Archived: Cedar Court Care Home

Updated 11 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 13 January 2106 and was unannounced. The inspection team consisted of three inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert had experience in caring for someone living with dementia and older people.

Before the inspection, we reviewed all the information we held about the provider. This included information sent to us by the provider in the form of notifications and safeguarding adult referrals made to the local authority. Notifications are information about important events which the provider is required to send us by law. We did not ask the provider to send us a provider information return (PIR) before this inspection as we were undertaking this inspection within six month of our previous visit. The PIR is a form that askes the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider sent us an action plan following our last inspection outlining how they had planned to make improvements following

We used a number of different methods to help us understand the experiences of people who used the service. We spoke with 12 people, eight members of staff, the registered manager, the head of care, the nominated individual, the dementia champion, twelve relatives, the chef and five health care professionals.

We spent time observing care and support being provided. We read people’s care plans medicine administration records, recruitment files for staff, supervision records for staff, mental capacity assessments for people who used the service and other records which related to the management of the service such as training records and policies and procedures.

The last inspection of this service was 4 June 2015 where we found the service was in breach of several regulations and we rated the service inadequate. The service was also placed in special measures. This inspection was to check to make sure that improvements had been made.

Updated 11 March 2016

Cedar Court Care Home is a purpose built care home that provides accommodation and nursing care for up to 75 people. There were 51 people living in the home on the day of our visit. It has a designated unit that specialises in the provision of care for people living with dementia. Accommodation is arranged over three units. Albert unit provides nursing care for 30 people, Edinburgh unit provides care for 29 people living with dementia and Alexander unit provides support for 16 people who require residential care.

At the last comprehensive inspection this provider was placed into special measures by CQC. This inspection found that there was enough improvement to take the provider out of special measures.

The home is located close to Cranleigh Village and within easy access to local amenities and facilities. Bedroom accommodation is arranged over two floors. A passenger lift provides access to the first floor. Bedrooms are single occupancy and all have en suite facilities. There is a large garden to the side and rear of the service and a large car park is available at the front.

This inspection took place on 13 January 2016 and was unannounced.

The home was run by a registered manager, who was present on the day of the inspection visit. ‘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 treated well by staff who were kind and caring. People’s privacy and dignity was now being respected.

People were now protected from abuse because staff were able to recognise the signs of abuse and had undertaken training regarding safeguarding adults.

Staff now understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). DoLS authorisations had been submitted where restrictions were imposed to keep people safe. However one person’s best interest had been considered when they needed support to make decisions.

Assessments were now in place for identified risks, which had improved following our last inspection. .

Care planning had improved although one care plan was inconsistent with the person’s care needs. People were now encouraged and supported to be involved in their care.

People’s bedrooms had been decorated to a good standard and were personalised with their own possessions.

People were supported to keep healthy. People were registered with a local GP who visited the home weekly. Visits from other health care professionals also took place.

People had sufficient food and drink, although the lunch time meal was a little disorganised at times on the dementia unit.

We looked at the medicine policy and found all staff gave medicine to people in accordance with this policy. Medicines were managed safely.

Previously there were not enough staff working in the home to meet people’s needs and people had to wait for care. There were now sufficient staff available to support people and adequate ancillary staff were also employed to enhance the care provided.

Staff recruitment procedures were safe and the employment files contained all the relevant checks to help ensure only the appropriate staff were employed to work in the home.

Staff supervision and appraisal were now taking place and staff now received regular formal supervision from their line manager.

People had access to a range of activities which were overseen by an activities coordinator. People on the dementia unit required more support to engage in activities and this was disorganised at times on the morning of our visit.

The standard of cleanliness was an issue at the last inspection and the service was in beach of our regulations. During this visit we found the service was clean and fresh and people were satisfied with the general cleanliness throughout the service. Infection control audits were in place and there was a nominated person deployed in the service to undertake these audits as part of their clinical role.

People had been provided with a complaints procedure and knew how to make a complaint. We noted two complaints received since our last inspection had been resolved using the complaints process. .

At our last inspection the service was not being well managed. People and staff felt unsupported by the lack of leadership in the service. Since then there was a new registered manager in post and the service was now being well managed. Feedback from people included they felt listened to and the manager spoke with them every day.

The standard of record keeping had improved since our last visit and records relating to the care of people and the management of the home were kept up to date.

Staff were aware of the home’s contingency plan, if events occurred that stopped the service running. They explained actions that they would take in any event to keep people safe. The premises provided were safe to use for their intended purpose.