Cedar Lodge Care Home

Updated 25 February 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 Care Act 2014.

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 visit was completed by 1 inspector and 1 Expert by Experience. An Expert by Experience is someone who has experience of using this type of service.

Service and service type

Cedar Lodge Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Cedar Lodge is a care home without nursing care. Care Quality Commission (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 registered manager in post.

Notice of inspection

This inspection visit was unannounced.

What we did before inspection

We reviewed the information we held about the service, such as feedback from people and their relatives, statutory notifications, as well as any information shared with us by the local authority. 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. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who received a service to get their experiences about the quality of care received. We spoke with 2 members of care staff, the registered manager and the owner. The registered manager was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included examples of 2 people’s care records, samples of medicine records and associated records of people’s care. We looked at records that related to the management and quality assurance of the service and risk management. We reviewed 2 staff recruitment files.

Updated 25 February 2023

About the service

Cedar Lodge Care Home is registered to provide accommodation and personal care for up to 19 people, including people living with dementia. At the time of our inspection visit there were 18 people living at the home, with one person in hospital. Care is provided across two floors. A communal lounge and dining area are located on the ground floor. People’s bedrooms are ensuite and there are further communal bathroom facilities located on each floor.

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

At our last inspection, we found improvements were required. Some people’s health and physical risks were not always assessed and risks around safe medicines management were not managed effectively. Environmental and fire safety risks were also not managed safely. The provider’s systems of audits and checks had not always identified where improvements were needed.

Following the last inspection, we formally requested the provider to send us a monthly action plan telling us what they had improved and where improvements continued to be made at the service, with timescales.

At this inspection, we found the provider’s action plan had driven some improvements and risks associated with people’s care were managed safely. Known risks relating to people’s health and welfare and environmental risks were better managed.

The provider’s quality assurance systems were improved and had begun to highlight where further improvements were needed. Management restructuring and reviewing their own audit systems through a critical eye had begun to identify improvement. With increased adaptations and improvements, the audit processes now need to become embedded into everyday practice to ensure its true effectiveness. This meant the provider was no longer in breach.

People received their medicines from trained and competent staff. We found improvements had been made in the management of ‘patch medicines’ and body maps were now in place to show where those medicines had been applied. However, we recommended the registered manager sought advice to ensure patch medicines were applied as directed when increased rotational administration to the body was required.

People who required ‘as and when’ medicines had a protocol in place to tell staff, when, how and at what dose, these medicines should be given safely.

Risks for some people were updated, reviewed and reflected the support people needed. Staff knew how to manage those risks. The provider told us they had spent time since the last inspection, updating people’s care plans and they were more confident records supported positive outcomes for people.

People were pleased with the support and the quality of care they received. People were complimentary of staff and the management of the home and told us they felt safe receiving care and support from staff.

The provider had sufficiently trained and suitable staff on shift to meet people’s needs. People told us they felt there were enough staff on duty to meet their needs. Where people had used their call bell to request a staff member, people said they did not wait long for assistance. The provider continued to follow safe recruitment processes.

During our visit, the home was in a COVID-19 outbreak which had impacted on staff availability. The management team stepped in to cover gaps in shifts to ensure people’s needs continued to be 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.

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 requires improvement (published 12 May 2022) and there were breaches of regulations. Following this visit, the provider sent us an action plan telling us how they would improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 7 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well Led which contain those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cedar Lodge on our website at www.cqc.org.uk.

Follow up

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