Cedar House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not experience kind and respectful care at all times.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not consistently treat all people with dignity or demonstrate empathy for their care experience at all times. For example, we saw staff move a person in their wheelchair without always telling them what was happening or why. We saw staff wipe a person’s face after a meal using some paper roll usually used to clean surfaces. However, we also regularly observed staff providing sensitive, compassionate and patient support and treating people with kindness. Relatives said the staff and managers treated people with dignity and respect. A relative said, “They’re all very kind and caring.” Professionals told us they saw staff treat people respectfully when they visited.

The provider did not consistently treat all people as individuals or make sure people’s care and support met all people’s needs and preferences. Some people’s rooms were homely and personalised with decorations and pictures that were meaningful for them. However, other people’s rooms were very sparsely decorated with minimal personalisation to promote their self-expression or reflect interests and things that were important to them. We received mixed feedback about people’s rooms. One relative said, “Their room is lovely” while others told us, “It is always clean and tidy but soul-less” and “I have been disappointed that [the person’s] room was a bit bare. We mentioned it and they said they would fix it.” Staff knew people's needs and some relatives told us, “They know [the person] by their mannerisms, they know what they like and what they don’t.” However, we saw that at times the deployment of staff made it difficult to support people's individual choices and preferences. For example, when staff needed to supervise several people at the same time as managing other tasks or when staff only sat with people during meals when physically assisting them to eat.

The service did not always promote people’s independence and involve them in activities and aspects of their daily living. For example, we saw times during the day when people were not supported to be meaningfully engaged with activities that were appropriate to their interests, abilities and sensory needs. Also, people were not involved in things such as preparing their meals, snacks or drinks or keeping their home clean. There was a timetable of things for staff to support people with but these did not always seem to be offered. Records of the individual activities taking place with people showed these were minimal and repetitive. People were supported to go out on trips. A relative said, “They take [their family member] everywhere. [The person] goes down to London, they enjoy it.” The service supported people to maintain relationships with people who were important to them. A relative commented, “It’s nice to knock the door and they say, ‘Hello, come in’ even if we haven’t said we’re coming.” Some people could speak, one person communicated through writing and others through looking and through staff understanding and interpreting how they acted. We saw staff demonstrate a good knowledge of people’s individual communication needs when working with them.

Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. For example, staff did not respond quickly when we saw a person experiencing possible choking concerns or when another person appeared upset at how close a member of staff was standing in front of them. We also saw staff respond promptly to people throughout the day in a caring manner.

The provider cared about staff and their wellbeing. Staff told us they felt supported by the managers to provide care to people. This included providing bereavement counselling support to the team. A staff member told us that when someone in the team needed support with a personal matter, “[The registered manager] goes out of their way to support them and sort things out.”