Cedar Falls Care Home

Updated 16 December 2022

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.

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.

Inspection team

The inspection team consisted of 2 inspectors 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.

Service and service type

Cedar Falls 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 Falls 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 manager in post who had completed their application to be registered. They became registered during our inspection period.

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 professionals who work with the service. 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 10 people living at the home and 7 family members. We also spoke with the managing director, the registered manager, 2 deputy managers a care home assistant practitioner, a care worker and two housekeepers.

We reviewed a range of records. This included 8 people’s care records and multiple medication records. We also looked at a variety of records relating to the management of the service, including policies and procedures.

Updated 16 December 2022

About the service

Cedar Falls Care Home is a residential care home providing personal and nursing care to up to 93 people. The service provides support to adults of all ages, some of whom may be living with dementia, a physical disability or sensory impairment or mental health concerns. At the time of our inspection there were 83 people using the service. The home is in a purpose-built property set over two levels with access to secure grounds. There are also a number of bungalows on the grounds for those who wish to live more independently.

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

Systems to monitor the quality and safety of care provided in the home had not been effective. They had failed to identify concerns and to ensure that people received care personalised to their needs.

There were enough staff to meet people’s needs and the provider had effective recruitment practices which ensured staff were safe to work at the home. However, staff lacked the knowledge of good dementia care and needed further training in this area.

The lack of dementia knowledge and training impacted on the care people received with care becoming task focused instead of tailored to people’s individual needs. This meant at times people’s dignity and privacy were not respected.

Medicines were not managed safely. Some medicines administered “as required” were not given in line with the prescription and where medicine had to be hidden in food and drink there was not always advice from a pharmacist to ensure it did not affect the efficacy of the medicine.

People were supported to eat and drink safely and to maintain a healthy weight. However, more could be done on the dementia floor to ensure people had a positive mealtime experience.

Most risks were identified, and care was planned to keep people safe. However, risks relating to people living with dementia becoming distressed had not been identified and staff had no guidance to support them to care for people safely. Activities were not used effectively to support people living with dementia.

Staff had not always followed the provider’s policies to minimise the risk of infection. Some furniture needed attention to reduce the risk of cross infection. The maintenance of the home and not been completed to ensure it was a pleasant environment for people to spend time in.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The provider’s policies were in place, but staff had not followed them to support people’s rights.

We raised all these concerns with the provider during and after the inspection. They took immediate action to begin to rectify the concerns.

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

Rating at last inspection

This service was registered with us on 7 October 2019 and this is the first inspection.

The last rating for the service under the previous provider was good (published 10 September 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the management of medicines, infection control, the maintenance of the environment, respect of people’s privacy and dignity and failures in the oversight of the home at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.