a choice of meals and were supported appropriately to eat and drink.
People were supported to access healthcare services when needed.
People told us they were cared for by kind and caring staff. Staff respected people’s choices, their privacy and dignity and encouraged them to retain their independence.
Care plans were developed that provided guidance about how each person would like to receive their care and support and about their individual needs and risks.
Staff recognised and responded to changes in people’s health care needs.
A range of activities was provided which people enjoyed.
People and their relatives were able to express their views and give feedback about the service. Their views were listened to and acted upon. .
Complaints policies and procedures were in place and displayed within the home and within the information pack given to new people when they arrived.
People, their relatives and staff spoke positively about the manager and their leadership of the home. Staff told us that the service was a good place to work and that they enjoyed their job.
Systems were in place to monitor the quality and safety of the service.
Staff worked and interacted with people and visitors in a manner that was in keeping with the organisation values, aims and objectives.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.