Cedar Court Nursing Home (Dementia Unit)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question [requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The registered manager had systems in place to ensure learning took place when things went wrong, and this was shared with the wider staff team. At our last inspection we identified some agency staff employed, were not clear on the policies and procedures at the home to keep people safe. The deputy manager told us how lessons had been learnt from this and all staff were provided with this information before they commenced worked at the home. Staff had a good understanding of the policies and procedures in place to protect people from harm. The registered manager and deputy were open and transparent about incidents and accidents that occurred, they were recorded and reported appropriately. The registered manager and deputy encouraged people and staff to raise concerns to them and had a system in place to manage accidents and incidents and learn from any patterns or trends identified. Staff were confident in the leadership of the management team and told us their learning was continuously updated to ensure people’s changing needs were met.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People that were able to converse with us felt safe living at Cedar Court. We spent time observing care practices in communal areas and saw a lovely rapport between people and the staff supporting them. From discussions with staff, it was clear that they knew people well and understood how to communicate with them and what they liked to do. Leaders and staff understood their responsibilities to report safeguarding concerns and knew what to do if they had concerns about abuse or neglect. Staff confirmed they received safeguarding and whistleblowing training which included refresher training, to ensure they were up to date with current practice and guidelines. Safe practices were followed by staff when they supported people to move around the home and when assisting people to eat and drink.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks were assessed on an ongoing basis and actions put in place to mitigate them. Records were in place that demonstrated that accidents such as falls were reviewed and measures put in place to reduce the risk of reoccurrence. Staff understood people’s individual risks. Risk assessments and care plans were in place to guide staff on how to support people safely. Staff followed these to ensure people were supported in a safe way. For example, people that were prescribed specialist diets were offered these in accordance with their care plans. Risk assessments were reviewed on a regular basis to ensure the information was accurate.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People were supported in a well-maintained environment and the equipment and facilities in place met people’s needs. Maintenance staff were employed to ensure that the environment was safe and well maintained. Regular safety checks such as gas, electrical and fire safety checks were carried out and audits were undertaken on a regular basis. Equipment was serviced in accordance with manufacturer's instructions. Repairs took place when needed to ensure safety was maintained.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. There were enough appropriately trained staff to support people safely and meet their needs. Staff interactions with people were positive and meaningful and not only based on tasks. One person confirmed that the staff were always available when needed. Staff reported that the staffing levels were sufficient to ensure that people received good and safe care. The comments included, “There are enough of us on shift, and we all work together to ensure everyone has the support they need.” Staff confirmed they received training appropriate to their role and told us this included face-to-face training which several staff said they preferred. There were robust and safe recruitment practices to make sure that all staff, including agency staff were suitably experienced, competent, and able to carry out their role. The management team worked out a suitable staffing ratio based on people’s needs and were willing to change it when people’s needs increased. The staff training matrix was monitored and, when required action was taken to prompt staff to complete training.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People and relatives raised no concerns about infection prevention and control. Staff used personal protective equipment (PPE) as required when supporting people to reduce the risk of spreading infection. A cleaning programme was followed to ensure regular cleaning of the environment was maintained and to ensure, infection prevention control and food hygiene standards were met. We saw housekeeping staff cleaning throughout the day of our visit. On the day of our site visit, the home was clean and hygienic. The provider had systems and processes to assess and manage the risk of infection. Audits were completed to identify any areas of concerns and to drive improvements.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Medicines were managed safely by trained nursing staff. A medicines policy was in place along with people’s care plans and a medicines administration record which was completed when medicines were administered. Staff understood people’s health conditions. Staff knew what to do when people refused medicines or if an error was made. Protocols were in place for ‘as required’ medication (PRN). This meant staff were clear on when to administer this type of medicines The provider followed correct procedures for the receipt, storage, administration, and disposal of medicines. Where people lacked mental capacity to make decisions about their medicines, staff involved relevant people to reach decisions that were in people’s best interest. For example, people’s families and representatives, GP, and health care professionals.