Serenata Care Ltd Trading as Two Cedars

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.

This is the first inspection for this provider. This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed before they moved into the home. Care plans had been recently reviewed and provided information about people’s communication and health needs.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People and relatives provided mixed feedback about the quality of the food. Comments included, “Food is fine”, “It’s not too bad”, and “Food is not so good”. A recent residents meeting had gained people’s feedback about the food and menu suggestions to make improvements. Nutrition and hydration needs, as well as information on food allergies, were assessed and formed part of people’s care plan. This information was shared with the kitchen staff.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People were supported by staff who communicated with external professionals and shared relevant information when needed. Communication with healthcare professionals was documented.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. The provider did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were not always supported to access the community and enjoy meaningful activities. The provider did not always involve people in making decisions about their wellbeing. This meant the provider could not be assured care was consistently supporting people’s health or quality of life. Staff told us they supported people to maintain their independence. A staff member said, “I do very much feel like we empower as much independence as we can for the residents. I think this is super important.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Records showed staff monitored people’s care and support. For example, where people required to be regularly repositioned, turning charts were in place to ensure care was provided in line with their needs. Staff told us when they reported changes to people, care plans were updated and staff were informed of these changes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Where people had capacity to make decisions, the provider had worked with people and documented what aspects of care and support people consented to.The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Where appropriate, individuals with legal authority may make decisions in line with the requirements of the Mental Capacity Act (MCA). However, the provider did not have clear oversight of who was lawfully able to act on behalf of people and did not hold the necessary documentation to evidence this. As a result, some relatives had signed to give consent on behalf of people without evidence that they had the legal authority to do so. The manager told us they would obtain the relevant documentation from relatives to address this. Staff had completed training in mental capacity, and we did not identify any direct impact on people at the time of inspection.