We inspected this service on 1 August 2018. The inspection was unannounced.

The service provides accommodation and personal care for up to 37 older people. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The accommodation is over two floors and 29 people were living at the home on the day of our inspection.

There was a registered manager in post. 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 our previous inspection in February 2016, we rated the service as Outstanding in the key areas of caring and well-led. At this inspection we found people continued to receive a high standard of care. However, significant changes in the staff team had caused challenges over the last 12 months which meant the overall rating of the service has now changed to Good.

There were enough staff to meet people's needs safely and respond to their requests for assistance. The provider's recruitment procedures ensured staff were of a suitable character to work with people who lived in the home. People’s care plans included an assessment of their needs and identified the individual risks to their safety. Staff understood their responsibility to work in a safe way and report any concerns to the registered manager.

People were cared for by kind and compassionate staff, who knew people's individual preferences and how they wanted their care provided. Staff understood people's risks and abilities and received updated information at shift handovers to ensure the care they provided was responsive to any changes in people's needs. Staff received regular training and support to ensure the support people received was effective and safe.

People were supported to maintain a nutritionally balanced diet. People’s medical conditions were explained in their care plans and staff worked in partnership with other healthcare professionals to ensure people’s medical and health needs continued to be met and responded to. People's medicines were managed, stored and administered safely in line with GP and pharmacist prescription instructions.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005. They told us everyone who lived at the home had the capacity to express their wishes, which ensured they received effective support with no restrictions on their liberty.

People's equality, diversity and human rights were respected because one of the provider’s values was, “We treat every person as a unique individual.” Staff promoted people's dignity and respected their privacy. People were offered opportunities to engage in activities and conversations that met their physical, social and spiritual needs.

The home was adapted, decorated and furnished to meet people's needs. Staff had training in infection prevention and control and understood the importance of maintaining a clean environment.

Staff enjoyed their job because they were part of a supportive staff team who communicated and worked well together. Staff respected the registered manager’s leadership and described senior staff as visible and approachable. Systems were in place for the provider and registered manager to assess and monitor the quality of the service and respond to people's feedback. People were happy with the quality of care they received.

We carried out an unannounced inspection at Cedar Lawn Care Home on 04 February 2016. During our last inspection to the service in December 2013, we found the provider had satisfied the legal requirements in all of the areas we looked at and no concerns were raised.

Cedar Lawn is a residential care home providing accommodation for up to 37 older people who require personal care and who may be living with dementia. The home has two floors and access to a well maintained garden area, including a recently refurbished patio area, backing onto fields. At the time of our inspection visit there were 32 people living at the home.

Cedar Lawn care home had a registered manager in place. 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.

Throughout our time at Cedar Lawn we saw and experienced a very strong person-centred culture and staff understood and were proud to say that people were their priority and at the centre of all their thinking. Staff had an empowering and empathetic attitude to support people and ensured that the person got what they wanted from their lives and not what the service said they could have. Staff told us that people were not passive recipients of care and support but active participants who had broad and diverse aspirations in relation to their lives. Staff demonstrated they were highly skilled in understanding the importance of meaningful relationships with people.

All of the people we spoke with and their relatives told us people felt very safe living at Cedar Lawn and were extremely satisfied with the service they received. Without exception comments about staff and the management team were highly complementary. Comments about the overall care provided were particularly positive. Staff had an excellent understanding of the types of abuse that may occur and knew how to report abuse should they need to. All staff were trained in safeguarding and received a yearly update to refresh their skills and knowledge.

There were detailed risk assessments in place for each person who lived at the home that related to each person's care and support. There was noticeable attention given to peoples’ individuality in every aspect of the assessments which contained detailed information on how staff should assist people to minimise the risks. We found staff were acting to minimise the risks. There were processes in place to manage risks in connection with the operation of the home and the manager was highly effective in managing the risks to protect people from harm.

There were enough qualified, skilled and experienced staff to meet people's needs. Recruitment and selection processes were in place to ensure staff were of a suitable character to work with people who lived at the home.

Recording of medicine administration showed that people received their medication as prescribed. People told us they received their medicines correctly.

People we spoke with were able to tell us that they had been involved with the care planning process and had agreed to the content of their plans. There was a strong person centred ethos, which was embedded throughout the home, this ethos was intended to make people feel valued, supported and included. Members of staff we spoke with were extremely positive and enthusiastic about the standard of care they provided. All staff had up-to-date mandatory training and had undertaken additional training relevant to their roles. Mandatory training included a range of health and safety training as well as training in medication management and safeguarding. Staff told us that they had received regular meetings with their line manager which we verified in the supervision records.

All of the staff had received train

On the day of our visit we spoke with seven people who used the service, one relative and a visiting professional. We also spoke with the manager, four members of the care staff and the cook. One person who lived at the home said, “They listen to me and they know how to look after me.”

We observed staff interaction and talked with care staff about how they met the needs of people they supported.

Staff demonstrated a clear understanding of people's needs and engaged with people in a positive manner. People appeared relaxed and happy in the company of the staff and were not hesitant when they approached them.

The relatives and visitors we spoke with told us they were happy with the care at Cedar Lawns.

We looked at the care planning documentation and we found that care plans were very detailed and demonstrated that staff treated each person as an individual based upon their needs.

We saw that people’s nutritional needs had been identified and people were provided with a good choice of food. People told us they were happy with the choices available to them.

Systems were in place to ensure that medicines were managed appropriately on people's behalf.

Staff told us they were supported by the manager and had access to regular training.

We found the home was well led and had systems in place to monitor the quality of the service provided at Cedar Lawns.

We visited the home and spoke with a number of people living there during the visit; during lunch; whilst undertaking activities and individually in the privacy of their rooms.

People told us that they received their care as they requested and were aware of their care plans. They said that they were 'very well looked after' and that staff offering support were 'absolutely wonderful'.

People spoken with told us that the staff ‘would do anything for you’ and that ‘everybody gets on well, it’s great we are like friends’.

One person said that they had no regrets in moving to the home and that one of the main reasons was that they were treated respectfully.

People living in the home said that staff were consistent and that not many left apart from to go on to pursue careers in nursing. One person said ‘we do get new ones, but they are good’.

People told us that they were encouraged to voice their opinions about their experiences of living in the home by completing questionnaires, attending discussion meetings for people and their relatives and by talking with staff and managers. They said that if they had any 'grumbles', they were taken seriously.

Staff told us that they were happy working in the home, that staff worked well as a team and that they had confidence in the manager to listen to them and take appropriate action where required.

We carried out an inspection at Cedar Lawns on 7 June 2012. The visit was unannounced so that no one living or working in the home knew we were coming.

When we visited the home we spoke with two care staff, one relative, a member of support staff and two people living at Cedar Lawns.

People told us they received their care as they requested and were aware of their care plans. They said they could see a doctor when they wanted and this was arranged quickly for them.

People spoken with said “Its really nice, people are nice and staff are very good” “there is lots to do and its one big community really”.

They told us they are spoken to with their preferred name and they are treated with respect.

People told us they were encouraged to voice their opinions about their experiences of living in the home and they attended discussion meetings for people and their relatives.

We spoke with one relative who said “they give us peace of mind” as they contact us right away if there are any concerns.

We saw that people’s needs had been assessed and care plans had been devised to describe how people liked to be supported. Risks to people’s health and well being had been identified and measures had been put in place to protect people.

We saw that people had opportunities to make decisions about where they spent their time, whether to join in planned activities for example the Reading Group.

The care plans we looked at had not always been updated with current changes and needs of people living at the home. However, care staff were able to tell us about the individual needs of people.

Staff told us they were happy working in the home, that staff worked well as a team. We were told that training opportunities were frequent and planned to ensure staff had sufficient knowledge to meet people’s needs.

We saw there were quality assurance systems in place which measured people’s satisfaction with the service provided in the home. People and their visitors told us they were aware of the procedure for making complaints and felt confident any concerns raised would be taken seriously and acted upon. One relative told us “any concerns have always been addressed and resolved quickly”.