CQC report explained · a residential care home
What the CQC found at The Cedars
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and risks linked to their care. Medicines, infection control, staffing, recruitment and financial records were managed through established systems.
- Effective?
- Good
- Staff had training and understood how to support choice and decision-making. People received support with healthcare, mobility and dietary needs, including guidance from health professionals.
- Caring?
- Good
- People had positive relationships with staff and were treated with dignity and respect. Staff supported people to maintain family relationships and make choices about their daily lives.
- Responsive?
- Good
- Care was tailored to people's preferences, goals and communication needs. People were supported with activities, community access, personal development and raising concerns.
- Well-led?
- Good
- The management team used audits, monitoring visits, meetings and action plans to check and improve the service. People and staff were asked for their views.
What inspectors found, July 2018
The Cedars was rated Good; inspectors found safe, caring and personalised support, with improvements from the previous inspection sustained.
This was a comprehensive routine inspection on 23 and 25 May 2018. The inspector reviewed care records, staff records, medicines and management information, observed support, and spoke with people, staff and healthcare professionals.
The home supported six people at the time, who had learning disabilities or were autistic. Inspectors found people were safe, treated with respect, involved in their care and supported to take part in activities and community life. Staff understood people's needs and there were enough staff to provide planned one-to-one support.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home had previously been rated Requires Improvement in 2016 because care and risk assessments and quality checks needed strengthening. Inspectors found these improvements had been maintained.
Personalised support
Staff knew people well and supported their individual wishes, goals, communication needs and routines.
“People's care and support documents provided support workers information on people's needs and preferences and how to support them live a full and meaningful life.” from the report
Choice and independence
People were supported to make everyday choices, use parts of the home freely and take positive risks where possible.
“People were supported to have as much choice and control as possible regarding their daily life.” from the report
Active lives
People took part in activities and trips suited to their interests, abilities and goals, both in the home and in the community.
“People enjoyed a busy and active life, which included activities, events and tasks which were personalised to their needs, wishes and goals.” from the report
Strong oversight
The management team carried out regular audits and used action plans to address issues and check that improvements lasted.
“The quality, safety and effectiveness of the service was monitored by a wide variety of quality assurance processes and audits.” from the report
Inspectors raised no specific concerns in this report.
- 01What is the current position on the outstanding applications for Deprivation of Liberty Safeguards authorisations?
- 02How many staff are available for each person's planned one-to-one support, including during staff absences?
- 03How are medicines records checked now, and what happens if a recording gap is found?
- 04What progress has been made with the planned refurbishment and new annexe?
- 05How will the home keep relatives informed about each person's goals and progress?
This was a comprehensive routine inspection covering all five questions; six people lived at the home, but inspectors spoke with one person and briefly spoke with two others. This explanation was written from the published report of 5 July 2018 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 Requires Improvement; inspectors found safe, kind care and active lives, but care records and quality checks were not yet consistent.
This was an unannounced inspection on 12 and 13 October 2016. One inspector visited, spoke with people, staff, healthcare professionals and commissioners, observed care, and reviewed four care files and management records.
The home had improved since the previous inspection. Inspectors found good arrangements for safety, staff training, consent, food, medicines, dignity and community activities. People appeared comfortable with staff and were supported to make choices and enjoy busy lives.
The overall rating was Requires Improvement. Safe, effective and caring were rated Good. Responsive and well-led were rated Requires Improvement because some care plans were not up to date and newer monitoring systems had not yet shown consistent results.
Improved safety
The provider had acted on earlier safety concerns. Inspectors found that the home was safely maintained and people's risks had been assessed and recorded.
“At this inspection we found the provider had taken action to ensure the service was safely maintained and people's risks had been effectively assessed.” from the report
Kind and respectful care
People appeared comfortable and happy with staff. Staff treated people as equals and protected their dignity.
“Care staff interacted with people in a kind and compassionate manner.” from the report
Active lives
People were supported to have one-to-one time, join group activities and go out into the community. Staff also helped people build confidence and independence.
“All people had dedicated one to one time with staff, as well as access to group activities.” from the report
Training and healthcare support
Staff had access to relevant training and support. People could see healthcare professionals, and staff followed specialist advice about dietary needs and choking risks.
“People were supported by staff who had access to the training they needed to meet people's needs.” from the report
Care plans were incomplete
seriousNot all care plans had been reviewed or updated. Changes in people's needs were not always recorded, which could leave conflicting information or important details being missed.
“However not everyone's care plans had been updated.” from the report
Some medicine guidance was missing
seriousThere was not always a clear protocol for medicines prescribed as required. Inspectors raised the risk that a person could receive too much of this medicine.
“However, there was not always a clear protocol in place for staff to follow to ensure people were protected from the risk of taking too much of these medicines.” from the report
Quality checks were not yet consistent
needs fixingSome audits had only recently started, so inspectors could not yet judge their effect. Some care-record actions were also overdue.
“However some systems and audits such as infection control audits had only recently been implemented in September 2016 and therefore it was difficult to ascertain their consistency and impact on improving the service.” from the report
- 01Have all current care plans and risk assessments now been reviewed and updated, and how do you check that they match each person's needs?
- 02What written protocols are now in place for medicines prescribed as required, and how do you prevent too much medicine being given?
- 03Which quality audits are now established, and what evidence shows that they are being completed consistently?
- 04Have all actions on the home's action plan been completed, including those relating to care records?
- 05How are people's views about activities, daily support and concerns recorded and acted on?
This was an unannounced inspection of the overall service and all five rating areas; the inspector reviewed four care files and spoke with two people, four care staff, healthcare professionals, commissioners and the manager. This explanation was written from the published report of 30 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 The Cedars
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- July 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 8 December 2010.
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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38 live-in carers within about an hour of Gloucestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
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