Cedardale Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People and their relatives told us they felt safe living at Cedardale and liked living there. Staff were knowledgeable about safeguarding, had received training, knew what to report and to whom and how to escalate if necessary. The manager reported safeguarding concerns to the appropriate authorities and cooperated with investigations. Risk assessments were comprehensive and up to date and included health care risk assessments when required. People had been involved in their risk assessments and care planning and could choose what they wanted to do. Systems were in place to ensure there were enough staff on duty to meet people’s needs. People received their medicines safely and as prescribed. Medicines were administered by staff who had received training and had been assessed as competent to carry out this task. Health and safety within the service was managed effectively. The fire risk assessment had been completed by an external provider since the fire within the laundry and remedial actions had been taken where required. The service was clean and uncluttered and there was a redecoration plan in progress.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff were observed providing care to people in a safe manner. Equipment was functioning correctly, had necessary checks in place and was being used in the right way.

The training matrix identified that staff had completed training in relation to safeguarding. The provider had a safeguarding policy and procedure in place which staff had access to. The manager reported safeguarding concerns to the appropriate authorities and cooperated with investigations. Safeguarding concerns were documented along with their outcomes and lessons learned were transferred to a separate document so they could be shared. We discussed some of the safeguarding concerns that have been raised and the actions that have been taken. The manager maintained accurate records in relation to Deprivation of Liberty Safeguards (DoLS) and there was an up-to-date register of applications and evidence of follow ups where there were delays in the authorisation process. None of the current DoLS had any associated conditions, but the manager was able to talk through previous conditions and how these were met.

We spoke with eight members of staff, including managers. Staff told us they liked working at Cedardale and that they had received enough training to carry out their role. They had a good knowledge of safeguarding and whistle blowing procedures and knew what to report and to whom. They were confident actions would be taken if they reported something. Staff told us they felt people were safe living in Cedardale.

We saw written feedback from nine relatives. Feedback from people and relatives was overwhelmingly positive. People told us they liked living in Cedardale and felt safe living in the service.

Staff knew people well and we observed staff following people’s care plans and risk assessments during any tasks such as, supporting a person to use the bathroom.

Risk assessments were comprehensive and up to date and included health care risk assessments when required. One person who had diabetes controlled with insulin had daily visits from the district nurse to check the blood sugar levels and administer the insulin. Records of visits were completed and up to date. The risk assessment was comprehensive and contained enough information for staff to provide safe care and treatment. It included common signs of diabetes complications such as high or low blood sugars and gave detailed advice to staff on what actions to take and when to call for assistance from health care professionals. Daily notes were comprehensive and completed at the time of care delivery. Where people needed monitoring charts such as fluids or repositioning, these were in place and had been completed correctly. The GP visited the service weekly.

Staff knew people well and were able to support them to manage risks safely. People were encouraged to live their lives the way they wanted and to do activities that suited them. Staff told us they took people out regularly, either to shops, garden centres or to other external events. Risk assessments supported this process.

People told us they were involved in their risk assessments and care planning and could choose what they wanted to do. For example, when to get up or go to bed, what clothes to wear, when they wanted their personal care.

Health and safety was managed effectively. The service was currently sharing one maintenance person with their sister home and an advert had been placed to recruit another so they could have one each. All the regular checks had been completed, for example, water temperatures, fire alarms, window restrictors, call bell system, bed rails, wheelchairs, emergency lighting, hoists and slings. The service had a contract with an external company for some of the routine maintenance. Fire grab bags were available at appropriate exits. Up to date Personal Emergency Evacuation Plans (PEEPS) were in place.

The service is arranged across two floors with access to upper floors via a staircase with a stair lift. There are locked stair gates at the top and bottom of the staircase for people’s safety. Some rooms needed to be locked for people’s safety, such as sluices and rooms containing cleaning chemicals. These rooms were all locked. The service was clean and uncluttered and there was a redecoration plan in progress. Corridors were clear and people were seen walking around the service safely, including some people using mobility aids.

People told us their rooms were kept clean and tidy and they were able to summon assistance using their call bell when they needed to.

We discussed the fire that occurred last year with the manager. There was some extensive damage to the former laundry and damage to the corridor outside and two bedrooms. The bedrooms are currently out of use and the service was awaiting quotes from contractors to undertake the building works necessary to rectify. The service had a temporary mobile laundry set up in the car park as an interim measure. The fire risk assessment has been completed since the fire and remedial actions taken where required.

The manager used a dependency tool to calculate the number of staff required each day and currently there were five staff on during the day and three at night. Managers operated an on-call rota to ensure staff were supported out of hours. Staff had received training and records showed this training was up to date.

We saw staff attending to people promptly when they needed assistance and call bells were answered without delay. We did not see people waiting for assistance during the assessment visit.

The service was led by a manager supported by one deputy and one team leader. There were two senior care workers for night shifts and one senior care worker for day shifts. The support team consisted of an activity coordinator, a housekeeper, a laundry assistant, kitchen assistants and a maintenance person. Staff told us there were enough staff to provide safe care for people. Staff confirmed they had enough training to undertake their role and that training was updated regularly.

People told us they thought there were enough staff to provide their care and if they needed assistance they did not have to wait long. People told us staff knew what they were doing and thought they were well trained.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Medicines were administered by staff who had received training and had been assessed as competent to carry out this task. Training and competency records were up to date. Medicines were stored safely in locked trolleys that were secured to a wall and spare medicines were in a locked cupboard. Fridge temperatures were recorded daily to ensure medicines kept in the fridge remained safe to use. Creams and bottles were labelled with the date of opening to ensure they remained safe to use. Medicine administration records were completed correctly and people who needed medicine through a skin patch had records in place to ensure the patch site was rotated to prevent skin irritation. People who were on blood thinning medicines has risk assessments in place and alerts on their medicine administration records. Body maps were used to indicate sites where creams were to be applied. Protocols were in place for people who had medicines ‘as required’, for example pain relief. Covert medicines procedures were in place and had been agreed and signed by appropriate professionals; these were reviewed regularly.

People told us staff helped them with their medicines when they needed them.

Staff understood safe processes for the administration of medicines and showed us the storage arrangements as well as explaining the disposal and returning of medicines.