About the service:

Cedar House is registered to provide personal care to older people, people living with dementia, people with physical disabilities, people with sensory impairment, and younger adults. People live in a supported living housing complex and have their own flats. At the time of inspection 38 people were living in the complex.

People’s experience of using this service.

¿ People received safe care and they were protected against avoidable harm, abuse, neglect and discrimination.

¿ People’s medicines were safely managed.

¿ Staff were recruited following necessary checks, though these needed to be strengthened.

¿ There were enough staff to provide care and support to people to meet their needs.

¿ People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

¿ Staff had support, supervision and training to work effectively to provide personal care to people.

¿ Staff were compassionate, friendly and caring. They treated people with respect and dignity.

¿ Staff encouraged people to maintain their independence.

¿ People had personalised plans of care in place to enable staff to provide care and support in line with people’s preferences.

¿ Information could be provided to people in an accessible ways to enable them to make decisions about their care and support.

¿ People knew how to raise a concern or make a complaint. The provider had systems to properly respond to complaints received.

¿ The service had a system in place to provide end of life care to people.

¿ The service had a positive ethos and an open culture. Management were supportive of people and staff and listened to them.

¿ There were effective systems in place to monitor the quality of the service and drive improvements.

Rating at last inspection.

Requires Improvement (report published 19 June 2018)

Why we inspected.

¿ This was a planned inspection based on the rating at the last inspection.

¿ At the last comprehensive inspection, the provider was rated as Requires Improvement due to systems and processes not effectively in place to assess, monitor and improve the quality and safety of the service. We checked they had taken action to improve these systems and found they had.

Follow up.

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Cedar House is an extra care facility where people have their own flats. People receive personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates the care provided, and this was looked at during this inspection. The service provides personal care for older people and younger adults. This was the first inspection of the service since it's registration in February 2017. It was a comprehensive inspection.

The inspection took place on 30 April 2018. The inspection was announced because we wanted to make sure that the registered manager was available to conduct the inspection. The registered manager stated that 26 people were supported by the service at the time of the inspection visit.

A registered manager was in post. This is a condition of the registration of the service. 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 and associated Regulations about how the service is run.

Risk assessments and staff practice was not comprehensively in place to protect people from risks to their health and welfare.

Staff recruitment checks were carried out to protect people from receiving personal care from unsuitable staff.

People and a relative told us they thought the service ensured safe personal care was provided by staff. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area but had not been comprehensively aware of how to report to other relevant agencies if necessary. Policies set out that when a safeguarding incident occurred management needed to take appropriate action by referring to the relevant safeguarding agency. The registered manager was aware these incidents, if they occurred, needed to be reported to us, as legally required.

People told us that staff supported them with their medicines, though records had not always evidenced this had happened.

Comprehensive assessments of people's needs had not always been carried out, which potentially left them at risk from issues affecting their safety.

Staff had largely received training to ensure they had skills and knowledge to meet people's needs, though training on other relevant issues had not yet been provided.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives. Staff were aware to ask people’s consent when they provided personal care. Capacity assessments were in place.

People told us that staff were friendly, kind, positive and caring. Not everybody told us they had been involved in making decisions about how and what personal care was needed their needs, though they did not feel this had any impact on the quality of care they received.

Care plans included important information on people’s needs, which helped to ensure that their needs were met, though there was not comprehensive information in place on people’s lifestyles and preferences.

People were confident that any concerns they had would be properly followed up. They were very satisfied with how the service was run and complimented team leaders who had organised the personal care.

Staff members said they had been fully supported in their work by the management of the service, and especially complimented their immediate line managers, the team leaders.

Management had carried out audits in order to check that the service was meeting people's needs and to ensure people were provided with a quality service, though not all issues had been identified or action taken.