Cedar Lodge

Cedar Lodge is a residential care home providing personal and nursing care to people aged 65 and over. This registration also includes The Limes, a purpose-built recovery and rehabilitation centre adjoining Cedar Lodge. The Limes provides support for up to 15 people (mainly younger people) with a range of mental health conditions to support and enable them to move forward into the wider community. At the time of our inspection the service was supporting 39 people in Cedar Lodge and 13 people in The Limes.

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

There was a very homely and welcoming atmosphere where people were supported by staff who were very respectful, kind and caring. Feedback about the compassionate and caring approach of staff was positive. People were treated with dignity and respect in a way that truly valued them as individuals.

There was a person-centred culture that was driven by a motivated and committed staff team. They constantly looked for ways to improve the service and ensured people received the personalised care they deserved. The staff team told us they were truly valued and respected. They were skilled, motivated and knowledgeable. Staff told us they were encouraged to progress and develop.

People were placed at the centre of the service and were genuinely consulted in relation to all decisions about their care and the service. Families and visitors were welcomed into the service and were full of praise for the genuine warmth and kindness they experienced.

The service was very well-led. The registered manager demonstrated how their open and listening management style and robust quality assurance systems had sustained continual development and improvement at the service. They were clear about their expectations relating to how the service should be provided and led by example.

There were effective and robust quality assurance systems in place to monitor and improve the service and to ensure legal requirements were met. This meant people were at the heart of the service .The registered manager shared examples of the service being used to share best practice approaches to other homes.

People and relatives were complimentary about the food. Where people had specific dietary requirements, they received food and drink to ensure their needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Rating at last inspection:

The last rating for this service was Good (published 12 January 2017).

Why we inspected

This was a planned inspection based on the rating at the last comprehensive inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

On the day of the inspection, there were 42 people living at Cedar Lodge and 13 people living at The Limes. There was an excellent registered manager employed at the home who was clearly passionate about providing a high quality, individualised service. They managed both units with support from a deputy manager qualified in mental health on The Limes. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

At the last inspection in December 2014 we found the areas of caring, responsive and well led required improvement and effectiveness was inadequate. The service had sent us an action plan and we saw all areas had been very much improved. There had been many meetings to discuss with staff and the management team how improvements could be made and these had all been addressed. For example, people on both units had opportunities at any time to voice their views about their care and be involved, privacy was respected and people and relatives felt able to make complaints knowing they would be addressed. We had raised an issue about access to the kitchen at The Limes. We found there was always open access to the kitchen and food that people wanted to eat whilst being encouraged to work towards independence in shopping and cooking, taking responsibility and meeting goals. Where restrictive equipment was used to protect people’s safety, people and their representatives were involved or the appropriate best interest decisions made using the correct processes to protect people’s rights.

People were supported by very kind, caring and compassionate staff who often went the extra mile to provide them with excellent, high quality care. This high standard of care enhanced people's quality of life and wellbeing. The staff were extremely passionate about providing people with support that was based on their individual needs, goals and aspirations. They were pro-active in ensuring care was based on people’s preferences and interests, seeking out activities in the wider community and helping people live a fulfilled life.

People had access to activities that complemented their individual hobbies and interests. Links with the local community had been established and people were supported to participate in community events and other events that were important and meaningful to them. This provided them with a sense of purpose and wellbeing.

The staff were happy working in the home and felt very supported in their role. They were clear about their individual roles and responsibilities and felt valued by the registered manager and the wider senior management team. Good leadership was demonstrated at all levels with pro-active effort to encourage ideas from staff to further benefit the people in their care and maintain a strong, stable staff team with a shared goal. Each individual staff member was engaged in sourcing new opportunities for people and putting ideas into practice. There were effective systems in place to monitor the quality and safety of the care provided.

There was a strong culture within the home of treating people with respect. The staff and the registered manager listened to people, offered them choice and made them feel that they mattered. People and the staff knew each other well and these relationships were valued.

People were able to make decisions about the support they received and to live their lives as they wished. Staff clearly enjoyed spending time with people and making each day matter. People's diverse needs were met and respected.

People were safe living at Cedar Lodge and The Limes. There were enough staff to meet people's care needs safely and also to provide individualised support in and out of the service.

People received their medicines when they needed them. The staff had received appropriate training in line with nationally recognised qualifications and regular supervision to provide them with the necessary skills and knowledge to provide people with effective care.

People received enough to eat and drink to meet their individual needs and timely action was taken by the staff when they were concerned about people's health.

Family members that we spoke with told us "When we came and looked around, we did not have an appointment, it felt welcoming and the atmosphere was right", "My Mum has been here two years, she has dementia and the staff have been fantastic" "I think I have chosen well for a care home", "They put her earrings in and do her nails", "I got my husband a different room, the staff are wonderful, they are very kind", "I have no concerns about the care in the home, "They always knock on the door before they come in", "I told a number of staff about a person's incontinence, they told me the person refused to be changed, the situation was resolved"

We spoke with a visiting General Practitioner who told us they were involved with people's care planning and " I have no concerns about Cedar Lodge, the staff are open to suggestion and I feel we have a good relationship" "Having worked as a Complex Care GP I feel I know the staff at Cedar Lodge"

We also spoke with two visiting physiotherapists who told us "It is good to see instructions carried out and I have not seen anything to bother me"

All the family members told us that it had been a very difficult decision to place their loved one in a home, but that Cedar Lodge had made the transition as easy as possible. We were told that family, friends and even pets are welcome to visit whenever they like. And that the staff go out of their way to make visits as comfortable and stress free as possible.

We saw that everyone was appropriately dressed and that many of the women had their nails done. One person showed us the hairdressing saloon. People where engaged in conversion with each other and with the staff. There was a positive atmosphere and we saw evidence of lots of activity both with-in and outside of the home. On the wall of the dining room was a display of recent photographs and in one of the lounges people were preparing for Valentines Day.

Staff addressed everyone by name and we saw that they knew people well and treated everyone with dignity and respect.