Archived: The Cedars

Updated 11 May 2016

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 inspection took place on the 9 February 2016 and was unannounced. The inspection team consisted of one adult social care inspector, one bank inspector, a specialist advisor and an expert by experience. The specialist advisor had experience of this type of service and had a nursing background. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed other information we held about the home, including the notifications we had received from the provider about serious injuries or other incidents. We contacted the local authority commissioners for the service and the safeguarding team, the local Healthwatch and the clinical commissioning group (CCG). Healthwatch is an independent consumer champion which gathers and represents the views of the public about health and social care services. We also contacted the local fire and rescue service. We used their comments to support our planning of the inspection.

During this inspection we carried out observations using 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.

The service was made up of a multi-disciplinary team whom supported people. It included consultants, physiotherapists, GP’s, occupational therapists, nurses and carer staff. During the inspection we spoke with 14 people who were receiving rehabilitation and with eight relatives. We also spoke with 11 members of care staff (including nurses and support coordinators), the service administrator, two members of domestic staff, two kitchen staff, the registered manager, two assistant managers and the lead speciality doctor for orthogeriatric medicine at the service.

We observed how staff interacted with people and looked at a range of records which included the care and medicine records for five of the 29 people who used the service, five staff personnel files, health and safety information and other documents related to the management of the home.

Updated 11 May 2016

The inspection was unannounced and took place on 9 February 2016. When we last visited the service in 2014 we found the service was meeting the regulations that we inspected.

The Cedars is a 30 bedded short term rehabilitation service. A range of services is offered, including support after surgery for fractures and support to increase independence and confidence in daily living skills. The aim is to help people with a safe return to their home. There were 29 people receiving rehabilitation and support at the service on the day of the inspection.

There was a registered manager in place. 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.

Although the service was clean and tidy, overall, we found the premises generally in need of an update. The décor was dated and there was limited specialist signage in place to support people who may have had issues with their memory or those who may be living with dementia.

People told us they felt safe and well cared for and staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe.

Accidents and incidents were recorded and monitored and risks had been assessed. Actions had been completed to reduce the likelihood of risks occurring.

People were cared for by staff that demonstrated knowledge of the different types of potential abuse to people and how to respond to actual or suspected abuse.

Medicines were safely managed and people received them as they were required. Temperature checks were required to ensure that medicines were suitably stored.

People told us their needs were met promptly and staff confirmed sufficient staff numbers enabled them to meet people’s needs and perform their roles effectively.

Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. We found the provider was complying with their legal requirements.

People were positive was about the food they received. People accessed other healthcare professionals such as GP’s, occupational therapists and physiotherapists to aid their rehabilitation.

People using the service were positive in their feedback about the service. People were involved in making decisions about their care and treatment and said their privacy and dignity was maintained. We made observations which supported this.

People received care which met their individual needs. They were encouraged to express their views and give feedback about their time at the service. People said staff listened to them and they felt confident they could raise any issues should the need arise.

Staff spoke highly of the management team and felt supported. Staff and external health professionals told us the culture of the service was positive and spoke well of the teamwork within the service. The quality of service provision and care was continually monitored and actions taken where required.