Archived: The Cedars

Updated 27 March 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place after we had received notification of an incident following which a person using the service sustained a serious injury. This incident is subject to review and as a result this inspection did not examine the circumstances of the incident. However, the information shared with the Care Quality Commission (CQC) about the incident indicated potential concerns about the management of risk of falls from height. This inspection examined those risks. The inspection was carried out by two adult social care inspectors.

Service and service type:

The Cedars is a care home. People in care homes receive accommodation and nursing or personal care. 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:

The inspection was unannounced, meaning the staff and management did not know that the inspection was going to take place.

What we did:

Before the inspection visit we gathered information from a number of sources. We looked at the information received about the service from notifications sent to the Care Quality Commission by the registered manager. We spoke with the local authority commissioning and safeguarding teams to gain their views on the service.

We spoke with seven people using the service to gather their views and experiences and one visiting relative. 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 spoke with two staff members, the registered manager and the owner. We looked at documentation relating to three people who were using the service, three staff files and information relating to the management of the service.

After the inspection we received feedback from a health professional who works with the service.

Updated 27 March 2019

About the service: The Cedars is a small residential care home located in Baildon, near Bradford. It provides accommodation and personal care to up to 12 people aged 65 and over. At the time of the inspection 9 people were living in the service.

People’s experience of using this service:

People, relatives and health professionals provided very positive feedback about the service and the level of care provided to people. Staff were dedicated in providing people with a highly personalised and companionate service. There was a lovely atmosphere within the home and the staff and management team all knew people extremely well. The service was homely, decorated to a very high standard and kept very clean.

Medicines were not always managed in a safe or proper way. Overall, risks to people’s health and safety were appropriately assessed, although improvements were needed to the pre-assessment process for new residents.

There were enough staff deployed to ensure people received prompt care and support. Recruitment practices were not consistently operated in a safe way. Formal systems of staff supervision and appraisal needed to be put in place.

People received a good and varied diet and the management team went out of their way to provide people with food in line with their individual choices and preferences. People were treated equally and fairly and their human rights upheld.

People’s needs were assessed and people received care and support in line with their choices and preferences. The service worked effectively with health professionals to help meet people’s needs. There was an excellent range of activities and social opportunities for people.

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

Systems to assess, monitor and improve the service needed improving. The registered manager was very ‘hands on’ and this was sometimes at the detriment to ensuring robust systems and documentation were in place. The service needed to assess and monitor its activity on a regular basis to ensure it was meeting the requirements of our regulations and standards.

Rating at last inspection: At the last inspection in January 2018 the service was rated as Requires Improvement overall.

Why we inspected: We inspected the service to follow up on the warning notice we issued the provider at the last inspection in January 2018.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will meet with the provider to discuss our concerns and monitor their governance arrangements on an ongoing basis.