CQC report explained · a nursing home
What the CQC found at The Cedars
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2019
The Cedars is rated Good overall; inspectors found safe, kind and personalised care, but the leadership and checking systems require improvement.
This was a planned, unannounced inspection on 2 July 2019. One inspector and an expert by experience observed care, spoke with people, relatives and staff, and checked care and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found enough staff, safe medicines practice, suitable training, access to health professionals, kind staff and care that reflected people's needs and preferences.
The well-led rating fell from Good to Requires Improvement. Some checks did not identify problems, or did not ensure that identified problems were put right. The overall rating stayed Good, and the safe rating improved from Requires Improvement at the previous inspection.
Enough staff
Inspectors saw enough staff available and found that people did not have to wait for support. Call buzzers were answered promptly.
“We saw there were enough staff available for people and they did not have to wait for support.” from the report
Kind and respectful care
People described staff as kind and confident in their care. Inspectors saw staff offering reassurance, choices and support with independence.
“People were treated in a kind and caring way.” from the report
Personalised support
Care plans contained detailed information and staff knew people's preferences, including preferences about who provided personal care.
“People had care plans which were personalised, detailed and regularly reviewed.” from the report
Activities and relationships
People could take part in activities they enjoyed, and inspectors saw people enjoying an indoor cricket activity together.
“During our inspection we saw various activities were taking place, including a game of indoor cricket.” from the report
Checks did not always lead to action
needs fixingSome audits failed to identify problems or ensure that known problems were corrected. This included a medicines fridge temperature that remained out of range after action had been taken.
“These checks were not always effective.” from the report
Missing capacity assessments
needs fixingNot all capacity assessments were in place for restrictions such as bed rails or bed sensors. The provider took immediate action during the inspection, but an earlier audit had already identified the issue.
“We found not all capacity assessments were in place.” from the report
- 01How will you make sure audits identify problems promptly and that agreed actions are completed?
- 02Have all capacity assessments now been completed for people using bed rails, bed sensors or other restrictions?
- 03How do you check and record the medicines fridge temperature, and what happens if it is out of range?
- 04How do you decide when staffing levels need to be increased or decreased?
- 05How are people's personal preferences, including preferences about staff providing personal care, recorded and followed?
This was a planned, unannounced inspection covering all five CQC questions, with care, premises, records, staffing and management systems examined. This explanation was written from the published report of 20 July 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, September 2016
The Cedars was rated Good overall; inspectors found kind, personalised care, but staffing levels required improvement.
This was an unannounced inspection on 6 July 2016. One inspector and an expert by experience observed care, spoke with people, relatives, staff and a health professional, and checked one care plan and service records. There were 29 people living in the home, which could accommodate 42.
The overall rating was Good. Effective, caring, responsive and well-led care were all rated Good. The safe question was rated Requires Improvement because staffing levels did not always reflect people's dependency and needs. Some people had to wait for meals, and staff said they struggled at busy times.
Inspectors found that people generally felt safe and received medicines safely. Staff knew people well, treated them with dignity, supported their choices and responded to changing health needs. The acting manager monitored incidents, complaints and quality, although some Deprivation of Liberty Safeguards authorisations had lapsed and new applications had not yet been made.
Kind and dignified care
Inspectors saw staff treating people respectfully and compassionately. Staff gave people time, listened to their wishes and supported privacy.
“We saw that people were treated in a dignified, compassionate and caring way at all times.” from the report
Personalised support
Staff knew people's preferences and routines. Care plans included people's wishes, including future and end-of-life preferences.
“The information we read was individual to that person, and they were able to tell us what was written in the plan.” from the report
Safe medicines practice
Medicines were given by trained and competent staff. Records were audited weekly and staff competence was checked every six months.
“People received their medicines from staff that had the knowledge and competence to give medicines safely.” from the report
Learning from incidents
The manager reviewed accidents and incidents and made changes to reduce the chance of them happening again.
“We saw that, where an accident or incident had occurred, the acting manager looked at what caused the accident and how they could reduce the possibility of it happening again.” from the report
Staffing did not always match needs
seriousStaffing levels were not based on people's dependency. Some people waited for meals, and staff were described as stretched when people needed two staff for moving and handling.
“We found that people were not always supported by sufficient staff.” from the report
Some authorisations had lapsed
needs fixingInspectors found that some Deprivation of Liberty Safeguards authorisations had expired without new applications being made. The acting manager said this had been identified and action had started.
“We saw that some DoL authorisations had lapsed but no new applications had been made.” from the report
Manager registration was in progress
minorThe registered manager was working elsewhere for the provider. The home was being run by an acting manager who was applying to register with the CQC.
“On the day of our inspection the service was being run by the acting manager who used to be the deputy manager.” from the report
- 01How are staffing levels now calculated for people who need two staff for moving and handling?
- 02How do you make sure people do not wait too long for meals or help with eating and drinking?
- 03Have all lapsed Deprivation of Liberty Safeguards authorisations now been renewed or replaced?
- 04Who is currently managing the home, and has the acting manager's CQC registration application been completed?
- 05How are accidents, incidents and complaints reviewed, and what changes have been made recently?
This was an unannounced comprehensive inspection covering all five questions, with the inspection team observing care, speaking to people and staff, and checking one care plan and service records. This explanation was written from the published report of 7 September 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- December 2012
Registered with the Care Quality Commission on 4 December 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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57 live-in carers within about an hour of Shropshire
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 £960 to £1,230 a week. 52 can care for a couple. 9 years' experience on average.
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