Cedar Tree Care Home Limited

This focused assessment was carried out to follow up on the breaches of regulations found at our last assessment. These related to the processes used to recruit staff, the provision of safe care and treatment, the processes to ensure proper consent was obtained under the Mental Capacity Act (MCA) and the governance at the service.

We found the provider had made sufficient progress and was no longer in breach of the regulations regarding consent, recruitment and governance. However, whilst some improvements had been made in the regulation for safe care and treatment, we continued to find concerns with the care planning and management of behaviours that could cause harm to people or others. Therefore, this constituted a further breach of regulation for safe care and treatment.

Care plans and risk assessments were now more up to date however, this was not consistent. Improvements were still needed to ensure risks were identified when people could have behaviours that placed themselves or others at risk, and to ensure their care plan provided clear guidance in such situations to ensure people’s care was safe and effective. The policy for managing behaviours that could place people and others at risk needed improvement. Incidents were not used as opportunities to learn and improve people’s care.

Staff had now received recent training in the Mental Capacity Act 2005. Records showed where this had now been applied to people’s care decisions however, this still needed further improvements to be made to ensure mental capacity assessments and best interest decisions were recorded in line with the guidance.

Staff had now completed recent training in areas relating to people’s care. All the required pre-employment checks had been completed in line with the requirements for people working in care settings.

Cleaning records had now been completed to a better standard and the carpets downstairs had now been cleaned. Carpets throughout the rest of the home were scheduled to be replaced however, there was no specific timeframes attached to this work. Armchairs and dining chairs remained stained.

Records of people’s care were now more accurate however, details of how staff assisted people to re-position themselves to help prevent pressure damage were not consistently made.

Medicines were now stored in line with good practice.

People enjoyed their meals and people’s weight was monitored to help reduce risks associated with weight loss.

Policies had been revised however, some needed further revisions to ensure they were in line with current guidance.

The provider now had meetings with relatives to hear their views and feedback on their actions. Further work was needed to ensure staff views could also be heard and contribute to the development to the service.

Feedback described the registered manager as helpful and approachable. Feedback continued to be mixed over how successful the provider had been in creating a trusting and open culture at the service.