Archived: The Cedars Care Home

Updated 21 June 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The first day of the inspection was carried out by one inspector, an assistant 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. In this incidence they had experience of caring for an older person and dementia care. Two inspectors returned to the service on the second day to complete the inspection process.

Service and service type:

The Cedars Care Home is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

Both days of this inspection were unannounced.

What we did:

Before the inspection we looked at information, we held about the service. Including; previous inspection reports, details about incidents the provider must notify us about, such as serious injury, events that stop the service running and safeguarding alerts. We reviewed the information in the provider information return. This is key information providers are required to send us about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection, we spoke with six people living in the service and six relatives to ask about their experience of the care provided. Some people living in the service could not easily give their views and opinions about care. To help us gain a better understanding of people's experiences we observed interactions between people and staff in communal areas. We spoke with 12 members of staff including the registered manager, care workers and activities and domestic staff. We also spent some time with the provider.

To gather information, we looked at a variety of records, including care records relating to five people living in the service. To ensure the provider and registered manager had oversight of the service we also looked at other information relating to the management of the service.

Updated 21 June 2019

About the service:

The Cedars Care Home provides accommodation and personal care for up to 63 people. The service is spilt into two units, both of which support people who may have dementia related needs. At the time of the inspection 40 people were living in the service.

People’s experience of using this service:

The service had made improvements since our last inspection. However, further improvements were required following this inspection.

Risk assessments did not consistently reflect people’s current needs. Further work was required to ensure the consistency of recording in care plans.

There were not always enough staff to ensure people received care and support tailored to meet their individual needs.

Staff did not have access to regular supervision sessions or annual appraisals.

The provider and registered manager did not have systems in place to ensure they had oversight of the service.

Staff understood their responsibilities to safeguard people from the risk of harm. There were systems in place to ensure the safe management of medicines.

People were supported by caring and compassionate staff who supported people with patience. People's right to privacy was up held and their independence was promoted.

Relatives knew how to raise concerns or make a complaint and were confident they would be responded to appropriately.

From our discussions with the provider and the registered manager, we were assured they were committed to making the required improvements to ensure people experienced consistently good outcomes.

Rating at last inspection: At the last comprehensive inspection the service was rated as Requires Improvement (published 30 January 2018).

This is the second time the service has been rated as Requires Improvement.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. At the last inspection on, 28 November 2017 we found some staff were task focussed and did not have the time to offer or support and encourage people to do a meaningful activity. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the quality of the service. At this inspection, we looked to see whether the provider had implemented the action plan.

Enforcement:

During the inspection we found two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to staffing and governance. When we returned to the service for the second day of the inspection we found some progress had been made to address the concerns highlighted but continued improvements were required.

Details of action we have asked the provider to take can be found at the end of this report.

Follow up:

We have asked the provider to send us a report outlining what they are planning to do and by when to improve the quality of the service. We will check the action plan has been put into place and will continue to monitor all information we receive about this service. 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