All inspections: Cedars Care Home - Care Quality Commission

We visited the home unannounced on 24 May 2012 to check on the care and welfare of people using this service. We also wanted to review the improvements that we had asked the provider to make following our last inspection undertaken in March 2012. We also made a brief visit to the home on 15 June 2012 and 20 June 2012. This was because we were alerted to changes in the home's management and staffing arrangements and had received concerns about the care and welfare of people using the service.

We spoke with seven of the 22 people who were currently using the service on 24 May 2012 and a number of other people on 15 June 2012 and 20 June 2012. The majority of people we spoke with shared positive experiences of the care they received. They told us they liked living at the home and considered staff respected their privacy and dignity. One person said, 'The staff respect me. Everybody is very very kind, I'm very well looked after, I'm happy here and can't think of anything better.'

The majority of people told us they were happy with their care and this was also reflected in discussions held with visiting relatives. One visitor said, 'I have no concerns regarding the care and welfare of my mother.' One person expressed concern about not having their personal care needs attended to as often as they would like and needed.

People told us they felt safe living at the Cedars. Staff told us they had received training in the protection of vulnerable adults and were aware of the procedure to follow if they suspected abuse or if they observed any poor practice.

We found the home in need of cleaning. There were not effective systems in place to reduce the risk and spread of infection. We were told the cleaner was not at work when we visited on 24 May 2012. One person told us they had raised concerns about the cleanliness of the home. During our initial visit two agency workers were sent to clean the home.

People told us they got their medication and they received it on time. We found that the health and welfare of people living at the Cedars was not being protected in relation to the management of their medication.

People told us they liked the staff. One person said, 'The staff are very nice and I get on well with them.' Not all staff files were available for inspection therefore we could not be assured that all of the necessary checks had been undertaken on staff prior to them commencing work at the Cedars. Staff said they had attended a number of training courses since our last inspection to better equip them to do their job. Agency staff confirmed they had received training via their agency and had received a brief induction to the home.

All but two people considered there were enough staff on duty to meet their needs. One person said they were kept waiting for a long time for staff to attend to them in the dining room in the mornings. They said, 'I have no complaints but you just can't get them when you want them.' Another person said, 'There's not enough staff, definitely not.' One visitor told us they were always met with kindness but the change of staff was confusing. We saw the home was heavily reliant on agency staff although we were told the home used the same regular staff wherever possible to provide continuity of care.

People told us staff looked after them well. They considered the staff had the right skills to do their jobs. Staff told us they had received training to keep people safe and meet their needs.

The majority of people told us they are asked on a daily basis if they were OK but no formal meetings or surveys were in place to gain their views about their care or how the service was run. One visiting relative told us they were happy to report concerns. They said, 'I do complain and they do put things right.' The relief manager shared the audits that she had started and acknowledged improvements needed to be made.

The relief manager had started to review record keeping systems and had introduced some new documentation for staff to complete. Not all records required by law were available for inspection.

We spoke with nine people about their experiences of living at the Cedars. Everyone told us that they liked living at the home; many commented they liked the location and the setting. People said they enjoyed their meals and were always offered a choice of food and drinks. People told us their rooms were kept clean and were personalised with their own belongings. Most people said staff respected them and attended to their everyday needs and they were well looked after. People told us staff maintained their privacy and dignity.

Not everyone was able to recall seeing their plan of care but considered their care was delivered in a way they wanted. Everyone we saw looked well presented throughout our visit. We saw people wearing clothing that was appropriate to their individual needs and choices.

People told us they were washed on a daily basis but three people told us they would like to be bathed or showered more often. People considered their general physical health needs were being met, however we found the way people's medicines were being looked after and administered required improvement.

People told us staff worked very hard and worked long hours. Three people said, 'The staff keep changing here'. Prior to our visit we had received concerns from a number of people about staffing levels, particularly in the dementia care unit. Six people who lived at the home and three other people we spoke with considered there were not enough staff on duty. Comments included, 'There isn't enough staff to look after us, it's not as good as it used to be when I first came here'. 'Staff are always rushed off their feet and I'm often left waiting for them'. 'There's not enough staff at all and people with dementia are neglected'. We observed staff being busy attending to the needs of people in their bedrooms and people in communal areas being left under the supervision of students on a frequent basis throughout our visit.

People told us they could remain in their own rooms or join other people in the communal areas. They told us they watched TV and occasionally did some singing. They also said the home had held a recent Valentines party, which they thoroughly enjoyed. We saw an apprentice on a placement playing skittles with some people on the ground floor late morning. However, prior to this most people had little to do as the staff were busy attending to other people's needs throughout the home. On the day of our visit it was a sunny day but people were not offered the opportunity to get out and enjoy some fresh air. We saw that staff were task focussed and therefore were unable to offer positive stimulation and structure for all of the people living at the Cedars.

We found there were insufficient systems in place for the assessment and monitoring of the quality of the service so that people could be confident that the home was run in their best interests. The manager does not have any designated time in order to complete the management tasks and responsibilities required of her role.

We talked with two people who lived at The Cedars. One person told us that the staff were, 'ok' and that they 'looked after you ok, if you asked them'. The other person said that staff were 'first class'. We observed a carer supporting that person and they were seen to make them comfortable in a way that the person preferred. The person told us 'they know what i need'.

One person told us that they had to wait for support this morning and that sometimes there were no staff around.

People told us, "the staff are all wonderful", "the staff are very kind and caring and that nothing is too much trouble". They were complimentary about the care, treatment and support they receive. They told us staff are attentive and when they need anything staff are very willing to help them.

All of the people we spoke with during our visit told us that they are involved in the assessments of their care and are supported to make decisions in how their care is provided.

People told us staff respect their privacy and dignity in many ways and shared examples of the good practice they experience to include staff knocking on their bedroom doors before entry and being discreet when delivering personal care.

People told us they are happy with their bedrooms and that they can either remain in the privacy of their own room or join other people in the communal areas provided. They said their rooms are kept clean and tidy and that the laundry facilities are excellent.

A healthcare professional told us that they are made welcome, staff are friendly and helpful and any recommendations made have been actioned in the best interests of people using the service. They told us that staff alert them to any changes in people's health needs and request advice where necessary.

Staff told us that they enjoy working at the home and that they are well supported and have no concerns.

Archived: Cedars Care Home

All Inspections

24 May 2012

During a routine inspection

1 March 2012

During a routine inspection

23 December 2011

During an inspection in response to concerns

7 February 2011

During a routine inspection