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Reports


Inspection carried out on 24 July 2018

During a routine inspection

We inspected this service on 24 July 2018. The inspection was unannounced.

The service provides accommodation, nursing and personal care for up to 47 older people who may live with dementia. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The accommodation is split into two units over two floors and 42 people were living at the home on the day of our inspection.

There was 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.

At our previous inspection in May 2017, we identified improvements were required in delivering responsive care and treatment and in the leadership of the service. At this inspection, we found improvements had been made and the overall rating of the service has now changed to ‘Good’.

There were enough suitably trained staff with the appropriate skills and knowledge to care for people safely and respond to their emotional and social needs. People’s risks to their health and wellbeing had been identified, and staff understood the importance of their role in supporting people to minimise those risks. The registered manager checked staff’s suitability to deliver care and support during the recruitment process.

The provider worked in partnership with other healthcare professionals to ensure people received effective care that was responsive to their needs. People’s medicines were stored and managed safely. Medicines were given in accordance with people’s prescriptions by staff who had received training in safe medicines management.

Staff knew people well and were kind and compassionate in their approach. Staff recognised how their attitudes and contribution had an impact on the quality of care people received. They worked in accordance with the provider’s values of recognising people’s individuality and treating them with dignity and respect. Families were encouraged to spend quality time with their relatives and staff helped people share special moments with those who were important to them.

The home had a welcoming atmosphere, was clean and well-maintained and supportive of people’s needs. People were able to take part in a range of leisure activities and other pursuits which reflected their choice and interests and promoted their physical, emotional and mental health.

The registered manager understood their responsibility to comply with the requirements of the Deprivation of Liberty Safeguards (DoLS). People's right to make their own decisions about their care, were supported by staff who understood the principles of the Mental Capacity Act 2005.

There was a strong emphasis on people eating and drinking well. Staff had a good understanding of people’s nutritional risks so they could meet their individual dietary requirements.

People were encouraged to raise concerns and make complaints and they were confident these would be listened to and responded to promptly.

The registered manager had been registered with us since August 2017 and had the skills and ability to provide effective leadership within the home. The registered manager had a clear vision and created a positive culture where staff felt supported to learn and develop. Staff felt confident to raise any concerns or make suggestions knowing they would be listened to by a responsive management team.

The provider and registered manager conducted regular audits of the quality of the service to make sure people received safe. effective care. They also responded to feedback they received from people to improve the standards of care and identify areas of developmen

Inspection carried out on 3 May 2017

During a routine inspection

This inspection took place on 3 and 4 May 2017 and was unannounced. Cedar Lodge provides personal care and accommodation for up to 48 older people. There were 44 people who were living at the home on the day of our visit.

While there was a registered manager in place at the time of our inspection they were not working at the home and an interim manager was in place. 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.

People lived in a safe environment as staff knew how to protect people from harm. We found staff recognised signs of abuse and knew how to report this. Staff made sure risk assessments were in place and took actions to minimise risks when supporting people. Staff ensured people remained safe. People’s medicines were administered and managed in a safe way.

The interim manager supported staff by arranging training so staff developed the skills to provide care and support to people which was in-line with best practice. People and relatives told us of the positive benefits this had on the care and support received. We found that staff provided people’s care with their consent and agreement.

People were supported to eat a healthy balanced diet and with enough fluids to keep them healthy. People had access to healthcare professionals, such as their doctor when they required them.

We saw people and relatives were involved in the planning of their care and staff knew people well. People and relatives told us that staff were kind and treated them with dignity and their privacy was respected.

Staff told us they had to prioritise their personal care and were not always able to spend time with people to support them emotionally, we found this had a negative impact to people who lived with dementia.

People were supported to continue with their hobbies and interests. People told us they had a choice to attend outings and entertainment in the home. People told us they enjoyed these activities where they had attended. Where people wanted to spend time in their rooms staff respected their decision.

We found people knew how to complain and felt comfortable to do this should they feel they needed to. We looked at the providers complaints over the last three months. We found two complaints had been received, all of which had been responded to with satisfactory outcomes for the complainants.

Relatives and staff felt that better communication from the provider was needed around the leadership of the home. We found that the checks that the provider had in place looked at people's experiences however had not considered staffs views and how they supported staff to meet people’s emotional well-being needs.

Inspection carried out on 21 October 2014 and 22 October 2014

During a routine inspection

The inspection took place on 21 October and 22 October 2014. It was an unannounced inspection.

Cedar Lodge provides residential and nursing care to older people with dementia. It is a purpose built home which is registered to provide care for 48 people. The home has two floors, a ground floor unit provides care for people who are more independent. The first floor provided nursing care to people with more complex needs. People who lived at the home had limited mobility. At the time of our inspection there were 35 people living at the home.

Cedar Lodge is required to have 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 and associated Regulations about how the service is run. At the time of this inspection, there was a registered manager in post.

People who lived at Cedar Lodge, relatives and staff told us people were safe. There were systems and processes in place to protect people from the risk of harm. These included robust staff recruitment, staff training and systems for protecting people against risks of abuse. Risks to people were minimised because people received their care and support from suitably qualified staff in a safe environment that met their needs.

People told us staff were respectful and kind towards them and we saw staff were caring to people throughout our visit. We saw staff protected people’s privacy and dignity when they provided care to people.

People told us there were enough suitably trained care and nursing staff to meet their individual care needs. We saw staff spent time with people, provided assistance, support and reassurance to people who needed it. We saw people were encouraged to participate in activities and were supported by staff to go out on trips within the local area.

Staff understood they needed to respect people’s choice and decisions if they had the capacity to do so. Assessments had been made and reviewed about people’s individual capacity to make certain care decisions. Where people did not have capacity, decisions were taken in ‘their best interest’ with the involvement of family and appropriate health care professionals. This meant the provider was adhering to the Mental Capacity Act 2005.

The provider was meeting their requirements set out in the Deprivation of Liberty Safeguards (DoLS). At the time of this inspection, no applications had been made under DoLS for people’s freedoms and liberties to be restricted. The registered manager had contacted the local authority and was in the process of reviewing people’s support in line with recent changes to DoLS.

People’s health and social care needs had been appropriately assessed. Care plans provided accurate, detailed and relevant information for staff to help them provide the individual care people required. Any risks associated with people’s care needs had been assessed and plans were in place to minimise the potential risks so people remained safe.

There was a procedure in place for managing people’s medications safely.

There were systems in place to monitor and improve the quality of service people received. The registered manager had plans in place to ensure the effectiveness of regular checks would be maintained. Staff told us they felt supported by colleagues and managers and if they had any concerns, these would be listened to and acted upon.

Inspection carried out on 4 April 2013

During a routine inspection

We carried out an inspection on 13 December 2012 and published a report setting out our judgements. We asked the provider to send us a report of the changes they would make to comply with the standards they were not meeting.

We have carried out an inspection to make sure that the necessary changes had been made and found the provider was meeting the standard included within this report.

Some of the people who lived at Arden Valley were unable to express their views verbally, so we spent time observing how staff supported them. We were able to speak with some people who used the service and their relatives to obtain their views.

We were told by the people and relatives that they had been involved in their care and treatment.

We saw people�s care files contained up to date information. This meant staff had information available about the people they looked after.

People�s nutritional needs were being met by the home. One person told us �The food is excellent.�

We saw there were enough staff on duty to look after the needs of people who lived at the home. However, at lunchtime we saw some people were kept waiting for their meal.

Systems were in place for the provider to monitor the quality of service provided at Arden Valley. There was a process in place to enable people to raise concerns about the service.

People who lived at the home were given the opportunity to discuss the day to day running of the home with the manager.

Inspection carried out on 13 December 2012

During a routine inspection

We carried out an inspection at Arden Valley Nursing Home. The visit was unannounced so that no one living or working in the home knew we were coming.

Some of the people who lived at Arden Valley were unable to express their views verbally, so we spent time observing how staff supported them. We were however able to speak with three people who used the service and two relatives to obtain their views.

We were told by one person and two relatives that they had been involved in their care and treatment. We saw that the consent to care form had not been signed by the person who lived at Arden Valley or their representative.

Although care staff knew people�s care needs, we saw people�s care files did not always contain up to date information. The care files were not well organised which meant we found it difficult to find some of the information.

People and their relatives told us they felt safe at Arden Valley. One person said �Staff are polite and I feel safe.�

We looked at training records and we saw that not all staff had received training in key elements of care. The manager told us further training had been arranged.

We were told by care staff that they met regularly with their manager.

Systems were in place to monitor the quality of care at Arden Valley. People who lived at the home were given the opportunity to discuss the day to day running of the home with the manager.