Cedar Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

Good: This meant people were safe and protected from avoidable harm. People were fully involved, and the provider was open and transparent when things went wrong.

The provider was previously in breach of the regulation in relation to infection control and cleanliness. Improvements were found at this inspection and the provider was no longer in breach of this regulation.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager was able to demonstrate that they took complaints seriously and listened to people’s concerns and took action to satisfy the complainant. We examined these records and saw actions taken. Feedback from the local authority was positive. They told us, “Any concerns and feedback are always responded to. The service looks into each concern and provides a response which includes what they have already done or will do”. A relative told us that when they made a complaint improvements were made. We found the registered manager to be open and willing to actively listen to feedback.

The registered manager worked with people and health/social care partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

All people were assessed before they moved into the service by the registered manager who was able to determine that Cedar Lodge could meet their needs. A relative described the assessment visit, “The registered manager made the effort to find out about my relative, his likes and dislikes, so this made his transition easier.”

Additional information was routinely sought from other professionals to support that judgement. This included assessments and advice that was then utilised to keep the person safe. People were safely readmitted to the service if they had a stay in hospital as their needs were reviewed before their return so that any adjustments could be made.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

There were systems in place that staff were aware of and staff were confident to report any concerns they identified. One person told us that they wouldn’t stand for any abuse and would stand up for themselves and others. A relative said, “I have found the staff to be pleasant,and they do update me when I visit. I think they do treat [my relative] well.” Feedback from the local authority was that the registered manager would involve them and seek advice where needed.

The registered manager was aware of their duty of candour and conduct in such circumstances and was able to follow local reporting processes and use advice lines to keep people safe.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s safety were identified and managed well, in a timely way. For example, people’s emergency evacuation plans were in place and kept under regular review or when circumstances changed. A relative recounted that their relative had several falls when living alone, but since admission to Cedar Lodge none had occurred.

People’s care plans and associated risk assessments contained detail for staff to guide them on the type and level of support a person needed to meet their needs and mitigate any risks to their safety. Risk assessments were detailed and contained risks such as the risk of developing pressure sores, mobility and falls. This resulted in people receiving consistent support from staff to manage risks associated with their health and wellbeing. Staff knew people at the service well and were able to describe their needs and support required to keep them safe. Staff told us that they received training in a range of areas including moving and handling, nutrition and first aid.

The provider detected and controlled potential risks in the care environment. They made sure equipment, and facilities supported the delivery of safe care.

There were arrangements in place to check the safety and upkeep of the premises, and address issues that presented a potential risk to the health and safety of people using the service.

The environment had improved since our last inspection. For example, new furniture in the hair salon had been purchased along with decoration and replacement of curtains and lampshades. The walls had been painted and there were new floor coverings in some areas.

Since our last inspection, the staircases were now risk assessed and altered to make them safer for people using the service. A relative spoke of the keypad entry to keep people safe and the step free entrance for people who use wheelchairs and that they were able to reverse their car right up to the front door to make visiting easier for disabled people.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There were systems in place to ensure staffing levels met the changing needs and number of people who lived in the home. People’s dependency levels were assessed and regularly reviewed. Staff told us that they had the time they needed to meet people’s needs. One member of staff told us, “There is enough staff, the manager makes sure there is enough, even at a weekend.” Feedback from relatives was that there were sufficient staff provided.

We observed that staff were visible in communal areas and ensured that people did not have to wait for care when they needed it. Staff told us of the supportive team in which they worked. Staff were willing to cover for each other to enable them to take leave or attend training.

Staff were recruited safely and records evidenced that checks were undertaken prior to new staff commencing employment.

The provider assessed and managed the risk of infection known to them They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly once they were aware of the risks.

Since our previous visit a wash hand basin was now located within the laundry room to allow staff to wash their hands before leaving, this reduced the risk of cross infection. There were cleaning schedules in place and audits by managers. However, we identified a small number of rooms that had an odour despite regular cleaning of carpets. The registered manager agreed to replace those carpeted rooms with a more suitable flooring for the occupant, that would also allow thorough cleaning. Some seating in the entrance hall had visible stains and odour of stale urine. The seating was domestic in nature and was not easily sanitised.

A relative was not satisfied with the frequency and thoroughness of a person’s bedroom being deep cleaned. This was brought to the attention of the registered manager to resolve and was resolved to the persons satisfaction.

Staff confirmed they had received training in prevention and management of infection control.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were stored securely and there were systems in place to ensure people had access to their medicines as prescribed. Clear records were maintained and stock levels checked tallied with the administration records. This included controlled medicines that required additional checks and security. There were protocols in place for medicines prescribed on an ‘as required’ basis which helped ensure staff followed a consistent approach. Staff handling people’s medicines had their competence assessed regularly. There were regular monthly audits to check on whether policy and procedures were followed and medicines administered in line with best practice.