Cedar Court Residential and Nursing Home

Updated 25 July 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.

Inspection team

The inspection was carried out by 2 inspectors, a specialist advisor who was a registered nurse 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.

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.

Service and service type

Cedar Court Residential and Nursing Home 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. Cedar Court Residential and Nursing Home is a care home with nursing 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.

At the time of our inspection there was a registered manager in post. At the time of inspection, the registered manager was on leave.

Notice of inspection

This inspection was unannounced.

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 Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 family members for their experience of the care their family member received. We spoke with the interim area director, regional director, newly appointed home manager, nurse, regional nurse, interim clinical lead, a senior care worker, a health care assistant, 2 care staff, a domestic and maintenance person. We reviewed a range of records. This included 6 care records, 4 staff files in relation to recruitment and supervision and multiple medication records. We looked at a variety of records relating to the management of the service, including audits, staff training, meeting records and staff deployment.

Updated 25 July 2023

Cedar Court Residential and Nursing Home is a 52 bed purpose built residential care home providing personal and nursing care. The care home is split into three floors. At the time of the inspection 28 people were living at the service.

People's experience of using this service and what we found

People received safe care and support. Improvements had been made to the assessment and ongoing review systems and processes of people’s individual care and treatment needs. Additional monitoring of quality and safety had increased, and management oversight and leadership had improved risk management.

Overall, positive feedback was received from relatives about the care and treatment of their family members. Relatives reflected on improvements made at the service in relation to better communication, management, and leadership.

People received their prescribed medicines safely and when required. The provider’s medicines management and monitoring procedures had been reviewed and improvements made.

Improvements had been made to the guidance provided for staff about how to meet people’s needs. Where we identified minor shortfalls in relation to some inconsistencies in information, the management team took immediate action.

People were protected as far as possible, from avoidable harm and abuse. Staff had received safeguarding training and understood their responsibilities to protect people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way. Improvements were ongoing in relation to the assessment process of people’s mental capacity.

Staff deployment was based on people’s dependency needs and was regularly reviewed. Staff recruitment had increased, resulting in a reduction in the use of agency staff. This promoted increased consistency and continuity in care and treatment.

Staff had been safely recruited and had received refresher training and their competency assessed. Staff were found to be knowledgeable about people’s individual care and treatment needs. Staff spoke positively about the improvements made at the service and how they felt well supported.

Observations of staff engagement with people was positive. There was a calm, organised and relaxed atmosphere at the service.

The service was overall clean and hygienic. Some shortfalls with storage of equipment and products were identified. This was discussed with the management team.

The provider had developed their procedures in reviewing and learning from accidents and incidents. Incident analysis identified learning opportunities, and this was shared with staff to support their learning and understanding.

Internal audits, checks, systems, and processes had been strengthened. Actions identified from monitoring procedures were added to an ongoing improvement plan. This supported the service to continually develop.

The management team were open and honest and had worked well at making the required improvements. The management team acknowledged further time was required for improvements to become fully embedded and sustained.

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

Rating at last inspection and update

The last rated inspection for this service was inadequate (published 17 November 2022). Breaches in regulations relating to safety and governance were identified, and warning notices issued.

At this inspection, we found enough improvements had been made and the service was no longer in breach of regulation.

This service has been in Special Measures since the last inspection. During this inspection, the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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.

Please see the safe and well-led sections of this full report. You can read the report from our last inspection, by selecting the 'all reports' link for Cedar Court Residential and Nursing 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.