Cedar House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met. The service was in breach of legal regulation in relation to providing person-centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care plans did not always reflect all of their physical, mental, emotional and social needs. For example, some people’s plans gave little information about their interests or hobbies or set out how to promote these during the day or evening. Plans did not set out longer-term aims on how to support people to have the opportunity to try different things or to learn new skills in ways that would make these fun and achievable. However, some areas of people’s care plans took into account their individual characteristics, such as their religious and cultural background, and noted things that were important to them. A person’s plan, for example, was clear about the pace at which they liked to do things and the particular way they wanted to wear some clothing.

The service worked to support the health and care needs of people in their local communities. The staff worked with other services and people’s relatives to provide care and support to people. People received care from the same staff so they experienced continuity of care. Professionals told us the service worked cohesively with them.

The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. There were some pictures added to parts of people’s care plans, but in their current format care plans were not accessible to people. We were not assured that the service had explored information in other formats to support meaningful communication with people. Some information about safeguarding people from abuse was available in an easy read format. People’s care plans set out information about how people communicated their needs. Relatives said the service provided them with information about people’s care and support. A relative commented, “They call me if anything happens.” People’s personal information was stored appropriately.

People and their relatives or advocates were able to share feedback and ideas, or raise complaints about the care and support. Staff involved them in decisions about people’s care. A relative told us the staff listened to their suggestions for their family member’s care and implemented these. Other relatives commented, “They always consult me”, “We can say our likes and dislikes” and “They’re all very approachable. You can speak to the manager or the key worker anytime, they are very responsive.” Relatives were able to raise concerns or complaints and felt listened to. A relative commented, “If we had any complaints we’d go to the manager – they would respond quickly.” The provider had policies in place to manage complaints and make improvements from these.

People’s care plans included one-page profiles, documents designed to summarise key information about a person's strengths, preferences, care and communication needs. These helped professionals and other staff to understand quickly how best to support a person and reduce potential barriers to care within the health and social care system. However, these profiles did not always provide some important information needed to help people access services easily. For example, a person’s profile did not mention that they lived with epilepsy, used a catheter and were at risk of choking. We noted, though, staff accompanied the person when accessing other services. Staff supported people to attend appointments and access emergency care when required as well. The service supported people to access care, support and treatment. Staff completed training on understanding the needs of autistic people and people with a learning disability. The premises and equipment people used were accessible.

People’s care plans did not always focus on a person’s whole life, including their goals, interests and abilities. This meant the provider could not be assured people always received fair care and support that provided them with opportunities for spending their time meaningfully. However, people’s care plans recognised their protected characteristics. Staff supported people to celebrate their cultural heritage by observing particular holidays and festivals and supporting people to enjoy meals that recognised their cultural backgrounds. A staff member said the registered manager supported the service in recognising and learning about both people’s and staff cultural diversity. This encouraged promoting equality. Relatives felt people experienced care that met their needs and a relative told us, “They do everything to accommodate [their family member].” People were supported to go out in their local community. Relevant policies were in place to protect people from discrimination and staff had received training promoting equality and diversity.

People were supported to plan for important life changes. This included moving to another service and their care at the end of life. No one was receiving end of life care at the time of our assessment, but people’s care plans set out arrangements and preferences for what they would like at that time. This included ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decisions. The provider had processes in place to support this and staff had completed training on providing end of life care.