Archived: Cedar House Care Home

Updated 23 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an unannounced inspection and took place on 27 June 2018

This inspection was carried out by two adult social care inspectors.

There were 24 people living at the home. We spoke with three people, four relatives, two staff, the registered manager, one person visiting the home and one of the directors of the service.

Prior to the inspection we reviewed all of the information we held about Cedar House including any statutory notifications that the provider had sent us and any safeguarding information we had received.

Notifications are made by providers in line with their obligations under the Care Quality Commission (Registration) Regulations 2009. They are records of incidents that have occurred within the service or other matters that the provider is legally obliged to inform us of.

We checked to see if there had been a recent visit from Healthwatch. Healthwatch is an independent consumer champion created to gather and represent the views of the public. A visit had been made on 27 September 2017. No concerns had been raised as part of this visit and the Healthwatch report included positive feedback regarding a recent survey of the service.

We also contacted the local authority commissioning authorities and safeguarding teams and used the information they provided when planning this inspection.

During our visit we observed care and support provided by staff within the home. We looked at the personal care and support plans for two people and two staff files.

We also checked a variety of records related to the quality and safety of the service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 23 August 2018

This inspection took place on the 27 June 2018 and was unannounced. This meant that the provider did not know we would be visiting

Cedar House 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. Cedar House provides care for up to 31 people some of whom are living with dementia. At the time of our inspection 24 people were living at the home.

The home had a registered manager. 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.

We previously carried out an unannounced inspection in July 2016 where we rated Cedar House as good. The provider had a breach under Regulation 9 HSCA Regulations 2014, Person centred care. This meant that people’s care was not always designed in such a way as to meet their needs and reflect their preferences.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve person centred care to at least good.

At this inspection we saw that the provider had taken appropriate action and the breach identified at our last inspection had been addressed.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last comprehensive inspection.

People and their relatives who we spoke to during the inspection, confirmed they felt safe living at Cedar House. Care provided was person centred and compassionate and staff knew the people they cared for very well.

Staff followed the provider’s procedures for safeguarding and were able to explain how they would keep people safe from harm or abuse. Staffing levels were suitable to meet the individual needs of people. Records reviewed showed the provider had a robust recruitment process in place to ensure that only people who were suitable to work with vulnerable people were employed to work at Cedar House.

On the day of the inspection we identified an issue was identified with the fire exit. You can read more detail regarding this later in the report.

We reviewed training records as part of our inspection and found that some training was out of date. We have made a recommendation about the timeliness of training.

Staff supervision and an appraisal system ensured staff had regular opportunities to discuss and evaluate their learning and development needs and their work performance.

Staff understood the principles of the Mental Capacity Act, 2005 (MCA) and ensured they gained people's consent before providing personal care and support. People were encouraged to be involved in decisions about their care.

The provider had a quality assurance process in place to check the quality of care provided, this included medicines management, monthly health and safety audits, premises checks and accidents log.

Activities play a big part of daily life at Cedar House and the provider places great emphasis on ensuring that people have access to activities both inside and outside of the service. Some staff have undergone specific training for people living with dementia, and the provider has invested in equipment one of which allows people to enjoy more meaningful contact with their families who live abroad.

A complaints procedure was available and people were able to provide feedback of their views of the service. This included the opportunity for attendance at residents and relative’s meetings.

Staff and relatives that we spoke to confirmed that the registered manager was both supportive and approachable. Staff confirmed they were encouraged to share ideas and improvements with both the registered manager and provider.