Cedar Lodge (Nuneaton)

Vestige Healthcare (Nuneaton) is a residential care home providing nursing, personal care and rehabilitation services for up to 20 people with their mental health. At the time of inspection eight people lived at the home. The home was divided over three floors. Two floors were designated for accommodation, whilst the third floor was dedicated to staff areas. The provider had named the home Cedar Lodge.

People’s experience of using this service and what we found

People were kept safe by staff who knew how to report concerns, manage risks and identify when people might need support. Staff knew how to raise safeguarding concerns. There were sufficient numbers of staff to meet people’s needs. We saw that medicines were managed in a safe way.

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. Staff had received training to ensure they had the skills and knowledge to support people safely with their individual needs. Staff told us they also received regular, supportive supervisions. People’s dietary needs were being met, and they had access to healthcare services including a psychologist where needed.

People was supported by staff in a kind and caring way. People were supported and encouraged to become more independent, where possible. The service offered people an opportunity to take managed risks to increase their independence and wellbeing.

Staff knew the people well and care records detailed people’s preferences, likes and dislikes.

People had access to social activities that met their interests and needs. A complaints procedure was available for people to access.

People received personalised care and support to meet their needs and wishes. People using the service, relatives and staff were given the opportunity to provide feedback on the service. Audits took place to ensure the quality of the service was maintained.

Why we inspected

This was a planned inspection based on the previous 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.

Rating at last inspection and update

The service was registered with us on 11 April 2019, this was the first full inspection of the service to provide a rating in all five key areas. We previously inspected the service in September 2020 in the areas of Safe and Well Led only. At our previous inspection the service was given a rating of requires improvement in Safe and inadequate in Well Led. We identified two breaches of the regulations. The provider completed an action plan after the last inspection to show what they would do, and by when, to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Vestige Healthcare (Nuneaton) is a residential care home providing accommodation and personal care for 15 children and younger adults with learning disabilities and/or autism spectrum disorder. The service can support up to 20 people.

People’s experience of using this service and what we found

The providers systems and processes did not always ensure risks to people were known and people remained safe. While people received their medicines as they were prescribed, medicines were not always stored and managed in a safe way. Staff were recruited safely, however the provider relied on a significant number of agency staff. Infection control was well managed, and the provider ensured staff followed current government guidelines.

The providers systems to monitor the quality and safety of the service were not always effective and had not identified all areas for improvement. The providers systems had not identified the concerns that may arise with children and adults sharing the same space. The provider did not always communicate effectively with families and other professionals involved in peoples care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Rating at last inspection and update

This service was registered with us on 28 June 2011 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding, use of restraint and the care being provided. Additional concerns were shared with us by the Warwickshire Clinical Commissioning Group and Warwickshire Local Authority. A decision was made for us to inspect and examine those risks.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Vestige Healthcare (Nuneaton) on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to person centred care, safeguarding, recruitment practices and governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.