Cedarwood Care Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Requires Improvement]. At this assessment the rating has changed to Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People's needs were assessed before and during their time at the service to help ensure care and support reflected their individual requirements, preferences and circumstances. People had detailed, person-centred support plans which described the support they required from staff and how they preferred this support to be provided. Care plans reflected people's physical health, mental health, emotional wellbeing and social needs, helping staff to deliver consistent and personalised care.

Assessments were completed by experienced senior staff and team leaders and were reviewed regularly to ensure they remained accurate and relevant. Most people and relatives told us they had been involved in the assessment process and felt their views, preferences and wishes had been considered when planning care and support.

Systems were in place to ensure changes in people's needs were identified and responded to promptly. We saw examples where people had returned from hospital and care plans and risk assessments had been reviewed and updated to reflect their changing needs. The electronic care planning system generated alerts to inform staff of significant changes, helping to ensure important information was communicated consistently across the staff team.

People had access to specialist advice and support when required. Records showed timely referrals had been made to healthcare professionals, including tissue viability nurses, physiotherapists and memory services. Staff used this information to adapt care and support and respond to people's changing needs.

The provider utilised a range of recognised assessment tools to monitor people's health and wellbeing, including assessments relating to nutrition, hydration, pressure care and risk. We saw where changes had been identified through these assessments, prompt action had been taken to minimise risks and obtain appropriate professional input.

Care plans also reflected important aspects of people's lives and individual circumstances. For example, where a person received support from a companion, records detailed the role they played in the person's wellbeing and included contingency plans should they be unable to visit. This demonstrated consideration of people's wider support networks and the impact these relationships had on their care and wellbeing.

Staff told us they had sufficient information available to support people safely when they arrived at the service. They explained that opportunities were provided to raise queries or identify gaps in information and that management responded by updating records where necessary.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People received care and treatment that was based on assessed need, current best practice and professional guidance. Staff had access to detailed care plans and risk assessments which provided clear information about how people should be supported. Care records reflected people's physical, emotional and social needs and incorporated advice from healthcare professionals where required.

The provider used recognised assessment tools to monitor people's health and wellbeing, including tools to assess nutritional needs and the risk of pressure damage. Records demonstrated that where changes in people's wellbeing were identified, prompt action was taken to review care and seek appropriate professional input.

Systems were in place to ensure staff were informed of changes in people's needs. For example, where people returned from hospital or experienced a change in their health, care plans and risk assessments were reviewed and updated. The electronic care planning system generated alerts to notify staff of significant changes, helping to ensure people received consistent care and treatment.

Staff told us they had access to the information they required to support people effectively and felt involved in reviewing care documentation where changes were identified.

Staff demonstrated a good understanding of people's individual needs and how care should be adapted to reflect changing circumstances.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People experienced coordinated care because staff worked effectively with one another and with external professionals involved in their care. Systems were in place to promote effective communication and ensure important information about people's needs was shared appropriately.

The service used an electronic care planning system to communicate changes in people's needs and support requirements. Where changes occurred, information was shared with staff through updates to care records and electronic notifications. This helped staff remain informed and supported continuity of care.

Daily handovers and regular team meetings provided opportunities for staff to discuss people's wellbeing, changes in needs and any actions required. Staff told us communication within the service was effective and they felt they had access to the information they needed to provide consistent support.

The service worked collaboratively with a range of external health and social care professionals to help ensure people's needs were met. Feedback from professionals was positive regarding communication and partnership working. One professional told us, "The staff are very good here and know people well. They always let us know if there is a problem."

Information was available to support continuity of care when people accessed other services. For example, people had hospital passports containing important information about their health and support needs, helping to ensure relevant information could be shared when required.

The registered manager described challenges in securing a more appropriate placement for 1 person whose needs had changed. The service continued to work with partner agencies and support the person whilst alternative arrangements were explored, helping to maintain continuity of care during the transition.

The provider supported people to achieve good health and wellbeing, taking account of their individual needs, preferences and capacity. Staff enabled people to make choices and be involved in decisions about their care wherever possible, supporting positive outcomes.

People were supported to maintain their health and wellbeing by staff who knew them well and understood their individual healthcare needs. Staff were able to describe people's health conditions and understood how to recognise changes in their wellbeing, helping to ensure appropriate action could be taken when required.

People's health and wellbeing were monitored and reviewed, and records showed action was taken when concerns were identified. People had access to healthcare support when required, which helped them to maintain their health and achieve positive outcomes.

We saw evidence of positive outcomes for people living at the service. One person's health and wellbeing had improved significantly since moving into the home and plans were being considered to support them to return to independent living. This demonstrated how the support provided had enabled the person to regain skills and independence.

Another person told us they had recently been supported to move to a ground floor bedroom to better meet their needs. They said, “This has made me happy as I see more people and can be a little more independent with my care." This demonstrated how the provider had taken a proactive decision which had better outcomes for the person.

People and relatives were generally positive about the support provided. One person told us, “I have gained weight since I have been here. They cannot do enough for me." This demonstrated how staff supported people to maintain their wellbeing and achieve positive outcomes.

However, during our observation of a mealtime, we saw a person who required monitoring of their food and fluid intake had not eaten their meal. Staff removed the meal without encouraging the person to eat or exploring whether an alternative option would be preferred. We discussed this with the registered manager was receptive to this feedback and took action to review practices and strengthen oversight of people's nutritional support needs.

We saw that the service regularly monitored people’s weight and took appropriate action where there was a concern.

Healthcare professionals spoke positively about the service and the support provided to people. Feedback indicated staff knew people well and responded appropriately when concerns relating to people's health and wellbeing were identified.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People experienced positive outcomes because staff understood their individual goals, preferences and aspirations and adapted support when required to help them achieve these. We saw examples where people's independence and wellbeing had improved since moving into the service including a person who was looking to move to a more independent living and another who told us since moving to the service and with the encouragement from the staff, their mental wellbeing had improved so much they felt able to make friendships with people and take part in activities.

People were supported to maintain their health through access to routine healthcare services, including dental and optical care, health checks and medication reviews. The service also facilitated weekly GP visits, helping to ensure non-urgent health concerns were identified and addressed promptly.

We identified opportunities to further develop assessments of the environment for people living with dementia, particularly in relation to the mealtime experience. Consideration of how the dining environment supported people to understand mealtimes and engage with food and drink could help further improve outcomes and experiences for people living with cognitive impairment.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were supported to make decisions about their care and treatment, and staff respected the choices they made.

Throughout our assessment we observed staff seeking people's consent before providing support. Staff explained what they were doing and provided people with opportunities to make decisions about their care, helping to promote choice, control and independence.

We observed positive interactions between people and staff. Staff communicated in a respectful manner and adapted their approach to meet people's individual communication needs. This helped people understand the support being offered and enabled them to make informed decisions wherever possible.

People were consistently given opportunities to consent to care and treatment. Where people initially declined support, staff respected their decision and returned later to offer support again. Records showed refusals of care and treatment were documented appropriately, enabling the management team to maintain oversight and identify any emerging concerns or patterns.

For people who were not always able to communicate verbally, care plans provided guidance on how they expressed consent and communicated their wishes. Staff demonstrated an understanding of people's individual communication methods and used these to involve people in decisions about their care and treatment wherever possible.

People and relatives told us they were involved in decisions about care and treatment and felt their views and preferences were respected by staff.