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Inspection carried out on 9 January 2020

During a routine inspection

About the service

Cedar House is a residential care home registered to provide personal care for up to five people with learning disabilities and on the autism spectrum. The home accommodates people in one adapted building. At the time of our inspection there were five people using the 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 and/or autism 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.

People’s experience of using this service and what we found

People felt safe living in the service and their belongings were protected. There were processes in place to ensure that staff knew how to protect people from abuse and where to escalate concerns if they needed to. There were systems in place to assess risks to people’s health and wellbeing which were individual to each person and staff were aware of how to keep people safe. .

Staff received training and development to be able to support people safely. Staff were supported to develop within the service and had been supported with additional training and qualifications. People were supported to maintain a balanced diet and received information about healthy eating choices. People were supported to maintain their health and wellbeing in line with recommended guidance.

Staff responded to people in a kind and caring manner and people were comfortable with staff. Staff knew people well and were able to communicate with people individually based on their abilities. People were involved in making decisions about their care. People had their privacy and dignity protected.

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. People were supported to access the community and maintain their hobbies and interests.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

We have made a recommendation about planning for end of life care.

People told us that they found the registered manager to be approachable. People said that they had their feedback listened to and felt involved in the service. There were systems in place which supported monitoring the quality of the service provided to drive improvement. The registered manager was actively involved in initiatives to improve the quality of care that people received.

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 16 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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 we may inspect sooner.

Inspection carried out on 6 April 2017

During a routine inspection

This inspection took place on the 6 April 2017 which was unannounced, the inspection team consisted of one inspector.

Cedar House is a residential care home registered to provide personal care for up to five people with learning disabilities and on the autism spectrum. At the time of our inspection there were five people using the service.

The service was safe. The service’s recruitment process ensured that appropriate checks were carried out before staff commenced employment. There were sufficient staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health. People’s medication was managed well and records of administration were kept up to date.

The service was effective. People were cared for and supported by staff who had received training to support people and to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. Records we viewed showed people and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints received in a timely manner.

The service was well-led. Staff and people spoke very highly of the registered manager and the provider who they informed to be very supportive and worked hard to provide an exceptional service. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Inspection carried out on 27 July 2015

During a routine inspection

This inspection took place on the 27 July 2015 and 28 July 2015 which was unannounced. The inspection team consisted of two inspectors on 27 July 2015 and one inspector on the 28 July 2015.

Cedar House is a residential care home registered to provide personal care for up to five people with learning disabilities and on the autism spectrum.

The service has a registered manager. ‘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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

Suitable arrangements were in place to ensure that people received appropriate care and support to meet their needs. Staff knew the needs of the people they supported and they were treated with respect and dignity. People’s healthcare needs were well managed and they had access to a range of healthcare professionals.

People’s needs were met by sufficient numbers of staff. Suitable arrangements were in place to ensure that staff had been recruited safely, they received opportunities for training and supervision. People were safeguarded from harm; Staff had received training in Mental Capacity Act (MCA) 2005 and had knowledge of Deprivation of Liberty Safeguards (DoLS). The manager identified that she needed to update her knowledge on the recent changes to the law regarding DoLS; however she was aware of how and when to make a referral and knew how to make a referral if required. People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were being met.

People were provided with the opportunity to participate and engage in activities of their choice which met their needs. Relatives and people who used the service knew how to make a complaint and we felt reassured that all complaints would be dealt with and resolved efficiently and in a timely manner.

The service had a number of ways of gathering people’s views which included holding meetings with people, staff, and relatives. The manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to help them make improvements.

Inspection carried out on 30 April 2013

During a routine inspection

People who lived at Cedar House were engaged and involved in all aspects of their lives with the appropriate level of support provided. Where people did not have the capacity to consent or make informed decisions, the provider had the appropriate systems in place to protect people's human rights.

Staff offered people choice and opportunities and were supportive and respectful with regards to people's lifestyle differences and diverse needs. People were able to access health care services that were coordinated and kept them well. The assessment and monitoring of the service enabled people to benefit from a quality service that met their needs and kept them safe.

Inspection carried out on 11 April 2012

During a routine inspection

People we spoke with told us that they were satisfied with the staff, the food and their

activities. They told us that they helped to make up their support plan and were able to

choose the way their rooms were furnished and decorated. People told us that staff

supported them in accessing the local and wider community, so that they could take part in

their chosen interests and activities. People also told us that they were satisfied with the

way the home is run and with staff attitudes towards them.