Background to this inspection
Updated
7 March 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Cedar House is a ‘care home’ that provides short term respite care for people with physical disabilities, learning disabilities and/ or autism. 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, and both were looked at during this inspection.
The service also provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service did not have a manager registered with the Care Quality Commission at the time of the inspection. 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. However, there was a manager in post who was in the process of registering with the Care Quality Commission.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We reviewed information we had received about the service since our last inspection and sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and one set of relatives about their experience of the care provided. We spoke with six members of staff including the manager, regional manager, senior care workers and a care worker. We observed care being provided in communal areas.
We reviewed a range of records. This included three people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We looked at additional information the provider gave us including training data and staff rosters. We spoke with two more relatives whose family members regularly use the service.
Updated
7 March 2020
About the service
Cedar House is a respite service providing short term accommodation and personal care and support for up to seven adults with physical and learning disabilities as well as people with autism. At the time of our inspection three people were using the service. There is also a small supported living group home for adults with learning disabilities who receive personal care. Five people were using this service at the time of our inspection.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Relatives of people using the respite service said their family member enjoyed their visits and staff were very responsive to their individual needs. Routine was important for some people to maintain their well-being and we were told staff were careful to maintain their routines. People receiving personal care in supported living, said they were happy and staff provided the care and support they needed.
People were protected from avoidable harm and abuse by staff who were alert to the signs of abuse and knowledgeable about the action to take if they identified a concern. Staffing levels were planned to take into account people’s individual needs. Medicines were managed safely and people told us staff ensured they received their medicines regularly.
Staff were supported to deliver effective care and received training to gain and further develop their knowledge and skills. They received regular supervision and appraisal.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Staff were kind and caring and showed empathy and respect for the people they cared for. They protected people’s privacy and dignity, and supported them to express their views.
Staff were aware of each person’s needs and preferences and they received personalised care, tailored to their needs and wishes. People and families told us staff were flexible and willing to accommodate changes to their care and support needs. People were supported to maintain a healthy, varied and balanced diet. Staff worked with health and social care professionals to ensure people received coordinated and consistent care.
There was good leadership and management of the service. Quality audits were completed to monitor the service provided and identify areas for improvement. Staff and people using the service were able to express their views; they felt they were listened to and any concerns were addressed.
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 06 October 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.