CQC report explained · a nursing home
What the CQC found at Cedar Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured that infection prevention and control arrangements were in place, including safe admissions, PPE, testing, visiting and outbreak management. The wider Safe question was not fully rated at this inspection.
- Effective?
- Good
- This question was not covered by this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff supported independence and involved people in decisions about their care.
- Responsive?
- Good
- Care plans had improved, complaints were investigated and activities were tailored to people's interests and needs. Inspectors said more detail was still needed in some care plans and end of life plans.
- Well-led?
- Good
- Inspectors found visible and supportive management, regular involvement of people and relatives, and audits that identified and followed up improvements.
What inspectors found, October 2021
Rated Good overall; inspectors found kind, responsive care and improved leadership, but Safe was inspected without a rating.
This was an unannounced, focused inspection on 16 September 2021. Three inspectors spoke with people, staff and the manager, observed care, and checked care plans, complaints, daily notes, audits and meeting records.
The home was rated Good overall. Caring, Responsive and Well-led were rated Good. Safe was inspected but not rated. Inspectors were assured about infection prevention and control, including PPE, testing, visiting and managing outbreaks.
The home had improved since the previous Requires Improvement rating. Inspectors found that earlier problems about dignity, care planning, complaints and some records had been addressed, so the provider was no longer in breach of regulations.
Inspectors still said some care plans and end of life planning needed more detail. They also said the home’s overall rating included ratings carried over from the previous comprehensive inspection.
Kind and respectful care
Staff were observed treating people courteously and with compassion. People said staff listened to them and respected their choices.
“Staff looked after people in a kind and compassionate manner and treated them with dignity and respect.” from the report
People involved in care
People were involved in care planning and could make choices about routines, clothing, activities and who supported them.
“People and relatives were at the centre of decision making about their care.” from the report
Activities and relationships
The home offered varied activities linked to people's interests. People staying in their rooms were also supported to take part in hobbies and conversation.
“Activities were tailored to people's individual needs and wishes.” from the report
Improved management
Management was visible and approachable. Audits covered areas such as falls, medicines, infection control, skin integrity and health and safety, with actions followed up.
“The provider and the management team undertook audits to review the quality of care being provided.” from the report
Care plans needed more detail
needs fixingCare plans had improved, but inspectors said some still lacked enough specific guidance for people's individual needs. The manager said more detail would be added.
“However, we raised with the manager that more detail was needed to ensure that the appropriate guidance was included relevant to the specific needs of people.” from the report
End of life wishes still being developed
needs fixingEnd of life care was described as dignified and respectful, but the planning of people's specific end of life wishes was not yet complete.
“The registered manager told us the care planning for end of life care was still being developed.” from the report
- 01How will you make sure each person's care plan contains detailed, individual guidance for their specific needs?
- 02What information is recorded about each person's end of life wishes, and how are families involved?
- 03How do you check that care plan updates have been completed and are being followed by staff?
- 04What infection prevention arrangements are currently used for visitors, testing, PPE and possible outbreaks?
- 05How can my relative take part in activities if they usually stay in their room?
This was a focused inspection of Caring, Responsive and Well-led, with infection prevention and control checked under Safe; other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 5 October 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2020
Rated Requires Improvement; care was safer and more effective than before, but records were not always accurate or up to date.
This was an unannounced focused inspection on 15 October 2020. Three inspectors spoke with people, relatives, staff and a healthcare professional. They reviewed care records, medicines records, staff files and management records.
Safe and Effective were both rated Good. Inspectors found improvements in staffing, medicines, infection control, risk management, staff training, consent and access to healthcare. People and relatives generally said staff were available, caring and competent.
Well-led was rated Requires Improvement because some care records were incomplete or not updated when people's needs changed. The overall rating changed from Inadequate to Requires Improvement. The home was no longer in special measures.
Risk management
Staff knew people's individual risks and followed support plans. Records for repositioning, food and fluids were up to date, and accidents were reviewed for lessons.
“If risks were identified, clear support plans were in place detailing the care people needed to minimise these risks.” from the report
Staffing
Staffing levels had improved and the home had reduced its reliance on agency staff. Inspectors saw staff respond quickly when people needed help.
“During the inspection we saw that where people needed support this was provided by staff straight away.” from the report
Medicines
Medicines records reflected people's current treatment. Staff training and checks of their competence were completed before they were signed off.
“Medicines were managed in a safe way and people told us that they received their medicines when needed.” from the report
Consent and choice
Staff offered choices during the day and had improved their understanding of mental capacity requirements. Capacity assessments were specific to the decisions being made.
“Where people's capacity was in doubt MCA capacity assessments were completed and these were specific to the particular decisions that needed to be made.” from the report
Management improvement
The report found a more stable and supportive management approach than at the previous inspection. People, relatives, staff and a healthcare professional spoke positively about the changes.
“People and relatives were positive about the new manager at the service.” from the report
Care records
needs fixingSome records did not accurately show the care provided. Inspectors found gaps in recording topical creams and daily exercises, and care plans were not always updated when needs changed.
“The records at the service required some improvements to ensure that they were accurate and up to date.” from the report
- 01How do you check that topical creams and daily exercises are recorded every time they are provided?
- 02How quickly are care plans updated when a person's needs change?
- 03What staffing levels will be in place for each shift, and how often are these reviewed against residents' needs?
- 04How will you show us that medicines, food and fluid monitoring, and repositioning records remain complete?
- 05Has the manager now become registered with the CQC, and who is legally responsible for the home until registration is complete?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not assessed and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 4 November 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Cedar Court Care Home
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2020Requires improvementup from InadequateWell-led: Requires improvement
- December 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- November 2016
Registered with the Care Quality Commission on 23 November 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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