Cedar Tree Care Home Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Whilst care plans were now more reflective of people’s needs, they still lacked effective guidance on what staff should do when people with behaviours placed themselves or others at risk of harm. For example, staff had recorded repeating incidents of behaviours that could cause people and others harm, usually when people were supported with care interventions. However, there was no record to show how these had been reviewed, raised with other relevant professionals and had led to any changes that could help improve people’s care. For example, one record raised concerns over how the person’s care had been provided. However, this had not been identified by any staff member reviewing these records prior to our inspection. For another person, staff had recorded they had attempted to get out of their bed however, there was no record to show this had been reviewed and whether the use of bed rails was still safe and appropriate for this person. We raised these concerns with the registered manager to investigate.

Records showed people and their relatives had been involved in discussions about some aspects of their care and choices, for example over Best Interest Decisions. However, there was still limited information to show how people and their relatives had been able to access and review their full care plans and risk assessments. For example, one relative told us, “My [family member] has been here for [a number of] years. I haven’t seen [the care plan] but I know there is one.” Another relative told us, “I think I saw one when [family member] first started.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

At this inspection we found policies had been revised however, some policies were still not correct and some needed further improvements.

People told us they enjoyed their meals, with one person saying, “The food is very good, no complaints at all.” People could choose from a variety of meal options and vegetarian diets were catered for. We observed staff provide people with drinks throughout the day.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

People’s weight was now monitored in line with the frequency identified as needed in their care plans and risk assessments. Other assessment tools were used as appropriate for example, to calculate falls risk and risk from pressure damage.

Pressure sore records showed wounds were regularly monitored and evaluated however, records did not demonstrate people were repositioned in line with the frequency identified in their care plans and risk assessments. Where people were unable to independently reposition themselves, this meant records did not support that people had been repositioned to help manage and prevent risks from pressure sores.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff told us how they would check people consented to their care prior to assisting them. People we spoke with confirmed this.

Staff had received training in the Mental Capacity Act 2005 (MCA) and understood the principles of providing care in line with this. However, records for mental capacity assessments and best interest decision making were not always made in line with the MCA.