We carried out a review of the data available to us about Blue Cedars on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Blue Cedars, you can give feedback on this service.
We were assured that the provider had implemented most aspects of national guidance into practice and people and staff were appropriately protected against the risk of the spread of COVID-19. However, we found the provider’s IPC policies and records of procedures were not always up to date. We have asked the provider to review and updated their IPC governance.
We found the following examples of good practice.
The provider had made necessary changes to the service to protect people from the risk of the spread of COVID-19. This included review of communal areas and people’s individual routines such as mealtimes and implementing personal protective equipment stations throughout the home.
The provider had installed a “visitors pod” to facilitate safe visits for people and their loved ones. This was a designated space which allowed people to have visitors at the home and included safety measures such as appropriate screening and ventilation to reduce the risk of transmission of viruses. Visitor's were also required to pre-book appointments and completed a range of screening questions on arrival at the service.
The provider ensured there was ample supply of appropriate personal protective equipment, and we observed staff using this in line with national guidance. Staff monitored people's wellbeing which included daily temperature and oxygen level checks. The registered manager discussed how these supported staff to be aware of and respond to any changes in people's presentation and wellbeing where people may not be able to communicate their needs.
People and staff were supported appropriately to have access to regular testing in line with national guidelines and staff were able to access the COVID-19 vaccination programme.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
Why the service is rated Good.
The home continued to ensure people were safe. There were enough suitable staff to meet people’s needs. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People received their medicines safely. People were protected from abuse because staff understood how to keep them safe, including more senior staff understanding the processes they should follow if an allegation of abuse was made. All staff informed us concerns would be followed up if they were raised.
People continued to receive effective care. People who lacked capacity had decisions made in line with current legislation. Staff received training to ensure they had the skills and knowledge required to effectively support people. People’s healthcare needs were met. People were supported to eat and drink in line with their nutrition assessments. People were supported to have maximum choice and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The home continued to provide a caring service to people. We observed that staff were kind and patient. People’s privacy and dignity was respected by staff and their cultural or religious needs were valued. People were involved in decisions about the care and support they received. People’s choices were always respected and staff encouraged choice for those who struggled to communicate with them.
The home remained responsive to people’s individual needs. Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. People were supported to follow their own activity programmes. These considered people’s interests and reflected people’s preferences. Relatives told us they knew how to complain and there were a range of opportunities for them to raise concerns with the registered manager and designated staff.
The home continued to be well led. Relatives and staff spoke highly about the management. The registered manager continually monitored the quality of the service and made improvements in accordance with people’s changing needs.
The inspection took place on 3 and 5 November 2015 and was unannounced. Blue Cedars provides residential accommodation and care for up to six people with learning and/ or physical disabilities, including people with autistic spectrum disorder. All six people were living in the home at the time of our inspection. The home is a two storey building. People were able to access all areas of the home and garden as they wished, using a lift between floors.
The home had 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were protected from the risk of abuse, because support workers understood and followed processes to protect people from harm and report any concerns. Risks affecting individuals’ health or wellbeing had been identified, and measures put into place to reduce the risk of harm. Servicing and checks of the home environment protected people and others from potential risks in the home.
There were sufficient support workers available to meet people’s care needs safely. Rosters were planned to ensure people were able to attend the activities they wanted to. The provider’s recruitment process protected people from the risk of support from unsuitable staff.
Support workers were trained to ensure they followed safe medicine administration processes. They understood how and when to report concerns, and ensured people were supported to take their prescribed medicines at the correct times to protect them from ill health.
Support workers completed and refreshed training to ensure they could support people effectively. Regular supervision and competency assessment ensured support workers demonstrated the skills and knowledge to meet people’s needs.
People’s consent was sought to ensure they were cared for as they wanted. Support workers understood and followed the principles of the Mental Capacity Act 2005 to make a decision in a person’s best interest where they lacked the capacity to make an informed decision for themselves. Deprivation of Liberty Safeguards protected people from unlawful restrictions in the home.
People were supported to eat and drink sufficiently to protect them from the risks of malnutrition and dehydration. Support workers understood risks affecting people’s nutrition, such as choking and poor intake, and followed people’s plans of care to protect them from harm. People were supported to access health treatment as necessary.
Support workers cared about people’s wellbeing. People turned to support workers for reassurance when they were upset or required assistance. People and support workers sang, joked and laughed together. They appeared to enjoy each other’s company.
People were involved in daily care and activities, as they were offered choice in all aspects of their care, such as meals, activities and daily living tasks. People’s privacy and dignity was protected, because support workers treated them with respect.
People experienced care that met their identified needs and wishes. They and others important to them were involved in care reviews to ensure changes were identified and managed appropriately. Risks affecting their health or welfare were managed to promote their wellbeing.
People and their relatives had opportunities to raise and discuss concerns through meetings and surveys. The registered manager resolved concerns effectively, which meant formal complaints had not been made. The provider’s complaints policy described how these would be dealt with appropriately should the need arise.
People experienced care in line with the provider’s values of promoting independence, supporting people respectfully, and providing individualised care. People and those representing them had opportunities to influence the care they received through meetings and discussions.
Relatives and support workers spoke positively about the registered manager, describing her as open and supportive.
Audits and a monthly operational meeting were used to identify areas of concern. Actions were implemented to address issues identified to drive improvements to the quality of care people experienced.
We looked at four people's records and found they were up to date and provided guidance to staff about the most appropriate ways to provide care and support. The records contained risk assessments which included clear guidance for staff regarding the steps they could take to ensure people's safety.
Relatives told us the staff were respectful of people's rooms and belongings. We found people were addressed by the name they had chosen and which was recorded in their care plans. When we observed staff supporting people they did not rush them and seemed to have good rapport with them. When people asked questions, the staff were respectful and friendly in their responses. The staff offered assistance to people when they requested it but did not take over. These measures ensured that people were supported to maintain and enhance their independence.
We spoke with one relative and three members of staff.
People told us they were able to choose their food and activities. Our observations confirmed that staff always offered people choices and respected people's opinions. Staff took time to listen to people and they provided appropriate support that met people's needs.
One relative told us the staff were brilliant and nothing was too much trouble. They told us the staff always looked after their family member's care and health needs and the staff always kept them well informed. This relative said they were always included in discussions regarding all aspects of their family member's care and welfare. They said they were asked to comment on the quality of the service and when they raised any issues these were responded to and resolved promptly by the staff.
This relative's positive comments were confirmed by the records we reviewed through speaking with staff and during our observations of the care and support.
People who used the service were involved in a variety of activities and these were planned in accordance with their choices.
The staff had been trained and had the guidance they required to protect people from abuse.
The residents told us they really liked the staff. They said the staff were kind and patient and never 'got cross'.
We saw the staff supporting the residents with kindness, respect and dignity. The staff offered the residents choices regarding their food, clothing and activities. The staff used assessed communication methods that suited individual residents as well as appropriate warmth, touch and humour.
One relative told us the staff were 'great' and they could not fault the care. They said the staff asked their opinions and kept them informed.