Cedar Court Care Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We identified two breaches of regulations. People and their relatives told us staff were kind and caring. However, people experienced inconsistencies with the quality of care they received. People were not always treated with kindness and compassion and people’s dignity was not maintained. The service provided activities which people enjoyed; however activities were not tailored for people with dementia. People’s needs were not always responded to immediately. Feedback about the service was not always responded to in a timely way. People’s independence was promoted.

This service scored 35 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives spoke positively about the care they received and told us staff were kind and caring. A person told us, “The carers are very kind and take the time to chat to me which is nice. I would go so far as to say they are wonderful.” Another person told us “The carers are friendly and helpful and always call me by my name. If I ever seem worried, they will check on me.” A third person told us “I feel that I am a person that people know and care about.” A relative told us “The carers are brilliant- very friendly too. They will listen any concerns or worries that [person] or I have. They are very respectful of [person] and really treat them as a real person they care about.”

Feedback from people and their relatives also indicated positive caring relationships had developed between people and staff. A relative told us “The carers are really jolly. They have nicknamed [person], and they really like it, and it makes me happy that they do this. It shows they care.” Another relative told us “The carers are so lovely and happy to help, and they don’t sit around. [Person] knows all the carers and they know them. They recognise me too.” A third relative told us “[Person] smiles at the carers. They are so friendly and welcoming. it’s heart-warming. They make the place homely the way they are.”

People using the service and relatives told us they found staff kind and caring. However, our observations were of some staff working in an uncaring manner. For example, a person walked into the dining room with the aid of a zimmer frame, and their clothing left them exposed. An inspector had to intervene and draw the attention of staff to maintain the person’s dignity.

Another example involved a person seen walking in the corridors with no shirt on and one foot stuck in their pyjama bottoms and their other foot was bear. Staff had not responded promptly to ensure the person’s dignity was respected and upheld.

We observed another instance in which staff did not respond to a person’s needs promptly when they were shouting in distress and the inspectors had to intervene. We saw the person left in their room in an undignified state and wanting a drink.

We spoke to the registered manager who told us the person was in living room but because the person started shouting, the person was taken to their room which often happens. We noted the person’s care plan did have some information about the person’s behaviours, however there was limited information which showed any proactive strategies to deal with behaviours such as giving people space, reassurance or diverting their attention to something they liked and enjoyed rather than resorting to leaving the person in their room.

The service had activities for people including day trips and celebrating special occasions. The service had pets which people enjoyed having at the service. A person told us “I’ve been out and about with a carer and many of us went on a trip to the seaside.” A relative “There are trips out, like to Abbey Lodge for lunch and they do things for Halloween and Christmas of course and so on. There have been garden parties. The dogs and cats on site are a lovely touch.” Records were completed which detailed the activities people were involved with including one to one interactions with staff.

However, relatives told us activities were needed for people with dementia. A relative told us “[Person] is declining because there’s nothing for [person], as someone with dementia, to do. [Person] needs 1:1 interaction, where they can talk about the many holidays they went on, or about their family. [Person] could manage that in a group setting. [Person] says they like bingo but doesn’t recognise numbers- only colours.”

Another relative told us “[Person] needs to get out more: it feels to me that [person] is shut in. [Person] tends to stay in their room and can be aggressive, so is difficult to engage with and the carers don’t force [person]. [Person] has been to the odd event and has been in the garden.” A third relative told us “[Person] did a picture five or six months ago, but I’ve seen nothing since. There was a sensory room, I think. The stimulus for those with dementia does not exist.” A fourth relative told us “[Person] likes the garden, and trips out like to Margate. Otherwise doesn’t seem to participate. To be honest I don’t see much going on that is targeted at people with dementia. People don’t seem interested in doing things.” A fifth relative told us “I am not happy with the home. I feel things have slipped. [Person] needs gentle, individual handling and I feel they treat [person] like everyone else.”

The service had a lead and deputy activities co-ordinator in place. However, some staff told us that activities could be better, and people were left in the lounge areas with nothing to do. One staff member told us there were not enough activities for people with dementia.

Outside of the formal activities, the remainder of people’s days were empty with people having nothing to do. There was little one to one activity for people with dementia and the use of any sensory items to help express themselves or be engaged in stimulating and meaningful activities to help people reminiscence about events and memories from the past that were important them. There was a sensory room at the service, but this was not in use and none of the staff or activities co-ordinator mentioned there was a sensory room when speaking with them.

In the lounge areas, we observed there were instances staff did not engage with people in a meaningful manner and spoke to people when needed. For people who wished to remain in their rooms, the activities co-ordinator told us they may chat to them, read a story or play a game, however there were no records completed which detailed these took place and what attempts were made to engage people.

There was a lack of activities specifically tailored for people with dementia. During the onsite assessment, we observed in the morning, there were twelve people in the downstairs lounge and eleven residents on the first floor lounge. The TV was on, but people showed no interest, and a number of people were dozing. There were some activities during the day such as puzzles, a ‘magic table’ and bingo but few people were engaged. There was no activities timetable available to show what activities was on offer and planned for people to engage with.

There were name plates detailing people’s key workers on their doors, however the name plates were in small font and did not have any pictures of the person or key worker, which meant that most people were not able to recognise or read them. A key worker is a staff member who has key responsibility for a person at the service to address any concerns and issues arising from a person’s care and can focus on a person’s individual needs, wishes and requirements. The registered manager told us the name plates with key worker details had been placed in July 2024 however since then people had still not been allocated keyworkers and when speaking with staff, none of them were aware of a keyworker system being in place.

People’s independence was promoted. People told us “They definitely let me help myself, to keep me independent.” Another person told us “They [staff] do for me all that I need to make things easier for me.” A third person told us “They look after me well and know how to look after me the way I would hope for. If I need help, they are there for me.” A fourth person told us “The carers give me confidence because they are there for me.”

Staff understood the importance of promoting people’s independence.

Care records set out how people should be supported to promote their independence. Care plans detailed what people could do for themselves.

There was no effective system to ensure people’s needs were immediately responded to. There were call bells situated on people’s bedrooms walls, but the leads had been removed. People’s welfare and safety was dependent on observation checks carried out by staff and/or people calling out for staff if they needed assistance. A person told us “I can get to push the bell on the wall and they don’t take long to get to me.” A relative told us “There is an alarm in the toilet but nothing by [person’s] bed.”

We were not assured that people who displayed behaviours that challenged or when in distress were being managed effectively by staff. It was not clear how staff would respond to people’s needs in the moment and act to minimise any discomfort, concern or distress.

For example, care records for two people showed they could display behaviours that challenged. However, there was no information showing what behaviour the person would display and guidelines on how to support them when they do. There was no information identifying the triggers and signs which may cause them discomfort and the support and positive proactive strategies that was required by staff to help them feel at ease.

Some behaviour charts had been completed; however the charts did not record the behaviours displayed, therefore the charts were ineffective. There were also no risk assessments in place to ensure this was safely monitored by staff and any risks were addressed to minimise the risk to people when in distress.

When speaking to staff, they were not able to tell us how they would support people in distress. A staff member told us a person had no behaviour issues even though, it stated this in their care plan and behaviour charts have been completed. Another staff member told us no one at the service had challenging behaviour and three staff members told us they had never completed an ABC chart for people with behaviours that challenge.

We could not be assured people’s immediate needs were being responded to in a timely manner. For example, call bells were mounted on the walls and not in easy reach for people to use if and when they needed support. We discussed this with the registered manager who told us the leads for the call bells had been removed due to an incident under the previous care provider, however this has not been reviewed since the new care provider took over in 2023. This meant people had been left without an effective monitoring system to ensure their needs were responded to in a timely manner.

The registered manager told us most people lacked the capacity to use the call bells, however risk assessments were not in place for these people which identified the risks to people unable to access a call bell and measures in place to maintain their safety and welfare.

Call bell audits were completed; however these were ineffective. We reviewed call bell audits for February, May, August and November 2024. We found the audits did not detail the names of people just their room numbers. There were no details of who were completing the forms, some of the forms were completed as ‘unable to answer.’ Where the responses were scored 4 or 5 which indicated ‘poor’ or ‘very poor,’ the responses had not been followed up. An analysis of the findings was completed, however overall ratings were either ‘unable to answer’ or ‘overall satisfactory’ with no further information detailing what this meant.

During the onsite assessment, staff told us they felt supported. Staff told us their training was up to date, and they received regular supervisions and had regular team meetings.

Team meetings were held with staff to discuss the management of the service. Minutes of these meetings showed aspects of people’s care were discussed and staff had the opportunity to share good practice and any concerns they had. Staff were rewarded and praised for their hard work and rewarded with initiatives such as ‘Employee of the month’ and prized raffles.

There was a lack of measures put in place which showed management staff had provided a timely and considered response and any examples of poor practice that may have a detrimental impact on staff and affect the quality of people’s care had been addressed and resolved promptly to ensure a negative workplace culture was not fostered.

For example, minutes of team meetings also highlighted concerns raised about a negative culture amongst staff at the service such as a lack of professionalism, poor and disrespectful behaviours such as gossiping and staff not providing the appropriate assistance to people when showering.

Surveys were also provided to staff to obtain their feedback. We reviewed surveys for January, April, July and November 2024. Although, records showed staff spoke positively about working at the service, there were also concerns from staff highlighting issues with the culture at the service such as negative staff, long shift hours and too much paperwork.