Background to this inspection
Updated
6 January 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team consisted of an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
The Cedars is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Cedars is a care home with residential care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
The nominated individual no longer worked for the company. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We made the registered manager aware and the provider addressed this shortly after the inspection.
Notice of inspection
This inspection was unannounced. Inspection activity started on 14 November 2022 and ended on 22 November 2022. We visited the location on site on 15 November 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider had completed a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, a senior carer, 2 care workers, an administrator and a member of the catering team.
We also spoke with 5 people living at the home, a visiting relative and a visiting health professional. We reviewed 4 care files in full plus other care records; 4 staff files and a variety of records relating to the management of the service. These included medication records, meetings, audits, policies, procedures and health and safety records.
After the inspection
We continued to seek clarification from the provider to validate evidence found and looked at supporting documents supplied electronically. We contacted a member of the night staff team, 2 relatives and 2 other health professionals.
Updated
6 January 2023
About the service
The Cedars is a residential care home providing care and accommodation for up to 34 people. The home provides care over 4 floors, including a lower ground floor, in a large, extended detached property. The home cares for people requiring help and support with daily living tasks, including people living with dementia. There were 30 people living at the home when we inspected.
People’s experience of using this service and what we found
People told us they felt safe in the home and with the staff who supported them. Risks to people's health, safety and wellbeing had been assessed and staff understood how to help keep people safe. The registered manager ensured enough staff were always on duty. Processes in place ensured safe staff recruitment, with a range pre-employment checks completed.
Medicines were managed and administered safely, with regular checks completed. We were assured the measures taken by the staff team contributed towards the prevention and control of infections. Premises checks and all maintenance records were up to date with the required test and safety certificates in place.
People, their relatives, professionals and staff spoke positively about the staff team; care and support was delivered by staff who were compassionate and respectful. There was confidence in the new leadership of the home. The new registered manager was approachable, maintained regular communication, and listened to the views of others; they had identified areas for improvement and were working to address these. People had no complaints.
A range of audits and checks were completed to maintain, and where required implement, any required improvements. The registered manager was keen to establish good working partnerships with professionals and local community groups, for the benefit of people living at the home.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 30 October 2019).
Why we inspected
The inspection was prompted in part by notification of an incident following which a person using the service sustained an injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk in relation to staffing levels. This inspection examined those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Cedars Rest Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.