Archived: Two Cedars Residential Care Home

About the service:

Two Cedars Residential Care Home is a residential care home that was providing personal care to 17 people aged 65 and over at the time of the inspection.

Rating at last inspection:

Good (published 20 October 2016).

Why we inspected:

This inspection was a scheduled inspection based on the previous rating.

People’s experience of using this service:

People and relatives told us they were happy, felt safe and that staff had a good understanding of their needs and preferences. Staff listened to what people wanted and acted quickly to support them to achieve their goals and aspirations. Staff were respectful and kind in their approach and looked to offer people solutions to aid their independence and develop their life skills.

People had good community networks which were personal to them. This included, religious services and supporting people to access the local amenities and maintaining regular contact with family and friends. Equality, Diversity and Human Rights (EDHR) were promoted and understood by staff.

People were protected from avoidable harm as staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. When people were at risk of falling or skin damage staff understood the actions needed to minimise avoidable harm. The service was responsive when things went wrong and reviewed practices in a timely manner. Medicines were administered and managed safely by trained staff.

People, professional’s and relatives spoke highly about the management and staff had a clear understanding of their roles and responsibilities. Staff told us they felt the registered manager was visible and supportive. The registered manager was proud of their service and their staff team. Checks of safety and quality were made to ensure people were protected. Work to continuously improve was noted and the registered manager was keen to make changes that would impact positively on people's lives.

People and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

A full description of our findings can be found in the sections below.

Follow up:

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

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

Two Cedars Residential Care Home provides accommodation and personal care for up to 17 people. There was one vacancy at the time of inspection. The service is located in Broadstone and is a large detached building with bedrooms on both the ground and first floors. All rooms are en suite and there are bathing and wet rooms facilities available for people. The first floor can be accessed via a lift and the ground floor has a large lounge and dining area with access onto a patio and level garden. The home is wheelchair accessible and there are ramps at each of the entrances to the home.

People and their relatives told us they felt safe with the staff who provided their care and support. Staff were aware of their responsibilities in protecting people from harm and knew how to report any concerns about people's safety or wellbeing.

People had individual risk assessments giving staff the guidance and information they needed to support people safely. People were supported by staff who were familiar to them and we saw that staff had enough time with people to meet their assessed needs.

People were supported to receive their medicines by staff who had received appropriate training and medicines were stored safely.

People received care and support from staff who had the skills and training to meet their needs. Staff spoke highly about the training offered and as well as mandatory subjects, undertook training in specific topics including Dysphasia, Diabetes and catheter care.

Staff sought consent from people before providing support and they were aware of the principles of the Mental Capacity Act and had received training in this area.

People were supported to have enough to eat and drink by staff who understood what support they

required. People had choices about what they ate and drank and mealtimes were a relaxed, social occasion.

People were supported to access healthcare services when required and a healthcare professional told us that referrals were prompt and appropriate.

People told us that staff knew what their preferences were and how they liked to be supported. Staff were kind and caring and we observed that they had a relaxed and comfortable rapport with people.

People had input into their care plans and these contained details about people's likes and dislikes. Staff offered people choices about how their received their support and knew what was important to them.

We observed staff treating people with dignity and respect and staff encouraged people to be as independent as possible.

People had individualised care plans which reflected what support they needed and how they wished to receive their support.

People and relatives were involved in regular reviews about their support and encouraged to feedback through surveys. Feedback was also sought from people in weekly informal meetings and information was used to develop and improve practice.

People, relatives and staff felt that the management of the service was good. There was a clear management structure and staff knew their roles and responsibilities.

People were aware of who to contact if they were unhappy about any aspect of their care and support and there was a system in place to manage complaints.

Communication between staff and management was positive. Staff were encouraged to raise issues and discuss queries and felt valued in their role. There were staff handover meetings three times each day where practice and ideas were discussed.

Quality assurance systems at the service were in depth and information received was used to identify trends and areas for development.

We looked at records relating to people's care and saw that people's wishes had been taken into account in planning their care, with the help of relatives if necessary. Risks to people's health had been balanced with their wishes to lead as independent a life as possible. We saw that the food provided at the home was of a good quality and people told us they enjoyed it.

We spoke with five people and one relative. One person told us "they're very good, very caring" about the staff. Another person said their relationship with staff was "very good" and added that the staff knew their needs.

We spoke with three members of staff who all felt well supported with training for their role. One member of staff told us they "couldn't fault the training here".

People living at Two Cedars were positive about their experience of living there. No one we spoke to voiced any concerns about the home, or the way in which it was managed. People told us they liked living there and it felt homely. They said that all the staff were very supportive and friendly. Some of the comments we received included ' 'I love it here and I can do what I like and the staff will help me'. Another comment included 'I couldn't have chosen a better home, its lovely here and I like my room and the staff'.

People told us that they were involved in decision making and the staff would ask them if they required support and respected their decisions. People told us they were always offered choice giving examples such as meals, drinks, what time they would like to wake up. People told us they could choose to live how they liked and the staff respected their wishes.

We found that people's needs were assessed and that care was delivered in line with their individual care plans and risk assessments.

We found safeguarding policies and procedures in place and spoke with staff who demonstrated a good understanding of safeguarding and what to do if they had concerns.

We found the provider had effective systems in place to monitor the quality of the service.