• Care Home
  • Care home

Archived: Cedar Court

Overall: Good read more about inspection ratings

138 Lensbury Way, Thamesmead, Abbey Wood, London, SE2 9TA (020) 8311 1163

Provided and run by:
Four Seasons 2000 Limited

Important: The provider of this service changed. See old profile
Important: The provider of this service changed. See new profile

All Inspections

23 November 2017

During a routine inspection

The Cedar court is a ‘care home’ providing residential care for older people with dementia. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Cedar court accommodates up to 47 people in one adapted building. There were 43 people using the service at the time of our inspection.

This inspection took place on 23 and 24 November 2017 and was unannounced. At the last inspection on 5 and 6 September 2016 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. We found some aspects of the arrangements for the safe management of medicines for people using the service were not robust. Some aspects of the quality assurance systems were not effective. We asked the provider to take action to make improvements in these areas. They sent us an action plan telling us how they would address these issues and when they would complete the action needed to remedy these concerns. At this inspection we found this action has been completed.

The service did not have a registered manager in post. The previous registered manager left the service in May 2017. However the provider appointed a new manager to run the home. The new manager’s application to the CQC to become the registered manager was being processed. 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.

Medicines were managed appropriately and people were receiving their medicines as prescribed. Staff received medicines management training and their competency was checked. All medicines were stored safely.

The service had an effective system and process to assess and monitor the quality of the care people received. As a result of the checks and audits the service made improvements, which included care plans and risk management plans were up to date, and falls management had improved.

Staff knew how to keep people safe. The service had clear procedures to support staff to recognise and respond to abuse. The manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service and they were up to date with detailed guidance for staff to reduce risks.

The service had an effective system to manage accidents and incidents and to prevent them happening again. There were arrangements to deal with emergencies. The service carried out comprehensive background checks of staff before they started working and there were enough staff to support to people.

The manager and staff understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS). 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 support this practice. People consented to their care before they were delivered.

Staff assessed people’s nutritional needs and supported them to have a balanced diet. Staff supported people to access the healthcare services they required and monitored their healthcare appointments.

People or their relatives where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing.

Staff prepared, reviewed, and updated care plans for every person. The care plans were person centred and reflected people’s current needs.

Staff supported people in a way, which was kind, caring, and respectful. Staff protected people’s privacy, dignity, and human rights.

The service recognised people’s need for stimulation and social interaction. The service had a clear policy and procedure about managing complaints. People knew how to complain and would do so if necessary.

The service sought the views of people who used the services, their relatives, and staff to improve the service. Staff felt supported by the manager.

5 September 2016

During a routine inspection

This inspection took place on 05 and 06 September 2016 and was unannounced. There was a registered manager in place at the time of our inspection. 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.

Cedar Court is a residential home for up to 47 older people most of whom are living with dementia. At the time of our inspection there were 43 people using the service.

Medicines were not always managed, stored and administered safely. Staff had completed medicines training and the home had a clear medicines policy in place which was accessible to staff. However, guidance from the pharmacist on the safe and effective way to administer the medicines covertly was not in place, which posed a possible risk that they would not then be effective.

This issue was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Quality assurance systems were in place to monitor and improve the service. However, improvements were required as they did not identify the issues we highlighted above. The registered manager was not clear on when DoLS applications should be made for people at the home. Staff also required updates to their MCA and DoLS training to ensure that they were refreshed in line with the provider’s requirements.

These issues were a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Records showed that staff received regular supervision; however there were some gaps in training. The registered manager showed us that future bookings had been made where gaps had been identified. Staff understood the requirements of the Mental Capacity Act 2005 (MCA 2005); however improvements were needed to ensure that Deprivation of Liberty Safeguards (DoLS) applications were only made where people lacked capacity.

The home maintained adequate staffing levels to support people’s needs. Staff were subject to regular appraisal and were safely recruited with necessary pre-employment checks carried out.

Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. Staff demonstrated an understanding of types of abuse and how to raise safeguarding concerns. Risks to people using the service were assessed, reviewed, recorded and managed appropriately. Detailed and current risk assessments were in place for all the people at the home.

People were supported to eat and drink. People were supported to maintain good health and have access to healthcare services.

We saw friendly and caring interactions between staff and people and staff knew the needs and preferences of the people using the service. Care plans reflected people’s needs and were reviewed regularly.

Appropriate activities were on offer to stimulate people, and meet their individual needs. An appropriate complaints procedure was in place.

The registered manager was accessible to people, and staff spoke positively about the support available to them. Notifications had been sent to the Care Quality Commission as required.

20 June 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. We found that staff had the relevant qualifications to undertake their roles and meet the needs of people who use the service and these were assessed as part of the recruitment process. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. One recent application had been submitted and proper policies and procedures were in place to prevent people from being unlawfully restricted. Relevant staff were trained to understand when an application should be made, and how to submit one. We found that staff had a good understanding about adult safeguarding and they told us they would always escalate any concerns. A safeguarding policy was in place and staff attended an annual training session.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. One person told us. "It's alright here they look after me.' Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. We observed this at lunch time when we saw staff assisting people at their pace and were not rushed. One person told us 'They look after us well." Two relatives told us they have no concerns about the care. One said' the staff they genuinely care about people, staff are very caring.' Another relative said 'she is safe and getting good care.'

Is the service responsive?

People's needs had been assessed before they moved into the home. People told us they were happy with the care they received. Records confirmed people's preferences, history and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities and the resident's questionnaire found that people liked the activities provided and 85% felt stimulated and happy. The home had a barbecue in the garden on the day of our visit. We spoke to relatives who told us that the home was responsive to feedback one relative said 'they keep me informed and communicate with me if there are any changes.'

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Staff told us they were well supported by the team leaders and managers and that could raise any issues with them. Staffs had regular team meetings and were supported through supervision and appraisals. We found people had been consulted about the quality of the service provided through regular surveys and the results were displayed on the homes notice boards. People said they were happy with the range of activities in the home.

8 May 2013

During a routine inspection

We spoke with some people who used the service and their relatives about the quality of care they received. Each person we spoke with was overwhelmingly positive about the care they or their family member received at Cedar Court. One person's relative told us "I can't fault it one bit", and another said "They can't do enough for mum". People who used the service told us they were happy living at the home and they were complimentary about the staff. One person said "you couldn't get better staff", and a relative told us "staff are caring and they take time with people". One person's relatives told us the staff had helped them to better understand their family member's dementia, and they were always informed about their progress when they were unable to visit.

We found that staff sought consent from people before delivering care for them, and the provider acted in people's best interests when they lacked the capacity to make decisions for themselves. People received the care that was planned for them and the provider ensured any risks posed to people were reduced. We found the management of medicines was appropriate in terms of the record keeping, administration, storage and disposal, and staff were appropriately supported through induction, training, supervision and appraisal. We checked to see if the provider had made improvements to its quality assurance processes and we found the majority of shortfalls identified had resulted in improvements being implemented.

26 June 2012

During a routine inspection

People who used the service we spoke with told us they were happy living at Cedar Court.

People told us they were offered choices throughout the day including at mealtimes and when being helped to get ready in the mornings. People told us they were encouraged to do things for themselves where possible.

The people that use the service at Cedar Court had dementia and therefore not everyone was able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We found that staff interacted with people who used the service and were attentive to people's needs. Interactions by staff showed compassion and empathy towards people living at Cedar Court.