Background to this inspection
Updated
20 September 2019
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 Care Act 2014.
Inspection team
The inspection team consisted of two inspectors.
Service and service type
Cedar Grange 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 service had a manager registered with the Care Quality Commission. 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.
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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and two relatives about their experience of the care provided. We spoke with members of staff including the registered manager, home manager care manager, two carer workers and the cook. The majority of people using the service were not able to comment because of their health conditions. 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 reviewed a range of records. This included seven people’s care records and medication records. We looked at a variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with four relatives by telephone.
Updated
20 September 2019
About the service
Cedar Grange is a residential care home providing personal and nursing care to people aged 65 and over. At the time of the inspection 29 people were living at the home.
Cedar Grange accommodates 36 people in one adapted building.
People’s experience of using this service and what we found
The management team and staff were exceptional in placing people at the heart of their service and home.
The provider offered people a home for life. Cedar Grange was an accredited Gold Standard Framework care home. They provided outstanding care and attention for people at the end of their lives to ensure their wishes were fulfilled. End of life care plans were in place, which helped to provide information to staff about how they wanted to be cared for. The home provided facilities to enable relatives to stay overnight with their family member. Family members were highly complementary about the care their relatives received and how staff paid particular attention to people's appearance. Support and facilities were provided for relatives, to enable them to stay with their loved one for as long as they wanted to.
The provider had invested in delivering exceptional care and recently developed part of the home into social areas, such as a pub and boutique. Activities took place throughout each day and included activities in the home and trips out into the local community. Staff were proactive in considering ways of reducing people's anxieties. For example, pet therapy animals regularly visited the home and spent time with people which promoted calmness. Staff encouraged and supported people to take part in fun and creative sessions as a group and in individual one-to-one sessions to enhance their wellbeing. Family members described the positive effects all range of activities had on their family member, reducing people's anxieties, brought them a sense of calm and happiness and provided physical and cognitive activity and encouraged social interaction.
The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people living at Cedar Grange. The leadership of the service promoted a positive culture that was person-centred and inclusive. We received positive feedback about the quality of care and support people received.
Staff were committed to delivering outstanding care in a person-centred way based on people's preferences and wishes. There was a stable staff team who were knowledgeable about the people living at the service and had built trusting and meaningful relationships with them.
Staff treated people with kindness and compassion. There was a very caring and friendly atmosphere in the home between staff and people using the service. People’s comments about the staff included, “The staff are lovely here”, “You can’t fault the staff”” and “The way they listen and interact with everyone along with humour is a credit to them all”.
Staff knew how to keep people safe from harm. Staff were recruited safely, and sufficient numbers were employed to ensure people's care and social 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.
People were supported to eat a varied and nutritious diet based on their individual preferences.
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 this service was Good (published 21 February 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.