Archived: Cedar Gardens

Updated 12 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection and took place on 9 May 2018 and was announced. We gave the service 17 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The inspection was carried out by two inspectors. Inspection site visit activity started on 9 May 2018 and ended on 10 May 2018 after speaking with relatives. As part of the inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us by law. We also spoke with the local authority about information they held about the provider.

The provider did not meet the minimum requirement of completing the Provider Information Return at least once annually. 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 made the judgements in this report.

Prior to our inspection we received a concern around aspects of people’s safety and the staffing levels. We considered this information as part of our inspection.

We met five people who lived at Cedar Gardens, we spoke with four people and spent time with them in the communal areas of the home. We spoke with the relatives of two of the people who lived in the home. We spoke with one support worker and one team leader. The registered manager of the home had left two months previous to our inspection, so we spoke with the manager of the provider’s other service who was assisting the staff team with the running of the service. We also spoke with the provider who is the owner of the home.

We reviewed aspects of two people’s care records and medication records. We also looked maintenance records, the complaints policy, compliments and provider audits and checks.

Updated 12 June 2018

This announced inspection took place on 9 May 2018. At our last inspection in April 2016 we had no concerns about the quality of care and had rated this service as good. At this inspection we found the service was not consistently safe, effective or well led and we rated it as requires improvement.

Cedar Gardens is a care home which supports people who have a learning disability. We inspected this service on 9 May 2018. This inspection was announced, as we gave the provider a call the previous day to ensure someone would be available within the 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. Cedar Gardens accommodates six people in one adapted building. There were five people who were living at the home on the day of our visit.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. We found the provider followed these values to ensure people lived as ordinary life as possible.

People received safe care and were supported by staff who knew how to protect them from harm however there were some incidents that had not been fully responded to. The management team were not aware of all incidents, to ensure people were always receiving the safest care. Staff were aware of people’s individual risks and plans were in place to minimise these while maintaining the person’s independence. Staffing was arranged based on people’s individual needs and what activities were happening in the home. Staffing remained flexible to suit the people living at the home. People received their medicines when required, however the management of people’s medicines was not always safe. People lived in a clean environment, staff had the right knowledge and equipment to protect people from potential risk of infection.

Staff were not always supported to receive training that reflected people’s changing needs. There were no competency checks in place to identify any potential further learning or development for staff. People’s mental capacity had been considered when making decisions about their care. However, where people were making decisions about their future the provider had not supported people to have an advocate to support them with decision making. People were supported by staff who knew their individual dietary requirements and how to support them in the right way. People had access to healthcare professionals when they required them. The environment had been adapted to support the people who lived there.

People were treated well which had a positive impact on their well-being. People were supported by staff who were kind and caring towards them. Staff helped people to make choices about their care and the views and decisions they had made about their care were listened and acted upon.

People and where appropriate their family members were involved in the planning and review of their care and support. People were supported to continue with their hobbies and interests which reflected people’s individual interests. Information was provided to people should they wish to raise a complaint. People who lived at the home were not receiving any end of life care. The staff we spoke with acknowledged this was an area to discuss with people and advised that when it was the right time for each person this would be discussed in a sensitive and individual way.

The registered manager left the service two months prior to our inspection. The service was being supported by the provider’s other registered manager alongside a team leader. The provider who was also the owner of the home visited often to support the management team and their staff.

There were opportunities for people, relatives and staff to feedback their views about their care. The provider had some systems in place to monitor and assess the quality and safety of the care provided, these checks focused on people’s experience of care. However, the checks had not identified shortfalls in the management of people’s medicine, incidents and accidents and around staffs competency. They had not highlighted areas for improvement to ensure lessons were learnt and used to improve the service delivery.

Further information is in the detailed findings below.