CQC report explained · a nursing home
What the CQC found at Cedars Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found systems for safeguarding, risk management, medicines, infection control and learning from incidents. There were eight vacant carer posts at the time, although the home said these had been recruited to and shifts were being covered by existing or agency staff.
- Effective?
- Good
- People's needs were assessed and care plans reflected their needs. Staff received induction, training and supervision, and people were supported with food, drink, health care and appropriate legal safeguards.
- Caring?
- Good
- Inspectors saw warm relationships and found that people were treated with dignity and respect. People were involved in choices about their care and encouraged to remain independent.
- Responsive?
- Outstanding
- Care and activities were strongly personalised, including individual trips, technology to support independence and imaginative end-of-life wishes. The home also responded to complaints and suggestions by making changes.
- Well-led?
- Good
- There was a clear management structure and systems to monitor quality and make improvements. People, relatives and staff were encouraged to share their views.
What inspectors found, June 2019
Rated Good overall, with Outstanding responsiveness and inspectors finding caring, safe support, although consent records needed improvement.
This was an unannounced planned inspection on 23 May 2019. Inspectors reviewed information held by the CQC, spoke with people living in the home, relatives, managers and staff, and checked care plans, training, recruitment files, complaints and quality checks.
The home was rated Good for Safe, Effective, Caring and Well-led. Inspectors found enough staff on duty, safe medicines systems, suitable training, clean surroundings and good support with food, health care and daily choices. People and relatives said staff were kind and that people felt safe.
The home was rated Outstanding for Responsive. Inspectors found highly personalised activities and particularly strong end-of-life care. The overall Good rating means the service met legal requirements and provided consistently good care, with some areas judged exceptional.
Personalised activities
The home offered activities based on people's past lives, interests and abilities, both inside the home and in the community. People could suggest changes to the programme.
“Staff recognised the importance of social interaction and mental stimulation and provided a range of person-centred activities.” from the report
End-of-life care
Inspectors found exceptionally personalised end-of-life support, with staff working closely with health professionals and helping people achieve important final wishes.
“Staff provided outstanding end of life care and worked extremely closely with healthcare professionals to ensure people experienced a comfortable, dignified and pain free death.” from the report
Kind and respectful care
Staff knew people well, respected privacy and dignity, and supported people to make everyday choices and keep their independence.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Safe systems
Inspectors found trained staff, safe medicines management, risk assessments, infection control and systems to learn from incidents.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Consent records
needs fixingPeople's consent had been signed on their behalf by senior management in the electronic care system because it could not accept people's signatures. The home said it would ask people to sign separate consent forms after the inspection.
“People's consent to care had been signed on their behalf by senior management.” from the report
Vacant carer posts
minorThere were eight vacant carer posts during the inspection. The home said successful candidates were going through recruitment checks, while existing staff and agency staff covered shifts.
“The registered manager informed us there were eight vacant carer posts.” from the report
- 01How many of the eight vacant carer posts have now been filled, and how often are agency staff currently used?
- 02How do you now record and obtain each person's consent to care, especially where someone may have difficulty signing?
- 03How will you make sure activities are tailored to my relative's interests, abilities and wishes?
- 04How would you support my relative's health needs and end-of-life wishes if these changed?
- 05How can relatives contribute to care plan reviews, complaints and decisions about the home?
This was an unannounced planned inspection of the care and premises, covering all five CQC questions and the overall rating. This explanation was written from the published report of 29 June 2019 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, December 2016
Rated Good; inspectors found kind, safe and personalised care, with some medication records and staff supervision needing improvement.
Inspectors visited the home without notice on 21 November and 5 December 2016. They spoke with people living there, relatives, staff and managers. They also checked care files, staff records, medicines, training, complaints, audits and rotas.
All five areas were rated Good: safe, effective, caring, responsive and well-led. Inspectors found enough staff, safe recruitment, good care planning and staff who treated people with kindness, dignity and respect.
There were some problems. Some medication records had gaps, and one person's medicine was not given on two occasions. Formal staff supervision was not happening regularly, and some complaint investigation records were incomplete. The manager acted on these issues and introduced extra checks and improvement plans.
Kind and respectful care
People said staff were kind and caring. Inspectors saw staff protecting people's dignity, privacy and independence.
“People were treated with dignity and respect by staff who knew them well and were kind, caring and compassionate in their approach.” from the report
Enough suitable staff
Inspectors found staffing levels were consistent and enough staff were available to meet people's needs promptly. Recruitment checks had been completed before staff started work.
“There were sufficient suitable, skilled and qualified staff to meet people's assessed needs.” from the report
Personalised care
People's needs, preferences and end of life wishes were recorded. Care plans were reviewed when people's needs changed.
“People received personalised care that was responsive to their individual needs.” from the report
Improved management
People and staff spoke positively about the new manager. The manager had made changes to quality checks and responded to concerns about staffing and food.
“The manager had implemented improvements to the quality monitoring system to ensure that it remained effective.” from the report
Medication recording and missed doses
seriousSome medication administration records had gaps. One person's medicine was not given on two occasions. The manager introduced extra checks and training after the inspection findings.
“However there were some gaps in recording on some MAR sheets that had not been identified.” from the report
Staff supervision
needs fixingFormal staff supervision was not happening regularly enough. The manager had started an improvement plan to address this.
“Although improvements were needed to ensure regular formal staff supervision took place” from the report
Complaint records
minorSome complaint investigations were handled by head office, so the records kept at the home did not contain all the investigation details. The manager said full copies would be kept there in future.
“The complaints records viewed did not contain full details of the investigation as they had been dealt with at head office level.” from the report
- 01What extra checks are now used to make sure every medicine is given and recorded correctly?
- 02How do you monitor whether staff receive regular formal supervision?
- 03If I make a complaint, will the full investigation and outcome be kept at the home?
- 04What changes have been made to staffing levels and agency staff use since this inspection?
- 05How are residents and relatives involved in checking whether the improvements to food and quality monitoring have lasted?
This was an unannounced inspection covering the overall quality of the home and all five CQC questions, using discussions, observations and checks of records. This explanation was written from the published report of 24 December 2016 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 Cedars Care Home
2 rated inspections over 3 years: the service has held its Good rating throughout.
- June 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2012
Registered with the Care Quality Commission on 3 February 2012.
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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