Cedars Lodge

We previously inspected Cedars Lodge in December 2017, at which time the service was rated requires improvement. At this inspection, the service was rated good. This was because we found medicines administration practices were not in line with good practice and were not well audited. At this inspection we found medicines practices to be in line with good practice and oversight of them was robust. As the appropriate improvements have been made, the service was rated good at this inspection.

Cedars Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service supports people living with a learning disability.

The care service is designed and run in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager was also responsible for the management of the provider's other small service nearby and was supported by an assistant manager.

Medicines administration practices were now safe and in line with national best practice guidance. This included improvements to homely remedies, 'when required' medicines, and prescribed creams. Staff were trained appropriately, had their competence assessed and demonstrated a good knowledge of people's medicinal needs.

Risk assessments were specific to people's individual needs and did not restrict people's freedoms to keep them safe. Staff demonstrated a good knowledge of the risks people faced and how to help them minimise them.

Staffing levels were appropriate to people's needs and to ensure the service was not task orientated; rotas were planned in advance.

Staff understood their safeguarding responsibilities. They knew what to do should they have concerns about people's wellbeing or safety. People who used the service felt safe and secure.

Training and support was well planned and effective. The induction covered all core areas and ensured new staff had the skills and confidence to support people. Staff told us they were well supported.

People had a choice of meal options and were encouraged to improve their own cooking skills.

People were supported to have maximum choice and control of their lives in the least restrictive way possible. Staff had received training in the Mental Capacity Act (2005) and consent was evident in care planning and through day to day interactions.

Care plans contained sufficient detail for staff to ensure people's needs were met and that visiting healthcare professionals could understand people's recent healthcare needs and wellbeing. Care plans had been reviewed and audited.

People who used the service were clear that staff were patient and respectful with them. We observed such interactions, as well as good levels of mutually shared humour. Relatives confirmed that people got on well with staff.

People who used the service played an active role in planning and accessing the outings and activities they were interested in. Staff supported them to be as independent as they could be in this.

There had been no complaints but people who used the service were clear they knew how to complain and to whom, if they needed. An appropriate, accessible policy was in place.

The assistant manager and registered manager interacted well with people who used the service and staff. Audits were in place and the managers demonstrated an awareness of areas of recent good practice. They were aware of their responsibilities with regard to making appropriate notifications to CQC.

The culture was open, inclusive and the atmosphere vibrant and welcoming. People felt at home and part of the home.

The five questions we ask about services and what we found