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Archived: Cedar House Good

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Reports


Inspection carried out on 4 February 2020

During a routine inspection

About the service

Cedar House is a respite service providing short term accommodation and personal care and support for up to seven adults with physical and learning disabilities as well as people with autism. At the time of our inspection three people were using the service. There is also a small supported living group home for adults with learning disabilities who receive personal care. Five people were using this service at the time of our inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Relatives of people using the respite service said their family member enjoyed their visits and staff were very responsive to their individual needs. Routine was important for some people to maintain their well-being and we were told staff were careful to maintain their routines. People receiving personal care in supported living, said they were happy and staff provided the care and support they needed.

People were protected from avoidable harm and abuse by staff who were alert to the signs of abuse and knowledgeable about the action to take if they identified a concern. Staffing levels were planned to take into account people’s individual needs. Medicines were managed safely and people told us staff ensured they received their medicines regularly.

Staff were supported to deliver effective care and received training to gain and further develop their knowledge and skills. They received regular supervision and appraisal.

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 supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff were kind and caring and showed empathy and respect for the people they cared for. They protected people’s privacy and dignity, and supported them to express their views.

Staff were aware of each person’s needs and preferences and they received personalised care, tailored to their needs and wishes. People and families told us staff were flexible and willing to accommodate changes to their care and support needs. People were supported to maintain a healthy, varied and balanced diet. Staff worked with health and social care professionals to ensure people received coordinated and consistent care.

There was good leadership and management of the service. Quality audits were completed to monitor the service provided and identify areas for improvement. Staff and people using the service were able to express their views; they felt they were listened to and any concerns were addressed.

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 Good (published 06 October 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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 c

Inspection carried out on 29 August 2017

During a routine inspection

The inspection visit took place on 29 August 2017 and was unannounced.

Cedar House is a care home that provides short term accommodation and personal care and support for up to seven adults with physical and learning disabilities as well as people with autism. At the time of our inspection five people were using the service. The service supports 33 people at various times throughout the year. There is also a small supported living group home for adults with learning disabilities who receive personal care. Four people were using this service at the time of our inspection. At the last inspection on 14 April 2015, the service was rated good. At this inspection, we found the service remained good.

People continued to receive safe care. Staff knew their responsibilities to help protect people from harm and abuse. Risks associated with people’s care and support were assessed to help them to remain safe. The registered manager was making improvements to some people’s care records where it was known that marks or scratches could occur as people sometimes self-injured. Staffing numbers were suitable. The provider was currently recruiting an additional member of staff as there was a vacancy. The provider had safely recruited staff. This included carrying out the required checks. People received their medicines safely by staff who had received guidance and training to make sure they remained competent.

People continued to receive effective care from staff. Staff received training, guidance and support to make sure that they had the required knowledge and skills.

People were satisfied with the food and drink available to them and they were supported to maintain their health.

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 provided guidance in this practice.

People were supported by staff who knew people well and who were kind and compassionate. People’s dignity and privacy was maintained and staff communicated with people in ways that were important to them. People were supported to maintain their skills and were involved in decisions about their support where they could. Information about advocacy services was not available to people. The registered manager told us they would look at ways to help people to understand about these services and to provide information.

People received care in a supportive way that was based on their preferences and interests. Their support plans were focused on them as individuals and staff had up to date guidance about each person’s preferences and support requirements. People had opportunities to take part in activities that they enjoyed.

The provider’s complaints procedure was available to people and their family members. People’s relatives were confident that their concerns or complaints would be appropriately responded to.

People’s relatives and staff had opportunities to comment on the quality of the service. Improvements to communication were required as some staff and relatives did not always get the information they required.

Staff were aware of their responsibilities and received feedback on their work. They understood the aims that the provider strove to achieve.

The registered manager was aware of their responsibilities. This included them carrying out quality checks of the service to drive improvement.

Further information is in the detailed findings below.

Inspection carried out on 14 April 2015

During a routine inspection

Cedar House provides short term residential respite care and day respite for adults with learning disabilities and complex physical disabilities, living with family carers. It is registered to provide care for 6 people. Cedar House has 6 single bedrooms, all with en-suite facilities.

This was an unannounced inspection on 14 April 2015, and at the time of our inspection there were two people on residential respite care and two people attending for day respite.

The service had 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.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. At the time of our inspection no one was being deprived of their liberty.

Staff knew how to recognise and report any concerns so that people were kept safe from harm. People were supported to take reasonable risks while at the same time helping them to avoid coming to harm. People’s medicines were safely managed. There were enough staff on duty and background checks had been completed before new staff were appointed.

Staff had been supported to assist people in the right way including helping them to eat and drink enough to stay well. People had received all of the healthcare assistance they needed. People’s rights were protected because the Mental Capacity Act 2005 Code of Practice and the Deprivation of Liberty Safeguards were followed when decisions were made on their behalf.

People were treated with kindness, compassion and respect. Staff recognised people’s right to privacy, respected confidential information and promoted people’s dignity.

People received all of the support they needed including people who needed special support to reduce the risk of them becoming distressed. People and their families were consulted about the support they needed and families were encouraged to be involved in people’s care and spend time in the service. There was a system for handling and resolving complaints.

People had been consulted about the development of the service and some quality checks had been completed. However, further audits were required on new initiatives to ascertain if they were being embedded in practice. Staff received appropriate training. However, we could not be assured that there were systems in place which ensured staff training and reviews of their performance were planned in advance and that all staff training was up to date in line with the provider’s policies.