Archived: Cedar Court

Updated 24 January 2018

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 23 and 24 November 2017 and was unannounced. A specialist nurse advisor, one adult social care inspector and an expert by experience inspected on 23 November 2017. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Two inspectors returned on 24 November 2017 to complete the inspection.

Before the inspection we looked at all the information we held about the service. This information included the statutory notifications that the service sent to the Care Quality Commission. A notification is information about important events that the service is required to send us by law. The provider had 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 contacted health and social care professionals and the local authority safeguarding team for feedback about the service. We used this information to help inform our inspection planning.

During the inspection we spoke with 13 people and their six relatives, nine members of staff, two external healthcare professional, the manager and a senior manager. We also spent time observing the support provided to people in communal areas, during meal times, and medication round. We looked at nine people’s care records and seven staff records. We also looked at records related to the management of the service such as the administration of medicines, complaints, accidents and incidents, safeguarding, Deprivation of Liberty Safeguards, health and safety, and policies and procedures.

Updated 24 January 2018

The Cedar court is a ‘care home’ providing residential care for older people with dementia. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Cedar court accommodates up to 47 people in one adapted building. There were 43 people using the service at the time of our inspection.

This inspection took place on 23 and 24 November 2017 and was unannounced. At the last inspection on 5 and 6 September 2016 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. We found some aspects of the arrangements for the safe management of medicines for people using the service were not robust. Some aspects of the quality assurance systems were not effective. We asked the provider to take action to make improvements in these areas. They sent us an action plan telling us how they would address these issues and when they would complete the action needed to remedy these concerns. At this inspection we found this action has been completed.

The service did not have a registered manager in post. The previous registered manager left the service in May 2017. However the provider appointed a new manager to run the home. The new manager’s application to the CQC to become the registered manager was being processed. 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.

Medicines were managed appropriately and people were receiving their medicines as prescribed. Staff received medicines management training and their competency was checked. All medicines were stored safely.

The service had an effective system and process to assess and monitor the quality of the care people received. As a result of the checks and audits the service made improvements, which included care plans and risk management plans were up to date, and falls management had improved.

Staff knew how to keep people safe. The service had clear procedures to support staff to recognise and respond to abuse. The manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service and they were up to date with detailed guidance for staff to reduce risks.

The service had an effective system to manage accidents and incidents and to prevent them happening again. There were arrangements to deal with emergencies. The service carried out comprehensive background checks of staff before they started working and there were enough staff to support to people.

The manager and staff understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS). 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 support this practice. People consented to their care before they were delivered.

Staff assessed people’s nutritional needs and supported them to have a balanced diet. Staff supported people to access the healthcare services they required and monitored their healthcare appointments.

People or their relatives where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing.

Staff prepared, reviewed, and updated care plans for every person. The care plans were person centred and reflected people’s current needs.

Staff supported people in a way, which was kind, caring, and respectful. Staff protected people’s privacy, dignity, and human rights.

The service recognised people’s need for stimulation and social interaction. The service had a clear policy and procedure about managing complaints. People knew how to complain and would do so if necessary.

The service sought the views of people who used the services, their relatives, and staff to improve the service. Staff felt supported by the manager.