Cedar Grange

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 71 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care was generally person-centred, and staff demonstrated knowledge of people’s preferences and histories. We observed staff offering choices during meals and adapting when preferences changed. For example, after viewing the ‘show plates’ at lunch time, 1 person chose fish and chips and then said they didn’t like fish. Staff quickly removed the fish and offered them an alternative meal, checking they were happy with this option.

Staff were attentive and respectful, encouraging independence where possible. Care plans included personal details, such as hobbies and bedtime routines, though some lacked detail and consistency. Relatives confirmed staff were caring and tried hard to meet individual needs, but some raised concerns about bathing and showering frequency. We discussed this with the registered manager who made plans to enhance the bathing and shower provision.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Care was delivered by a stable core team supported by agency staff when needed. Staff reported effective handovers and use of the electronic app system, which improved efficiency. One told us, “I believe the handheld system makes us work faster and efficient. You have all info you need instantly so helps a lot when taking care of residents.” The service worked with external professionals, including district nurses and GPs, and facilitated timely referrals.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People and relatives were generally kept informed and felt able to raise concerns. Staff described clear handover processes and found the electronic system was useful for providing real-time updates to relatives when required. The service met the requirements of the Accessible Information Standard and ensured people’s communication needs were known and understood. Noticeboards displayed complaints procedures and advocacy details. One relative told us, “I am kept informed and have my issues dealt with.”

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Relatives and people told us they felt listened to and involved in care planning, particularly during the admission process. Complaints were managed appropriately, and relatives confirmed they knew how to raise issues. However, ongoing involvement in reviews was limited, and some decisions (e.g., dental care) were made without clear MCA or best interest documentation.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

There was no evidence of discrimination and people had equitable access to the service. Staff had 24-hour access to the registered manager or senior leaders who operated an on-call rota.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People experienced positive and equitable experiences and outcomes, which were not limited to their needs. Staff received training on equality and diversity and were confident in their understanding of people’s equality-related needs. Care plans contained information about people’s protected characteristics.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

End-of-life care planning was in place, with RESPECT forms (where people’s wishes regarding emergency medical care are recorded when they are unable to express them in the future) and funeral arrangements documented. Wishes were considered, and staff were aware of people’s needs. People received care according to their wishes.