Cedar Court is registered to provide care and accommodation for up to thirteen people. At the time of the inspection there were eleven people living there. People living at Cedar Court were young adults who may have a learning disability or autistic spectrum disorder.

This inspection took place on 24 July 2017 and was unannounced.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 the last inspection of the service in May 2016 the service was rated as ‘requires improvement’. On this inspection we saw improvements had been made. For example on the last inspection the governance systems at the service were not robust, and quality assurance systems were not well developed. On this inspection we found improved systems had been put in place to assess, monitor and improve the quality and safety of the services provided. This included more robust auditing systems and regular assessments and reports being undertaken to highlight any concerns, trends or areas needing attention. Feedback was being obtained from people living at the service, relatives, staff and healthcare professionals in order to improve the service, and improvements had been made as a result.

On the last inspection we had identified concerns over the support planning systems in use. On this inspection we saw improvements had been made. People’s care plans contained information about any health concerns and support needed, for example with managing long term health conditions. Positive support plans and communication strategies helped identify potential signs and causes of anxiety or distress and how to support the person to reduce this. Some plans to do this had been drawn up with the support of specialist professionals, and covered any risks from or to the person.

People were protected from the risk of abuse as staff understood the signs of abuse and how to report any concerns. Staff spoke very positively of people, and were enthusiastic about supporting people at the service, including celebrating any advances people made towards greater independence. People’s rights were respected, and staff had received training and had a clear understanding of the Mental Capacity Act 2005 in practice. Where people lacked capacity to make an informed decision, staff acted in their best interests, and with significant decisions had involved other parties such as relatives or medical teams to assist with decision making. Appropriate applications had been made to deprive people of their liberty under the Deprivation of Liberty Safeguards (DoLS), and systems were in place to manage any concerns or complaints.

There were enough staff employed by the service to meet people’s needs. Many people had defined staffing levels, such as one to one staffing, or more in specific circumstances. The service had access to a flexible group of bank staff who were familiar with people, so they were always supported by someone who knew them well and understood their needs. This helped to reduce people’s anxiety. Since the last inspection improvements had been made to the staff recruitment process, with improved risk assessment processes. This helped to ensure people were supported by suitable staff.

Staff had the skills and support they needed to carry out their role effectively. There was a programme of training in place, and staff told us they were well supported both by their team colleagues and the service’s management. Staff training updates were booked and new staff were completing the care certificate, which is a set of standards that should be covered as a part of induction training for staff new to care.

People received their medicines safely as prescribed. Sta

Cedar Court is registered to provide personal care and support to 13 people in two separate semi-detached houses. People living at the home are younger people with a learning disability or autistic spectrum disorder. When we inspected the home there were 8 people living there. The building is made up of supported but semi-independent flats and more traditional residential care rooms to meet people’s needs.

The home had a manager in post, but they were not yet registered with us. They are referred to throughout the report as the manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

This inspection took place on 10 May 2016, and was unannounced. During the inspection we found some positive practice in place, and some areas where the home needed to improve.

Risks to people had not all been reviewed or updated since the person had moved to Cedar Court. Staff had positive approaches to risk taking, but some of the information in people’s files was from previous places where people lived, which meant it may not be accurate or up to date. People had been encouraged to be involved in decisions which affected them, and in writing their care plans. However not all the care plans were up to date or reflective of people’s care at the time of the inspection.

Staff training and support needs had not always been identified or met. Staff spoke passionately about their work and the people they supported, and we saw evidence of positive, caring and supportive relationships. But staff did not all have the up to date knowledge or skills needed to support people with their needs. Gaps in care planning and records meant this presented a higher level of risk as staff could not use these with confidence to support people. We have made a recommendation in relation to staff training and support systems.

People were protected from the risk of abuse as staff understood the signs of abuse and how to report concerns. People benefited from sufficient staff to meet their needs, and staffing levels were increased to meet their wishes regarding activity. However systems were not in place to manage any risks associated with the staff recruitment process. The staff team were clear about and were encouraged to work within the ethos and philosophy of the home. The home had a strong, visible person centred culture and was good at helping people who used the home to express their views. People were encouraged and supported to engage with the local community. Where people had raised concerns these were managed well.

People received their medicines as prescribed. The systems in place for the management of medicines protected people who lived at the home; however we identified some concerns that prescriptions were not always clearly written. The manager agreed to clarify these with the prescriber to ensure they were being given at safe intervals.

Accommodation was personalised and had been adapted to suit individual people’s needs. Some people had their own flats which they were able to personalise. Other people had more traditional residential care accommodation. Movement between the two semi-detached houses, which might be necessary to enable people to access the central kitchen was managed through the use of electronic key fobs.

People had access to the healthcare services they needed, including a staff having a clear understanding of when emergency care was needed for one person. The home had thought about people's needs and relatives were being involved in making best interest decisions where people needed support in making decisions. Appropriate applications had been made under the Deprivation of Liberty Safeguards to help protect people’s rights and safety.

There were

We carried out this inspection on 10 March 2014 to follow up on concerns found during our inspection of 17 September 2013. On that inspection we found that improvements were required in the numbers of staff available. We also had concerns about the training and support provided to those staff. During our latest inspection we found that improvements had been made.

We found that 10 people lived at Innisfree. We spoke with four of those people. They told us they enjoyed living there and were “well looked after”. One person told us “There are always enough staff to take care of me”. Another said “Staff know what they’re doing and are very pleasant.” A visiting relative told us “The staff are competent and can move people safely”.

We saw evidence that a great deal of relevant training had been scheduled and delivered since our last inspection. We found that the vast majority of staff had completed up to date training. This included training which would support the safe moving and handling of people who required assistance to mobilise.

Staff told us that they had received training in key areas since our last inspection and that they had received regular supervision. We found that staff meetings had taken place. All of the staff we spoke with told us that they felt supported.

We found that there were sufficient numbers of staff to provide care safely to everyone who lived at the home.