This inspection took place on 01 and 07 February 2017 and was an unannounced comprehensive rating inspection. The location was last inspected on 05 February 2015 and was rated as ‘Good’ overall.

Cedar Lodge is a nursing home and is registered to provide accommodation for up to 36 people who require nursing or personal care. At the time of our inspection there were 28 people living at the home.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were kept safe. Staff had received training and understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. Staff were provided with sufficient guidance on how to support people’s medical care and support needs. Staff had been safely recruited and relatives felt that staff demonstrated the appropriate skills and knowledge to provide good care and support. Staff were trained and supported so that they had the knowledge and skills they required to enable them to care for people in a way that met their individual needs and preferences. People’s medicines were managed and administered safely and as prescribed

People were encouraged to make choices and were involved in the care and support they received. Staff had an awareness of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguarding (DoLS) and knew how to support people within their best interests. Staff were respectful of people’s diverse needs and the importance of promoting equality.

Staff were caring and treated people with dignity and respect. People’s independence was promoted and staff responded to people’s support needs in a timely manner. People and their relatives felt they could speak with the provider about their worries or concerns and were confident that they would be listened to and have their concerns addressed.

The provider had quality assurance and audit systems in place to monitor the care and support people received, ensuring that the quality of service provided remained consistent and effective.

There were 30 people living at the home at the time of our inspection. We spoke with five people using the service, five staff, three relatives, the manager and the provider. All of the people spoken with told us they were happy with their care. One person told us, It’s warm friendly and I am treated well’’.

People told us and we saw that staff respected their privacy and dignity and that they were given choices about their care. One person told us, ‘’ Staff are very friendly, they help me when I need it, but leave me alone when I don’t want them too’’. This meant people were involved in their care.

Staff spoken to were able to tell us about people's care needs and records seen confirmed the staff knowledge about people. This meant staff had the information to support people and meet their needs.

There were effective systems in place to reduce the risk and the spread of infection.This meant people were care for and supported in a clean environment and the risk of cross infection was minimised.

Staff spoken with told us they felt supported by the manager, and have regular training opportunities. This meant staff had the skills to care for people safely.

There were systems in place to monitor how the home was run, and action taken where feedback from the people using the service would improve the service provided to them.

We visited the service to follow up the improvements required from our inspection in July 2012. We spoke with three people living there, the manager and two staff.

There were effective systems in place to reduce the risk and the spread of infection.

All three people using the service spoken with told us that their bedrooms were clean daily. One person told us “ It always smells nice here’’

Staff had been provided with guidance on their responsibilities with regards to the completion of cleaning records and the cleaning tasks that they were required to carry out. This meant people were care for and supported in a clean environment and the risk of cross infection was minimised.

We saw there were quality assurance systems in place which measured people's

satisfaction with the service provided in the home. Improvements in the service were made by listening to the views of people using the service and their relatives and taking the appropriate actions. This meant people were involved and their views were sought about the service provided.

There were 36 people living at the home on the day of our visit. The provider did not know we were coming. We visited the service as part of our planned review and to follow up improvements needed from our planned review in June 2011

Some of the people who lived at the home had dementia care needs. Because people with dementia are not always able to tell us about their experiences, we used a formal way to observe people during this visit to help us understand. We call this a Short Observational Framework for Inspection (SOFI). We spent 20 minutes in a communal area and observed two people. We recorded their experiences at regular intervals. This included their state of well being, how they interacted with staff members, other people who live at the home and the environment.

This enabled us to be more specific about the positive and negative aspects of the care provided to people. It gave us a clearer picture of the experiences of people living in the home over a period of the day. We spoke with the manager, area manager, and owner, four people living in the home, three staff and three relatives.

We saw that staff treated people with respect and dignity and understood how to

communicate with them. One relative said "We chose the right place, she is happy here”.

All three relatives told us they were happy with the care provided and found staff to be caring and friendly.. One relative told us that their relative health had improved since being in the home and they were very pleased with the progress they had made.

People using the service told us staff are very nice and helpful. Two of the four people we spoke with said that they had all the support they needed. One person told us “ it a nice place to live.’’

Care records were detailed to ensure peoples needs were being met.

Staff received a range of training so that they have up to date knowledge and skills in

order to support the people who lived there.

We shared some concerns with the provider about issues relating to the space for people to have the choice to sit where they wished and the cleanness of peoples bedroom. Improvement are needed in these areas.

Systems were in place to monitoring the service provided. We found that not all systems were monitored effective and improvements are needed in these areas.

The majority of people living in the home were unable to tell us about their experiences due to their dementia. Outcome areas where we have direct feedback from people are included in the main body of the report. In general the people using the service were happy with the staff and care they received.

We spoke with 4 relatives of some of the people living in the home.

Relatives said they were happy with the care their relatives received.

One relative said “staff are very kind and they go out of their way to please’’.

Another relative said “if I have any concerns I discuss this with the manager and the issues are dealt with immediately’’

The inspection took place on 30 January and 5 February 2015 and was unannounced. We last inspected the service on 4 July 2014. At the last inspection the provider was meeting all the regulations inspected.

The home provides nursing and residential care for up to 36 older people, including people who have dementia. There were 25 people living there at the time of our visit

All staff spoken with knew how to keep people safe from abuse and harm because knew the signs to look out for. Where incidents had occurred the provider took action to help in reducing re occurrences.

People were protected from unnecessary harm because risk assessments had been completed and staff knew how to minimise them.

Staff supported people with their nutrition and health care needs and referrals were made in consultation with people who used the service if there were concern.

People were support with their medication and staff had been trained so people received their medication as prescribed.

Staff respected people’s privacy and dignity and ensured that they were given choices about their care.

There were sufficient numbers of suitably recruited staff available to support people. Staff had received training that ensured they had the skills and knowledge to care for people.

People's care and health needs were planned and met in a personalised way. Action was taken to involve other healthcare professionals where required to keep people healthy.

Staff felt supported by the manager, and had regular training opportunities so they had the skills to meet people’s care needs

Systems were in place to monitor and check the quality of care being provided. The provider continually looked at how it could provide a better service for people and used feedback form people to improve the service.

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