Cedar Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Cedar Court is registered to provide nursing and personal care for up to 75 people. There were 62 people living at the service at the time of our inspection.

This inspection took place on 6 September 2018 and was unannounced.

There was a registered manager in post at the time of our inspection. 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 our last inspection on 28 July 2018, we asked the provider to take action to make improvements in relation to the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS), how people were respected, how people received personal care, the malodour on one floor and the quality assurance. We found at this inspection that action had been taken to address these concerns.

People’s rights were protected because staff acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Appropriate assessments had been completed where people’s capacity was in doubt and applications to the Local Authority were submitted if people were being restricted in their best interest. Staff gained consent from people before care was delivered.

People and their relatives told us that staff were kind and caring and treated people in respectful and dignified way . This was confirmed through our observations. People had choices around their care and felt involved in their care planning. Relatives and friends were welcomed at the service to visit people. People and their relatives were given support when making decisions about their preferences for end of life care. Religious services were available for people that wanted.

There were effective systems in place to assess the quality of care and to make improvements. This included audits, meetings and surveys where feedback was sought. Improvements were made as a result of this. Staff worked with organisations outside of the service to support the care being provided to people.

Start by saying what the provider had done to address the concerns we found last time, so move evidence highlighted in comments to here.

There were appropriate number of care staff to support people when they needed it. People told us that they felt safe and supported at the service. The management of medicines was safe by staff who had the appropriate training. Staff understood the need for good infection control practice to reduce the risk of spreading infections.

The environment was set up to meet the needs of people living at the service particularly for those people living with dementia. People were able to access the service independently where appropriate.

People and relatives felt that staff were competent in their roles. Staff received training and supervision and felt supported by their managers. Nurses were kept up to date with their clinical training. People told us that the care they received was effective.

There were appropriate plans in place to ensure that risks to people were managed. Staff understood what to do to minimise risks in relation to people. Emergency evacuation plans were in place and staff understood what to do if an emergency occurred at the service. Where people had accidents and incidents, actions were taken to reduce the risk of them reoccurring.

Staff had received training in safeguarding people from abuse and they had a good knowledge of what they needed to do if they suspected abuse. Staff at the service had robust re

This inspection was carried out on 28 July 2017 and was unannounced. Cedar Court Care Home provides residential, nursing and respite care for older people who are physically frail. It also provides care for people living with dementia. It is registered to accommodate up to 75 people. At the time of our inspection 62 people were living at the service.

There was a registered manager in post and present on the day of the inspection. 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.

People's human rights were not always protected because the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty (DoLS) were not being followed. MCA assessments were not always completed where needed. Staff did not always understand MCA or why it was important to understand if people had capacity to make decisions. There were some staff that did have an understanding of MCA and its principles. Where restrictions were in place this was not always supported by a MCA.

There were aspects to the care that people received that was not always dignified. Some areas of the service smelled strongly of urine and people did not always look clean and well presented. People were not always able to communicate with staff whose first language was not English. Other aspects of care to people was kind and considerate to people’s needs. People and relatives said that staff were caring and kind to them and treated them with respect. People and relatives were involved in their care planning and the care that was provided was person centred.

The provider did not always have robust systems in place to regularly assess and monitor the quality of the care provided. Concerns we identified were not always picked up on the providers audits. Where concerns were picked up on audits these were not always addressed. Records kept for people were not always up to date and did not always reflect the most appropriate care.

There were enough staff to support the needs of people at the service. When people required support this was provided quickly by staff. We did raise with the registered manager that staff were not always visible on the dementia unit which was a risk. The registered manager told us that this would be addressed.

People were protected from the risk of abuse and staff understood their roles and responsibilities. People told us that they felt safe. One relative told us, “The care is really good and my relative feels safe and happy here.”

Staff understood the risks to people. Staff encouraged and supported people to lead their lives as independently as possible whilst ensuring they were kept safe. People’s medicines were managed in a safe way. In the event of an emergency plans were in place to keep people safe. Accidents and incidents were monitored and action taken to reduce the risks.

Staff received appropriate training and supervision to provide effective care to people. People felt that they were being supported by staff that were effective in their role. Staff felt that they had sufficient training and support. Staff that worked at the service had appropriate recruitment checks before they started work.

People enjoyed the food at the service. Staff supported peoples nutritional and hydration needs and people accessed health care professionals when needed.

Care plans detailed and had specific guidance to staff on how best to support people. Staff communicated with each other the changes to people care. People were able to participate in a range of activities both inside and outside of the service.

Systems were in place if complaints, concerns and compliments were received. The provider actively sought, encouraged and supported people's invo