23 August 2022
During a routine inspection
About the service
Cedar House is a respite care home providing personal care to six people at the time of the inspection. The service can support up to seven people.
People’s experience of using this service and what we found
Right Support:
The service did not support people to have the maximum possible choice, control and independence. Staff did not support people in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Staffing levels led to staff focusing on completing tasks and failing to promote people’s strengths. There was a lack of meaningful activities to support people’s interests. Restrictions placed upon people were not monitored so it was not possible to review and plan care to reduce restrictions.
The environment was not safe, well-furnished or well-maintained so did not always meet people’s needs. Care plans did not support people’s ability to be involved in planning their own care. Medicines were not managed safely. Staff supported people to play an active role in maintaining their own health and wellbeing.
Right Care:
Staff understood how to protect people from poor care and abuse. However, the care provided at times placed people at risk of harm. Staff had training on how to recognise and report abuse and they knew how to apply it to protect people. There were not enough staff to meet people’s needs and staff were task focused. People’s care plans had not recently been reviewed with them or their relatives and were not in an accessible format.
Right Culture:
Staff turnover was high, so people did not receive personalised care from a staff group who knew them well. Agency staff did not know people or their needs well. Staff did not fully reflect best practice in the way they cared for people and did not always follow the registered manager’s instructions to keep the service safe.
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 24 August 2020 and this is the first inspection.
The last rating for the service under the previous provider was Good, published on 7 March 2020.
Why we inspected
The inspection was prompted in part due to concerns received about the overall quality of the care provided. A decision was made for us to inspect and examine those risks.
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.
You can see what action we have asked the provider to take at the end of this full report.
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 safety of the care provided, the numbers of staff available to support people, not ensuring people’s rights to make decisions and to keep them in the building were managed in line with legal requirements and the overall monitoring 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.