Cedar Oak Healthcare Services Ltd

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 50 (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 did not always treat people with kindness, empathy and compassion. People’s experiences of care were mixed. Staff did, however, respect people’s privacy and treated colleagues from other organisations with kindness and respect.

One person told us they felt staff were often in a rush, which had an impact on their family member. They told us, “Some of the carers are a little heavy handed with [family member] and I hate to hear [family member] calling out in pain. I’ve asked them not to be so rough.” Other relatives told us they felt staff rushed to get things done so they were able to leave. We shared this information with the provider who told us they would take steps to investigate these concerns.

In contrast, we received comments from people and relatives, which demonstrated they felt staff were kind and considerate of people’s needs. Comments included, “They are nice. I can’t think of nicer people.” And “They are all very nice. When I am in bed, they ask if I am comfortable before they go.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff were not always aware of people’s life histories, hobbies and past occupations. When asking staff to tell us about people, the majority of staff were able to describe people’s care needs but were not able to share information apart from the names of relatives who people lived or were close to. Knowing about people’s lives and what has been important to them is important to help staff in getting to know the individual and forming trusting relationships. Records showed this information was in people’s summary care plans and was therefore accessible to staff.

In other instances, people and their relatives described connections between staff and their family members positively. One relative told us, “The carers are really nice people. They have a laugh and a joke with, they treat [family member] very well. They joke together about [the football team the person supports] and have a coffee together.”

People’s preferences regarding the gender of staff were not always explored or recorded, and some relatives told us this had never been discussed. This meant people’s preferences were not always considered when planning their care.

One relative told us, “I don’t think [family member] minds but it would be nice to try a change and see if [staff of the opposite gender] would make a difference.” Whilst some people and relatives told us that having a consistent staff team meant they felt more at ease and in control of their care, others said that frequent changes in staff made their family member anxious. This was of particular concern when staff had not been introduced prior to them arriving to provide the person’s care. One relative told us, “They sometimes send new carers who have no experience of dementia. It causes major problems.”Following our assessment the provider shared evidence that people’s personal profiles were being updated to increase the level of personalisation.

In other areas we found measures were in place to support people with maintaining their independence where possible. This included ensuring people were able to cook, clean and run their household independently with the support of staff. One person told us they continued to enjoy cooking for themselves, and staff would later heat their meal up for them. One relative told us, “[Family member] is very independent. [Family member] has a wheelchair but if [they] want to walk, staff will support them but have the wheelchair ready. They help and do not overpower.”

The provider did not always listen to or understand people’s needs, views and wishes. Meaning people were at risk of not having their views understood or responded to. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

We received a number of concerns regarding how clearly staff communicated due to English not being their first language. One relative told us some staff would shout when speaking to their family member in an effort to make them understand what they were saying. A second relative told us, “They [staff] don’t sit down and talk to [family member] but they may stand and say something. [Family member] is not very responsive because most [staff are from overseas] and [family member] doesn’t understand their accents.” No additional measures to support understanding between people and staff had been implemented. This meant people were at risk of feeling their views were listened to or responded to.

Where people experienced falls or significant deterioration in their health, staff ensured they were supported and medical assistance summoned as required. Staff we spoke with were able to describe what immediate action they would take to ensure people’s safety. Records confirmed this action had been taken.

The provider did not always ensure staff wellbeing was promoted or that staff were consistently supported to deliver person-centred care.

Staff told us they felt supported by the provider and management team and able to raise any concerns with them. One staff member told us, “We receive excellent support from the office. They will support us in any way they can.”

Despite these positive comments we found the needs of care staff were not always considered when planning rotas where travel time was not provided between calls. This is known to contribute to staff fatigue and stress due racing against the clock to meet care visits, which placed staff under pressure and increased the risk of rushed or task-focused care

The provider told us they encouraged staff to contact the office or on-call service at any time and that support was always available. They told us, “There is always someone available for the staff, any problem at all we will listen to and assist them with.”