Archived: Cedar Court Care Home

Updated 31 October 2014

We visited this home on 8 July 2014. During the visit we spoke with three people who used the service and four relatives. Most of the people using the service were living with dementia and we were not able to speak with them. We spoke with 11 members of care staff, the activities co-ordinator and the manager. We observed care and support and looked at the kitchen and some people’s bedrooms. We looked at a range of records about people’s care and how the home was managed.

The inspection team consisted of a lead inspector, one other inspector, a dementia specialist and an expert by experience who had experience of older people’s care services. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Before our inspection, we reviewed the information we held about the home and contacted the commissioners of the service to obtain their views. We also looked at the Provider Information return (PIR). The PIR is a form that asks the provider to give some key information about its service, how it is meeting the five questions, and what improvements they plan to make.

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?

The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

Updated 31 October 2014

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. This was an unannounced inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

At our last inspection in October 2013 we found breaches of regulations relating to respecting and involving people, how people’s care and welfare needs were met and infection control. Following that inspection the provider sent us an action plan to tell us what improvements they were going to make. During this inspection we looked to see if these improvements had been made. Improvements had been made and the breaches were now being met.

Cedar Court is a purpose built nursing home caring for up to 63 people who have care needs associated with physical needs, mental frailty and/or dementia. At the time of our visit 56 people were using the service, most of who were living with dementia. The home is owned and managed by Lifestyle Care.

People told us they were happy at the home. They said they felt well cared for and safe. However we saw one person’s care regarding their personal hygiene was not always managed appropriately. We also saw that accurate records were not being maintained in relation to the care provided. However, this did not impact on people’s care.

Some people were not appropriately supported to eat their meals and did not always receive the personalised support they needed. We observed some people were left alone at mealtimes when it was clear they needed support to eat and drink. However, other people were supported appropriately.

Throughout our visit we observed caring and supportive relationships between people and care staff. Most people were treated in a caring way that demonstrated a positive caring culture existed in the home.

The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. All of the people we spoke with knew how to make a complaint.

There were sufficient numbers of appropriately trained staff on duty to support people. The manager had taken steps to reduce staff sickness and we saw from the attendance rota that improvements had been made.

People told us they felt their privacy and dignity were respected and made positive comments about staff. Care staff were able to tell us, and we saw, how they respected people’s privacy and promoted their dignity. Activities were enjoyed by people and we saw they were offered choices around activities and people who need it, were given the time to consider these choices.

Infection control concerns we raised at our last inspection had been addressed. The home was clean and free from malodours. Cleaning schedules were in place and were being followed and an infection control champion had been identified. An infection control champion is a member of care staff who receives additional training relating to infection control and acts as a source of information for other staff.

Care staff had knowledge of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and applied that knowledge appropriately. At the time of our visit no one was subject to a Deprivation of Liberty Safeguards (DoLS) application. This is where an application can be made to lawfully deprive a person of their liberties where it is deemed to be in their best interests or for their own safety. We spoke to the manager who told us that in light of the recent Supreme Court judgement they were assessing people with regard to future DoLS applications.

Care staff received training that enabled them to support people. They were also able to gain further training in specialist areas. For example, in dementia care, infection control and end of life care. 15 care workers had signed up to take further care qualifications.

People were supported to maintain good health. People had enough to eat and drink and appropriate referrals were made. For example, to GPs and Speech and Language Therapist (SALT) referrals were made where people were identified as being at risk of choking due to swallowing problems. People received support with regards to their tissue viability. Where people were at risk of pressure sores measures were put in place to reduce and manage the risk.