• Care Home
  • Care home

Archived: The Cedars Nursing Home

Overall: Inadequate read more about inspection ratings

Cedar Park Road, Batchley, Redditch, Worcestershire, B97 6HP (01527) 63038

Provided and run by:
Belmont Cedar Park Limited

All Inspections

27 April 2021

During an inspection looking at part of the service

About the service

The Cedars Nursing Home is a care home providing personal and nursing care to for up to 40 people. At the start of the inspection 28 people aged both under and 65 years old were living at the home at the end of the inspection 26 people lived in the home. The home consists of an adapted building with a purpose-built extension.

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

Risks to people’s safety were not always monitored or reviewed. People told us their care needs were not met in a timely way. People were not always supported by staff who had the skills and knowledge to do so. People who needed support to eat and drink were at risk of dehydration and malnutrition as records did not clearly demonstrate that people had sufficient amounts to eat and drink. People’s medicines were not always managed in a safe way. People were not protected from the risk of cross infection. Staff did not always recognise different types of abuse and how to report it. The provider could not be assured the staff group had sufficient knowledge and skills to support people.

The provider had inadequate systems in place to monitor and review the service provision. The provider had failed to sustain improvements of the service. This is the second time in two years the service has been placed into special measures. The leadership at provider level and management level within the home was unstable and lacked consistency. Staff morale was low and staff did not feel supported by the provider to fulfil their role to provide good quality care for people. The provider had hired an interim manager to oversee the service and ensure people’s safety, until a permanent manager could be recruited.

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 requires improvement (19 March 2020).

Why we inspected

We received concerns in relation to standards of care and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to people’s safety and the leadership of the service at this inspection. You can see what enforcement action we have taken at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Cedars Nursing Home on our website at www.cqc.org.uk.

4 February 2020

During a routine inspection

About the service

The Cedars Nursing Home is service that provides accommodation, nursing and personal care for up to 40 people. At the time of our inspection, 27 older and younger people were living in the home, some of whom may have a physical disability and/or dementia.

The Cedars accommodates 40 people in one adapted building over three floors.

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

The provider was not consistent in how they ensured people received support in a timely way when people used the call bell system for assistance. While people had not come to harm, the provider told us the call bell system would be reviewed as a priority, to ensure they could monitor people’s waiting times and, if necessary, address these shortfalls. People told us they continued to feel safe and supported by the staff who worked in the home. Staff recognised different types of abuse and how to report it. The manager understood their safeguarding responsibilities and how to protect people from abuse. Potential risks to people's health and wellbeing were now being identified and managed well. People and, where appropriate, their relatives had been involved with decisions in how to reduce risk associated with people’s care. There were now sufficient and suitably trained staff on duty to keep people safe and meet their needs. People's medicines were now managed and stored in a safe way and people received their medicines safely. Improvements were seen in staff’s practice in the management of infection control.

People's care needs had been assessed and reviews took place with the person and where appropriate their relative. Staff now had the training and support to be able to care for people in line with best practice. People were supported to have a healthy balanced diet and were given food they enjoyed. People were now supported to have sufficient fluids to keep them healthy. Where people required support to drink, staff were consistent in who required this support. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice. 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 did support this practice.

The provider had supported staff well to enable them to deliver good quality care to people. People were supported by staff who treated them well. People told us staff were kind and respectful towards them. Staff treated people as individuals and respected the choices they made. Staff treated people with respect and maintained their dignity.

People's care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported and encouraged to maintain their hobbies and interests. People had access to information about how to raise a complaint and felt confident that any concerns would be addressed, and improvements made. People's end of life care needs were met in line with their preferences and done so by staff in a respectful and dignified way.

The provider had put checks into place to monitor the quality of the service provision. However, the provider had further improvements to make around the monitoring of people’s waiting times should they use the call bell. Further work was also required to ensure the computerised care record system supported staff in the right way. All people, relatives and staff felt the provider had made positive improvements to the home and the way the service was run. The manager was new into the service, but people, relatives and staff spoke highly of them. The manager was visible within the home and listened to people and staff's views about the way the service was run.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 28 August 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 28 August 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Cedars Nursing Home on our website at www.cqc.org.uk.

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.

2 July 2019

During a routine inspection

About the service

The Cedars Nursing home is service that provides accommodation, nursing and personal care for up to 40 people. At the time of our inspection, 35 older and younger people were living in the home, some of whom may have a physical disability and/or dementia.

The Cedars Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is in one adapted building over three floors.

Why we inspected

The inspection was prompted in part due to concerns received about safe clinical care and competencies of staff. A decision was made for us to inspect and examine those risks.

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

Risks to people’s safety were not always monitored or reviewed. People told us that their care needs were not met in a timely way. People’s medicines were not always managed and stored in a safe way. People were not protected from the risk of cross infection. People told us they felt safe from abuse. Staff recognised different types of abuse and how to report it.

People’s care was not always robustly assessed and reviewed to ensure it was up to date and in line with best practice. People were not always supported by staff who had the skills and knowledge to do so. People who needed support to eat and drink were at risk of dehydration and malnutrition as records did not clearly demonstrate that people had sufficient to eat and drink. 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 support this practice.

Staff treated people in a kind and caring way and respected their dignity. Staff strove to treat people as individuals and respected the choices they made. However, people did not always receive care and support in a person- centred way.

People’s care was not always delivered in a timely way, people experienced consistent delays in receiving personal care. The provider could not be assured the staff group had sufficient knowledge and skills to support people with end of life care. People were supported to maintain their hobbies and interests. People and relatives did not have clear access to information about how to raise a complaint, where complaints had been received the provider had managed these in line with their policy.

The registered manager was approachable and visible within the service. The provider was aware the registered manager lacked experience in management but had not fully supported them to develop their role and skills. The audits the provider had in place were comprehensive however they had not been implemented effectively to escalate shortfalls and improve practice. Following our site visit the provider gave us assurances the providers representative would support the home until improvements had been made.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to safe care and treatment and governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

17 May 2017

During a routine inspection

The home provides accommodation with personal and nursing care for up to 39 older people. There were 38 people living at the home at the time of the inspection. At the last inspection, the service was rated Good overall. At this inspection the service remained Good overall.

There was a registered manager in post. 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’s care needs were assessed, but care records needed to reflect their views on how their care was planned and delivered as an individual. Where needed to aid planning, people’s relatives felt they were involved in the care and were asked for their opinions and input. People told us there were occasional entertainers visit which included music and exercise. Staff did not have time to carry out activities when the activities people were not available. We have made a recommendation about activities to ensure people remain engaged and stimulated.

People told us that they felt safe in the home and were supported by staff to maintain their safety. All staff told us about how they kept people safe and how they knew what to do if they suspected the risk of abuse. During our inspection staff were available for people and were able to support them by offering guidance or care that reduced people’s risks. People told us they received their medicines as needed and at the correct time.

Care staff told us their training supported them in their knowledge to care for people and the management team were on hand to offer guidance and advice. 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.

People told us they enjoyed the meals, had choices and drinks as often as they wanted to keep them healthy and free from the risks of associated illnesses. We saw where people needed additional support from healthcare professionals their treatment was provided by care staff who followed any advice and guidance.

People received support to have their choices and their decisions were respected. Staff were considerate of promoting their privacy and dignity. People choices and decisions were listened to and respected by care staff when providing care and support in the communal areas.

People were confident to approach the manager if they were not happy with the care. The provider had reviewed and responded to all concerns raised.

People’s views and opinions of the care they had received had been sought and reviewed to look at how improvements could be made. The management team ensured people and their relatives were kept informed of any changes or improvements planned. People and care staff told us the management team were easy to talk with and always available within the home which people and relatives liked. The registered manager provided assurance to review and address the area for improvement.

19 January 2015

During a routine inspection

This inspection took place on 19 January 2015 and was unannounced.

The home provides accommodation for people who require nursing care for a maximum of 40 older people some of who have a dementia related illness. There were 38 people living at the home when we visited and there was a registered manager in post.

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 told us that they felt safe and well cared for. Staff were able to tell us about how they kept people safe. During our inspection we observed that people received their medicines as prescribed and at the correct time.

The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The provisions of the MCA are used to protect people who might not be able to make informed decisions on their own about the care or treatment they receive.

We found that people’s health care needs were assessed, care planned and delivered to meet those needs. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People were supported to eat and drink enough to keep them healthy. People had access to drinks during the day and had choice of meals. People’s likes and dislikes had been considered alongside any specialist dietary needs and these were known by the kitchen staff.

The atmosphere was calm and staff responded to people’s request. Staff also recognised people’s needs by looking at visual clues. Relatives said that they were very happy with the care of their family member. Our observations and the records we looked at supported this view.

Staff had received training which they felt reflected the needs of people who lived at the home. People, their relatives and staff told us that they would raise concerns with the registered manager and were confident that any concerns were dealt with.

The management team had kept their knowledge current and they led by example. The management team were approachable and visible within the home which helped to look at culture of the service. The provider ensured regular checks were completed to monitor the quality of the care that people received and look at where improvements may be needed.