Archived: The Cedar Grange

Updated 28 January 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 carried out by three 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 Cedar Grange is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a new manager in post, they are in the process of registering with us.

Notice of inspection

The 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 also spoke with the police.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

During our inspection we spoke with 10 people and 1 relative. We also spoke with the manager and the provider. We spoke with 5 staff including, care staff, senior staff and deputies. We looked at the care records for 10 people. We checked the care they received matched the information in their records. We looked at records relating to the management of the service, including recruitment file and audits carried out within the home.

Updated 28 January 2023

About the service

The Cedars Grange is a care home providing personal care for up to 58 people. Some of the people in the home are living with dementia. People have access to their own bedroom along with communal spaces including lounges and gardens. The home is one adapted building that operates two separate wings. At the time of our inspection 36 people were living in the home.

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

People were not supported to have maximum choice and control of their lives. 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.

The home had improved since our last inspection. Where people displayed periods of emotional distress improvements were needed to ensure care plans were fully reflective of this and what this meant for people. Protocols that related to the administration of medicines for agitation also required further detail. Systems that had been introduced since our last inspection to manage the quality within the service, needed to improve to ensure they identified all areas of improvements.

Risks to people were assessed and monitored, when incidents occurred these were reviewed. Medicines were managed in a safe and people received these as prescribed when needed. There were enough suitably trained and recruited staff to support people. There were procedures in place to ensure people were protected from potential abuse. We also found infection control procedures were in place and followed.

People were happy with care they received and the staff that supported them, they felt the home had improved and involved with the process. People were treated in a kind and caring way. Their dignity and privacy were considered, and their independence promoted. When people had cultural needs, these were now considered.

When people had health needs these were considered and reviewed, and the home worked with external agencies and professionals to ensure people received the correct levels of support. People received foods in line with their dietary requirements and enjoyed a choice of foods that they were offered.

There were now systems in place to govern the home, audits in place were identifying areas of concerns and action was then taken. People felt able to complain and there were procedures in place. Staff felt involved with the running of the home, they felt supported and listened to by the new manager and the provider.

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

Rating at last inspection

The last rating for the service was inadequate. (Published 15 September 2022.)

This service has been in Special Measures since 16 September 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.

At this inspection we found the provider remained in breach of regulations. You can see what action we have asked the provider to take at the end of this full report.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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 have identified breaches in relation to capacity and consent.

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.