We carried out a review of the data available to us about Cedars Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cedars Care Home, you can give feedback on this service.
Cedars Care Home is a residential care home providing support to older people and people living with Dementia. It consists of two buildings known as Cedars Lodge and Cedars House and can accommodate up to 66 people. At the time of our inspection there were 60 people using the service.
People’s experience of using this service and what we found
There were enough staff to meet people’s needs. However, people, relatives and staff told us staff lacked time to provide meaningful activities. We have made a recommendation the service assesses how staff are deployed.
Infection prevention and control measures were in place. People were protected from the risk of harm; staff were aware of how to report concerns and told us they felt comfortable to do so. Risk assessments were in place and detailed how to keep people safe and regular checks were carried out on the environment and equipment. Medicines were safely managed, and people were receiving their medicines as prescribed. Incidents and accidents were monitored and shared with the senior management team, any actions required were identified and action taken to mitigate future risk.
People’s care plans were detailed, and person centred. The manager understood their role and responsibilities and there was an open and honest culture in the service. People were involved in decisions, regular meetings took place to gain feedback from people, relatives and staff The manager and staff worked in partnership with other healthcare professionals to ensure people received appropriate care and support. Auditing systems were in place and action was taken to ensure the management team continuously assesses and seeks to improve.
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
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 27 May 2021)
Why we inspected
This inspection was prompted by a review of the information we held about this service. We received concerns in relation to staffing and people’s care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cedars Care Home on our website at www.cqc.org.uk.
Recommendations
We have made a recommendation that the provider ensures suitable staff are deployed to meet people’s needs.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
People’s experience of using this service and what we found
We found there were not always enough staff on duty to meet people’s needs. Following the inspection the management team took immediate steps to address this.
People using the service, and their relatives, were positive about their experience of receiving care at the home. In particular, relatives praised the kindness of staff.
The systems in place to manage the risks of infection, including those presented by the COVID-19 pandemic, were robust. We observed visits being safely managed, and staff use of PPE was appropriate.
Medication was safely managed, and the systems used by managers to monitor the effectiveness of the service were thorough. Staff were recruited safely.
The provider had implemented imaginative ways to support staff during the pandemic, including gifts for staff, financial support for testing and isolating and the provision of a confidential counselling telephone service. However, staff we spoke with told us they didn’t feel supported. The management team told us they would therefore conduct a survey of staff to identify areas where additional support was required.
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 July 2018).
Why we inspected
The inspection was prompted due to concerns received about how the provider was ensuring people were cared for safely. A decision was made for us to inspect and examine those risks. As this was a focussed inspection, we reviewed the key questions of safe and well led only. Ratings from previous comprehensive inspections for other key questions were used in calculating the overall rating at this inspection. The overall rating for the service remains good.
We looked at infection prevention and control (IPC) measures under the Safe key question. We look at this at all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cedars Care Home on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
Staff were observed regularly decontaminating their hands and reapplying Personal Protective Equipment (PPE). Residents were observed being supported to clean their hands prior to having meals.
Designated visiting areas had been made available to accommodate safe visits. An outdoor pod was being used so visitors could sit in a sheltered area and have window visits with their loved ones.
Regular COVID tests have taken place and they had helped to identify an outbreak in the home and the provider had been able to follow guidelines on isolation and cohorting staff.
The service received regular input from external health professionals, who had offered support and guidance, which the provider had followed.
Regular and detailed infection control audits were taking place and action was taken to address any shortfalls identified.
Further information is in the detailed findings below .
The Cedars is a ‘care home’. People in care homes receive accommodation and nursing or 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 Cedars comprises of two units totalling 60 beds; one unit [The Lodge] accommodates people living with dementia, while the other unit [Cedar House] supports people requiring assistance with their personal care. Nursing care is not provided. At the time of our inspection 47 people were living at the home.
The service had a registered manager in post 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.
Care and support was planned and delivered in a way that ensured people were safe. People were protected, as any risks associated with their care were identified and appropriately managed. Systems were also in place to safeguard people from abuse.
The process for recruiting new staff ensured they were suitable to carry out their roles and responsibilities in a safe manner. Staff were trained and supported to develop their skills and provide people with the standard of care they required.
There was enough staff employed to meet the needs of the people living at the home at the time of our inspection.
Medication was managed safely and administered by staff who had completed appropriate training.
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 supported this practice.
People received a varied and healthy diet that offered choice. However, we noted the dining experience people received could have been better, the registered manager was working to address this.
Staff supported people in a compassionate, caring, responsive and friendly manner. They encouraged them to be as independent as possible, while taking into consideration their abilities and any risks associated with their care. All the people we spoke with made positive comments about how staff delivered care and said they were happy with the way the home was managed.
People’s needs had been assessed and care plans put in place to highlight where they needed support, and telling staff how each person preferred their care to be delivered. People’s care had been reviewed regularly to make sure plans reflected people’s changing needs.
There was a range of activities and events people were supported to take part in.
There were systems in place to continuously assess and monitor the quality of the service. This included obtaining people’s views and checking staff were following the correct procedures. Improvements to the premises were underway with a clear action plan as to what areas needed attention.
Further information is in the detailed findings below.