The Cedars

Updated 6 October 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 22 August 2018 with telephone calls to relatives on 3 and 6 September 2018. The inspection was announced to ensure that the registered manager or appropriate person would be available to assist with the inspection. An adult social care inspector conducted the inspection.

We reviewed other information we held about the home, including any statutory notifications we had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale. We also contacted the local authority commissioners for the service and the local authority safeguarding team, the local Healthwatch and the clinical commissioning group (CCG). Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Before the inspection, the provider 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 reviewed three people’s care plans. We examined documents relating to recruitment, supervision and training records and various records about how the service was managed.

People who living at the home were not always able to verbally communicate with us. Therefore, we spoke with their relatives to gain their views on the home. We spoke with one person who lived at the home, two relatives, the registered manager, a team leader, the cook and two staff members.

We carried out an observation using 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. We undertook general observations of how staff interacted with people as they went about their work. We looked around the home and visited people’s bedrooms with their permission.

Updated 6 October 2018

This inspection took place on 22 August 2018 and was announced. We telephoned and spoke with relatives on 3 and 6 September 2018. The inspection was announced to ensure people who lived at the home would be present.

The Cedars is a 'care home.' 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. The Cedars is registered to provide residential care and support for up to six adults with a learning disability or autistic spectrum disorder. At the time of our inspection five people were living at the home.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection, the home was rated overall Good with Requires Improvement in Effective. This was because the registered manager had not always taken appropriate action to ensure people had authorisations in place prior to being deprived of their liberty.

At this inspection, we found the home remained Good in Safe, Caring, Responsive, Well-led and improvements had been made in Effective. The monitoring of deprivation of liberty (DoLS) applications had improved ensuring people were not deprived of their liberty unlawfully. This inspection report is written in a shorter format because our overall rating of the home has not changed since our last inspection.

The provider had systems in place to protect people from abuse. Risks were identified, assessed and managed to minimise the potential risk to people who lived at the home. Where incidents took place, there was evidence that lessons had been learned. Sufficient staff members were deployed to meet people’s needs.

Relevant checks were completed to ensure staff had appropriate skills and were suitable to work with vulnerable adults. Staff completed specific training which equipped them to support people living at the home. Supervisions and appraisals were regularly held.

Medicines continued to be managed safely. Medicines records we viewed were accurate and up to date. The home supported people to access health professionals when required, including opticians, dentists, GPs and nurses. When guidance was given this was incorporated into people’s care plans.

The home carried out monthly health and safety checks including fire safety to ensure people lived in a safe environment. Systems were in place to ensure people would remain safe in the event of an emergency including a continuity plan to ensure people would continue to receive care following an emergency.

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 supported this practice.

People were supported to make healthy and balanced choices at meal times and people’s likes and dislikes influenced the planning of menus. People were supported to be as independent as possible. The home worked with people to identify goals to work towards and supported people to achieve these. People had regular involvement with health professionals.

Relatives told us staff were kind and caring. Staff we spoke with were knowledgeable about the people living at The Cedars and were able to describe people’s likes and dislikes. Dignity was maintained and respected. People were involved in planning their own care.

Activity programmes were designed around people’s likes and dislikes and involvement from people’s families. People were supported in learning new life skills and to access the community in a range of activities.

Care plans were personalised and contained detail on how best to support people in their preferred way. The home offered a range of accessible information tools enabling people to understand their care and express themselves.

The provider had effective quality assurance processes to monitor the quality and safety of the service provided. A good team was in place, who were supported by the registered manager. The registered manager ensured statutory notifications had been completed and sent to the CQC in accordance with legal requirements

Further information is in the detailed findings below.