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Inspection carried out on 3 October 2018

During a routine inspection

Cedar Oaks is a residential care home for three people with a learning disability or autism. The service is a small converted domestic property. Accommodation is arranged over two floors. There were two people living at the service at the time of our inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The registered manager had oversight of the service. They checked that the service met the standards they required and worked to continually improve the support people received.

People were involved in everything that happened at the service. Staff knew people very well and supported them to achieve their goals and become more independent. Staff were kind and caring and treated people with dignity and respect.

Assessments of people’s needs and any risks had been completed. Support had been planned with people and their relatives, to enable them to take managed risks. Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager. People were not discriminated against and received care tailored to them. People took part in domestic tasks and activities they enjoyed at the service and in the community.

People were supported to remain fit and healthy. Staff supported people to visit health care professionals for check or if they became unwell. People’s medicines were managed safely and people received their medicines in the ways their healthcare professional had prescribed. People were supported to plan and prepare a balanced diet of food they liked and met their cultural needs and preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Plans were in place to support people and their relatives to share their wishes and preferences about the care they wanted at the end of their life.

Staff felt supported by the registered manager, they were motivated and enthusiastic about their roles. The registered manager was always available to provide the support and guidance staff needed. Staff worked as a team and supported people in a consistent way. Records in respect of each person were accurate and complete.

There were enough staff to provide the support people needed when they wanted it. Staff were supported to meet people’s needs and had completed the training they needed to fulfil their role. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs. A safe system was in place to recruit staff. No new staff have been employed since our last inspection.

The service was clean and well maintained. The building had been adapted to meet people’s needs and make them feel comfortable. People used all areas of the building and grounds and were involved in planning the refurbishment.

A process was in place to investigate and resolve any complaints or concerns received.

The registered manager had informed CQC of significant events that had happened at the service, so we could check that appropriate action had been taken.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating in the entrance hall.

Further information is in the detailed findings below.

Inspection carried out on 9 March 2016

During a routine inspection

This inspection was carried out on 9 March 2016 and was announced. Forty eight hours notice of the inspection was given because people needed support to manage changes to their routine. We needed to be sure that we reduced any anxiety that people had about our inspection.

Cedar Oaks provides accommodation and personal care for up to 3 people with a learning disability. The service is a small converted domestic property. Accommodation is arranged over two floors. There were two people living at the service at the time of our inspection.

A registered manager was leading the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were treated with dignity and respect at all times. Staff were kind and caring to people.

The registered manager provided leadership to the staff and had oversight of the service. Staff were motivated and felt supported by the registered manager. The registered manager and staff shared a clear vision of the aims of the service. Staff told us the registered manager was approachable.

There were enough staff, who knew people well, to meet their needs at all times. The needs of the people had been considered when deciding how many staff were required on each shift. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

Checks had been completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff were supported to provide good quality care and support. Staff had completed the training they needed to provide safe and effective care to people. Some staff held recognised qualifications in care. The registered manager met regularly with staff to discuss their role and practice.

Staff knew the signs of abuse and were confident to raise concerns they had with the registered manager. Plans were in place to keep people safe in an emergency. Systems were in place to manage complaints received.

Care and support was planned and reviewed to keep people safe and support them to be as independent as possible. People, their relatives and professionals who knew people well were involved in planning and reviewing their care.

People received the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were offered a balanced diet that met their individual needs.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Risk to people had been identified and arrangements were in place to apply to the supervisory body for a DoLS authorisation when necessary.

Systems were in place but had not been used to assess if people were able to make decisions, this did not impact on people as staff assumed they had capacity and respected the decisions they made. When people could not make a particular decision, staff made decisions in people’s best interests with people who knew them well. The requirements of the Mental Capacity Act 2005 (MCA) had been met.

People were supported to participate in a variety of activities that they enjoyed. Possible risks to them had been identified and were managed to keep them as safe as possible, without restricting them.

The registered manager worked alongside staff and checked that the quality of the service was to the required standard. Any shortfalls found were addressed qu

Inspection carried out on 20 February 2014

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not all able to tell us their experiences. We observed staff interacting with people in a respectful way, including using calming techniques when people became anxious. We found that there were care plans, risk assessments and person centred plans in place for all people that used the service; these care records were regularly reviewed and updated as required. We spoke with staff and viewed records which showed that consent was sought from people and their representatives. When this was not possible, action in line with current legislation was taken. Medication was stored in a locked unit and was well-organised.

Staff arrangements showed that there were sufficient trained staff who were knowledgeable about the service and the people living there. Managers told us that staff had received training so they could competently complete their job role however we did not see any written evidence and were unable to confirm this.

Inspection carried out on 1 March 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not all able to tell us their experiences.

We observed staff interacting and communicating with people using Makaton sign language. We found that there were care plans, health files and person centred plans in place for all people that used the service and that these were regularly reviewed and changes made as necessary. We found that people were encouraged to be active in their home and their local community. People were treated with dignity and respect and supported to make their own choices.

Records showed that staff had been properly recruited, trained and supervised and that the service had systems in place to safeguard people. We found that the service monitored quality of care regularly and acted on any issues that had arisen.

Inspection carried out on 10 October 2011

During a routine inspection

People expressed that they were happy and safe within the service. They were comfortable in the environment and accessed amenities in the local community such as day centres.

People were encouraged to participate in activities to enhance their health and well being. Staff knew people well and were able to plan activities around what people liked and didn’t like to do.

People had access to local GPs, dentists and had been visited by care managers to ensure their health was maintained.

Reports under our old system of regulation (including those from before CQC was created)