The Cedars

Updated 18 April 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.

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 was conducted by 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

The Cedars 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. The Cedars is a care home without 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 an interim manager in post. They were not registered with the Care Quality Commission.

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.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

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

We spoke with 13 people living at the service. We spoke with 9 staff members which included the manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 7 people’s care records and multiple medicines records. We reviewed 3 staff recruitment records. We looked at a variety of records relating to the management of the service, including policies, procedures and audits. After the inspection we spoke with 3 relatives and gained feedback from 4 health and social care professionals.

Updated 18 April 2023

About the service

The Cedars is a residential care home that provides accommodation and personal care for up to 28 older people. At the time of the inspection 17 people were living at the home.

The service is set over 2 levels, with communal areas such as a lounge and dining room on the ground floor.

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

Improvements had been made and were ongoing at the service. Actions in relation to fire safety had been completed. A plan was in place to continue upgrades to the environment. Changes to systems to monitor and assess the quality of the service had been made. However, further improvements were needed to ensure care planning information was person centred and accurate.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Improvements were required to ensure people’s consent and capacity was obtained and assessed in accordance with the Mental Capacity Act 2005.

People told us they were happy at the service. The service was fully staffed, and improvements had been made to recruitment processes. Staff were supported through induction, training and supervision.

Activity provisions continued to be developed and people were supported to engage in activities of their choice and access the local community.

People were supported by staff who were kind and caring. People were treated with dignity and respect. People’s independence was promoted.

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 rating for this service was inadequate (published 13 October 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of Regulations 9 (Person Centred Care), 10 (Dignity and Respect), 12 (Safe Care and Treatment), 14 (Meeting Nutritional and Hydration Needs), 17 (Good Governance), 18 (Staffing) and 19 (Fit and Proper Persons Employed). The provider had met their recommendation in relation to the environment and had a plan of action in place to make further improvements.

This service has been in Special Measures since 22 August 2022. 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.

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.

Enforcement and Recommendations

We have identified a breach in relation to Regulation 11 (Need for consent).

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.