Cedarwood Care Centre is a care home that is registered to provide accommodation and support for up to 38 people with dementia and mental health needs. At the time of the inspection, 30 people lived at the service. The home is established over two adjoined houses with facilities that include dining and lounge areas, adapted bathrooms and a lift to access the first floor. People have access to a large level rear garden.

People's experience of using this service:

People felt safe living at the home and were very complimentary about the manager and staff in the way they cared for them. Improvements had been made to the deployment of staff since our last inspection. We saw people who were cared for in their bedrooms had regular checks on their safety and well-being.

Staff understood how to keep people safe without restricting their liberty and promoted positive risk taking . There had been a decrease in the number of safeguarding and whistle blowing notifications since the last inspection indicating people received safe care in line with their needs.

Safe systems were in place to manage people’s medicines. The home was kept clean and odour free and staff followed infection control measures.

People were supported in line with the Mental Capacity Act 2005 and their consent to care was obtained. Staff understood how to support people whose liberty was restricted for their safety. Staff received training and support to develop their skills and care for people effectively. People were supported to maintain a healthy diet with additional specialist support from professionals where needed.

People were consistently complementary about the caring nature of the staff. People had been involved in developing their care plan and their independence was promoted with age appropriate opportunities to pursue. People had access to activities and regular stimulation with plans in place to further develop people’s hobbies and interests.

People, relatives and staff all commented that the home was well managed and improvements had been made to benefit people. The manager had promoted a positive culture so that people were treated with care and compassion. The provider’s audits and checks were consistently carried out and had been effective in identifying areas and making improvements.

More information is in the detailed findings below.

Rating at last inspection: Requires improvement (report published 29 January 2018).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At the last inspection on 24 and 26 October 2017, the key questions around Safe, Responsive and Well led were rated ‘requires improvement’. This was due to concerns around staff deployment, people’s involvement in the development and review of their care plans and checks and audits not being carried out effectively. At this inspection we found that there had been improvements and the overall rating has now improved to Good.

Enforcement:

No enforcement action was required.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection was unannounced and took place on 24 and 26 October 2017. The decision to initiate a responsive comprehensive inspection was made following a high number of safeguarding incidents at the location over recent months since the last inspection. At the last comprehensive inspection in February 2017, we found the provider required improvement under the question of ‘Is the service’, Safe, Effective, Caring, Responsive and Well Led. We found at this inspection improvements had been made although some further improvement was required.

Cedarwood Care Centre is registered to provide accommodation and support for up to 33 people with dementia and mental health needs. On the day of the inspection visit there were 33 people living at the home. There was an acting manager in place who was in the process of registering with us as a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last comprehensive inspection in February 2017, the provider was found to be ‘requires improvement’ under the key question of ‘Is the service safe’. At this inspection we found improvements had been made to the way people were supported with how their medicines were managed, however other areas had been identified as requiring improvement. We identified that there were insufficient numbers of staff to respond to people’s needs.

At the previous inspection, the provider was found to be ‘requires improvement’ under the key question of ‘Is the service effective’. At this inspection we found improvements had been made to ensure that people’s rights were protected to ensure they were not unlawfully restricted and that their dietary needs were now being assessed and monitored.

At the inspection in February 2017, the provider was found to be ‘requires improvement’ under the key question of ‘Is the service caring’. At this inspection we found improvements had been made to the way people’s confidentiality was protected and their independence was being encouraged..

During our previous inspection, the provider was found to be ‘requires improvement’ under the key question of ‘Is the service responsive’. At this inspection we identified that there had not been significant improvements in people having access to activities that were meaningful to them and people and their relatives were not always consulted on how care plans were developed.

At the last comprehensive inspection the provider was found to be ‘requires improvement’ under the key question of ‘Is the service well led’. At this inspection we found that the provider was progressing in developing systems to monitor safety and quality of the service, although improvement was still required. We also identified that the views pf people and their relatives was not always sought regarding how the service was managed.

People were kept safe and secure, and relatives believed their family members were safe from risk of harm. Potential risks to people had been assessed and managed appropriately by the provider.

People received their medicines safely and as prescribed.

Staff had been recruited appropriately and all pre-employment checks had been completed.

Staff sought people’s consent before providing care and support. The provider ensured that the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) were being followed.

People’s rights to privacy and confidentiality were respected by the staff that supported them and their dignity was maintained.

People had a variety of food, drinks and snacks available throughout the day. They were able to choose the meals that they preferred to eat.

People were supported to stay healthy an

This inspection took place on 15 and 16 February 2017 and was an unannounced comprehensive rating inspection. The location was last inspected in February 2015 and was rated as Good overall although some improvement was needed regarding staff’s understanding of Deprivation of Liberty Safeguards ( DoLS) this lack of understanding about DoLS was still found to be the same at this inspection.

Cedarwood Care Centre is a residential care home providing care and accommodation for people with a range of care needs including people living with dementia and people with mental health needs. The provider in recent years had extended the service and increased its registered numbers to 33. At the time of our inspection 23 people were living there.

The manager was registered with us as is required by law and was present on the day. 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.

There were processes in place to monitor the quality of the service although they had not been effective as these had not identified issues that needed improvement in a timely way.

People were not always supported to take their medicines as prescribed by their doctor. Staff had not always ensured that the processes in place to ensure that people received care in line with their best interests had been followed and understood. Activities for people were not always offered and encouraged.

Staff were recruited and inducted safely into their role. However, staff had not received all the training they needed to meet people’s needs and keep them safe.

Processes were in place to prevent people from the risks of accidents and injuries and to protect people from harm and abuse. There were enough staff available to meet people’s needs and to keep them safe.

Staff supported people to have sufficient diet and fluids to prevent them experiencing ill health due to malnutrition and dehydration. People had mixed views about the quality of the food. People received assessment and treatment when needed from a range of health care professionals which helped to promote their health and well-being.

People were supported and cared for by staff who were kind and caring. People were encouraged and supported to undertake daily tasks and attend to their own personal hygiene needs.

People were enabled to make some decisions about their care and were involved in how their care was planned and delivered. Staff supported people to keep in contact with their family as this was important to them. People and their families were asked to give their view on the service provided. Complaints processes were in place for people and their relatives to access if they were dissatisfied with any aspect of the service provision.

The inspection took place on 2 March 2015 and was unannounced. This was the first inspection of this service since it was registered with CQC.

Cedarwood Care Centre is a residential care home providing accommodation for up to 21 people for reasons of old age. At the time of our inspection 20 people were living there.

The registered manager had resigned and a new manager had been appointed. 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 and associated Regulations about how the service is run.

Everyone who lived at the home told us they felt safe. Relatives and staff spoken with all said they felt people were kept safe. We saw that the provider had processes and systems in place to minimise the risk of harm to people.

We found that there was enough staff to meet people’s identified needs .The provider ensured staff were recruited safely and had the training they needed to meet people’s needs..

The provider had made appropriate applications under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards legislation so that people’s rights could be protected. However, not all staff understood what restrictions were in place for people.

We saw that people were supported to have choices and received food and drink at regular times throughout the day. People spoke positively about the quality of the food available.

People were supported to access other health care professionals to ensure that their health care needs were met. Peoples medication was well managed.

People told us the staff were very caring, friendly and treated them with kindness and respect. We saw staff were caring and helpful.

People told us they were confident that if they had any concerns or complaints, they would be listened to and addressed quickly.

The provider had management systems to assess and monitor the quality of the service provided. This included gathering feedback from people who used the service, their relatives and health care professionals. The provider had identified that these systems could be further improved and had implemented a more robust audit system.