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Two Cedars Residential Care Home Good

All reports

Inspection report

Date of Inspection: 13 December 2013
Date of Publication: 9 January 2014
Inspection Report published 09 January 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 13 December 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members and talked with staff.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We saw that several people had just finished breakfast when we arrived and we were told that most people preferred to have breakfast in their rooms in accordance with their wishes. We observed three members of staff assisting people from their rooms to the lounge for a mid-morning drink and/or snack and they treated people with dignity and respect. People's independence was promoted by the staff who allowed people to transfer from wheelchair to chair in their own time.

We looked at the care plans of five people and saw that care had been planned in conjunction with them and agreed by them. These included details of people's medical history, treatment, activities of daily living, risk assessments, a body map which showed any cuts or bruises, activities and daily care records. Care plans were stored in the office in a locked cupboard. We were told that the staff who cared for the person within each shift was responsible for completing the daily records. We found several scraps of paper with updates to care and contact details which the manager explained they were going to transfer to the relevant recording sheets.

The manager explained that the home employed an activities co-ordinator every afternoon but they were on holiday at the time of our visit. They showed us a book with details of activities and instructions for them to be carried out in the co-ordinator's absence. These included a range of age appropriate activities for people to take part in if they chose to. We spoke with three people who told us there was plenty of choice of activities they could join in with if they wanted to.

During our visit one person went out for coffee with a relative and came back in time for lunch. We were told that this person regularly went out and that several people had attended a Christmas carol concert the night before. Staff chatted at ease with people about the concert and people appeared to have a good relationship with the staff we saw. At lunch time people were asked where they would like to sit and whether they would like to eat in the dining area for lunch.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. We observed people being safely helped to transfer from a wheelchair to chair. One person had recently suffered a fall and we saw staff ask them to feel for the chair behind their legs before sitting down.

In the five care plans we looked at we saw that risk assessments had been completed for falls and pressure areas. In addition people had an appropriate nutritional screening assessment in place and we saw that these had been updated on a regular basis and signed. We saw that one person's risk of developing a pressure wound had increased and appropriate action, which included obtaining a pressure relieving bed, had been taken. This person's low weight was also monitored and appropriate action was taken such as pureeing their food.

We spoke with three people about their safety in the home and two people told us they had suffered a fall. We saw that falls risk assessments were in place for these people. In addition we noted that three of the five care plans showed cuts and/or bruises on a body map of people. We saw incident reports for the two months prior to our visit and noted that two people had each fallen twice. We were told that one of these people liked to mobilise in their room without the use of their rollator walking frame and that the other person was very independent.

The manager explained that the community specialist was involved after one person's fall and that mobilising treatment was carried out by staff in accordance with their treatment plan. We were told that staff had undergone training by a specialist falls company. In addition we saw non slip flooring in people's ensuite toilets and wash rooms. The provider might wish t