A Guide to Cedar Care Homes
All About Care and Health
The admission pack contains forms that will help us to provide everything that our Residents' need. These forms should be completed and returned them to homes' administrative team upon the first day of admission.
We’ll send further details (eg terms and conditions) in a contract to our Residents' family member/ representative. These are also available on our website.
Once all parties are happy with the details, the Resident or their family member/ representative should sign and return this to us.
We know how important it is for our Residents to be able to make choices about how they live their life: to live according to their habits and lifestyle, and make decisions about their health care. We plan and carry out our care services to enable them to live their life to its full potential.
At their new home, they will have a designated Named Nurse and Named Carer who will get to know everything about them, and their needs - clinical, personal and social care - so that we can care for them in the ways that suit them.
We'll outline all of this in an Enabling Plan which we'll agree mutually, and with their family members/ representatives if they're happy for them to be involved..
We’ll update and review our Residents' Plans on a monthly basis and whenever there are changes to their needs and preferences. We'll do this in consultation with them, and if they agree, with their family members/ representatives.
We will carryout regular risk assessments to make sure that they are willing and able to carry out daily personal tasks. We want to help them to be as independent as possible, while also offering all the support and care that they might need.
A GP from the local practice regularly visits our home and our Residents can talk to them about any of their health concerns. GP's responsable for all prescribed medications and any requests for further investigations, including referrals to other medical teams. They'll also be involved when we need to make decisions about what's in the best interests for our Residents' health. We try to avoid unnecessary hospital admissions as far as possible.
If our Residents prefer, and it's practicable, they can remain with their current GP.
Our Registered Nurses and Care Coordinators are the only ones responsible for providing them with any prescribed medication that they’re prescribed.
It’s important that they don’t take medicines from any other members of staff or their family, unless they’re supervised by our Registered Nurses or Care Coordinators.
If our Residents would like to be responsible for managing their own medication, we'd need to discuss this with the GP to make sure that it's safe for them to do so.
If our Residents are taking any home remedies, they must tell the Home Manager or their Named Nurse.
We can arrange any appointments that our Resident's need. We’ll do this through the NHS unless they or their family members/ representatives would like to arrange their own private treatment. If our Residents are treated privately, they will be responsible for the costs.
If our Residents need help getting to their appointment, we're happy to arrange for someone to accompany them. Please let us know in plenty of time. This is not included in their contract and so will cost £12.50 per hour.
We normally provide services such as physiotherapy or occupational therapy if an NHS health care professional makes a referral to our Residents. Any therapy arranged through the NHS is free of charge.
We can also support them to access private therapeutic treatment at their own cost.
Involving Your Family Members / Representatives in Decisions
We will always assume that our Residents are able to make choices on a daily basis and to make important decisions about their health care.
This is a requirement of the Mental Capacity Act 2005 which we are required to abide by in the way we provide care. This also means that:
- where they're not able to communicate their wishes in a conventional manner, we’ll take decisions based on their known and recorded preferences, and will obtain their consent through non-verbal communication;
- although we do take into account the suggestions or requests of family members/ representatives, our Residents' wishes and their healthcare will always come first;
- where important healthcare decisions have to be made, for example, taking medication or resuscitation, we are duty bound by the Mental Capacity Act 2005 to uphold the decisions made by our Residents', even if they’re considered unwise;
- although the views of family members/ representatives will be considered, the decision will always be based on the clinical prognosis, unless they have an advanced directive or living will.
- We will only ever decide that our Residents' unable to make these decisions by means of a formal assessment of mental capacity. This will involve a consultation with the relevant healthcare professionals and their Named Nurse and Named Carer.
- If our Residents' completed the ‘Lasting Power of Attorney process’ (see below), their Personal Welfare Attorney will be consulted as part of the assessment, but the assessing team will make a decision collectively in their best interests.
- If the assessment shows that they are unable to make decisions, we will make decisions in their best interests, in conjunction with their healthcare professionals, including an Independent Mental Capacity Advisor, should they have no family.
- If our Residents have a confirmed Personal Welfare Attorney (as part of the Lasting Power of Attorney process), we’ll consider this person to be their legal representative in any situation (see above) where we need to consult family members/ representatives about important health and care-related decisions.
- If they have a confirmed Property and Affairs Attorney (as part of the Lasting Power of Attorney process) we’ll consider this person to be their legal representative in any situation where we need to consult family members/ representatives about fees or other financial matters.
- If they have a family member/ representative who has registered Enduring Power of Attorney we will consult them in either situation.
We have tried to summarise the information relating to a very complex piece of legislation in this section, but we appreciate that there may have further questions. Please speak to the Home Manager if anything is unclear and/ or ask a copy of the guidance leaflet.
Staying in Touch
- The best times to call (apart from emergencies of course) are:
- 10.30am to 12.30pm
- 3.00pm to 5.30pm
- 6.30pm to 7.30pm
We have an open visiting policy, but the best time to visit is between 11:00am and 8:00pm. This is to help us maintain our residents’ comfort and privacy during times when we’re focusing on personal care.
If any of our Residents become seriously ill or are involved in an emergency then family members/ representatives can obviously visit outside these times.
We will always tell family members/ representatives about significant events or changes in our Residents' health, unless they ask us not to. While this is usually quite straightforward, things can become a bit complicated if more than one family member/ representative is involved.
That’s why it’s very helpful if our Residents can nominate a single point of contact. It helps to avoid any confusion (for example, if information given over the telephone is interpreted in different ways by different contacts) or making lots of calls about the same issue.
We realise that it might be difficult for a large family to nominate a single point of contact, but in our experience it’s extremely important. It helps us to ensure prompt and clear communication, and avoids confusion in difficult or complex situations.
If your nominated contact is likely to be unavailable for some time please let us have the details of a secondary point of contact.
Leisure, Socialising and Lifestyle
Our group activities usually take place in the afternoon, and are based on our residents’ collective interests and preferences. Residents' can of course choose if they’d like to participate or not.
These afternoons create a happy atmosphere for all of our residents and staff. They give you a chance to socialise, and take part in interesting and enjoyable activities. Family members/ representatives are welcome to join in too.
We also organise regular one-to-one activities, based on our Residents' hobbies, interests and abilities. They are usually risk assessed to ensure your safety.
Individual activities can often be spontaneous to suit our Residents, so their family members/ representatives may not always know when they've taken place. If they want to know, the Activities Coordinator or the Named Carer can update them.
We offer a range of group outings to places that are risk assessed and safe for our residents to visit.
We can also arrange individual outings, tailor-made to your specific interests and lifestyle and arranged at times to suit them. These can be much more fulfilling than group outings as they are specific to them. Family members/ representatives are welcome to join their loved ones.
For both types of outings, we will charge for transport, entrance fees, staff escorts, food and refreshments.
Most of our residents have supported and raised funds for their chosen charities all their lives. If they wish, we will continue to support them with this when they come to live with us.
If they want to continue to support their chosen charity, please let the Home Manager or Activities Coordinator know so we can help facilitate fundraising events.
Meals, Snacks and Nutrition
- Breakfast: We offer a range of choices for breakfast to give our Residents variety and ensure that they balance other meals during the day. For example, if the lunch dishes are rich, we’ll offer a lighter breakfast.
- During mid-morning and in the afternoon, tea, coffee or a preferred drink can be enjoyed with a selection of biscuits and fruit.
- Lunchtime: In the middle of the day, there’s a choice of two main courses and a vegetarian option. We’re also happy to prepare alternatives if none of the day’s choices are suitable for them.
- Supper: In the evening, we offer a choice of a hot meal, soup of the day, a selection of sandwiches, salads and a selection of desserts.
- Night-time: Drinks are available including hot chocolate, malt beverages or warm milk. Light snacks are also available if required.
- Some of our homes may serve the supper choices described above as a light lunch and the lunch choices for dinner in the evening.
- During meal times, all activities – apart from serving and assisting with food – are stopped so that our Residents can enjoy your meal in a relaxed environment without interruptions. We call this ‘protected meal times’.
- Family members/ representatives are welcome to join Residents for meal times on occasions, either to eat with them or to assist them. For this we ask for a nominal contribution to our Residents’ Fund, which is used to enhance the activities and entertainment we provide.
We serve hot and cold drinks throughout the day, and water is constantly replenished in bedrooms and lounges.
We’re happy for our Residents to bring in or order (at a cost) alcoholic drinks, as long as this is acceptable on medical grounds.
If our Residents' need a special diet for your health, or because they have a food intolerance or allergy, our chef is happy to make varied, nutritious meals that suit their specific needs.
Although we generally don’t encourage residents to have food that’s been prepared outside of our home, we accept that some residents may wish to continue enjoying special food prepared for them by family or friends. Food prepared outside of our home is acceptable if:
- it’s low-risk food such as cakes, biscuits, chocolates and fruits;
- any cooked meals must be chilled in a clear transport container, labelled with their name, date it was put into the fridge and the use by date.
We gather all this information during their first week here, but our chef is always pleased to talk to them about the choices available.
Looking After our Residents’ Safety and Personal Property
We use CCTV at some of our homes to ensure the security of the property and premises and to prevent or investigate crime. It may also be used to monitor our staff while at work, and the information collected will include visual images of individuals, their appearance and their behaviours.
This information may be about staff, residents and relatives, offenders and suspected offenders, members of the public, and those inside, entering or in the immediate vicinity of the area under surveillance.
When necessary, this information is shared with the individuals themselves, employees and agents, service providers, police forces, security organisations and the person(s) making an enquiry.
To keep our Residents' possessions safe and make sure that laundry and other items are returned to their room, we keep an up-to-date inventory of their personal belongings and clothes.
When our Residents move here we’ll ask them or their family members/ representatives to compile a list of your clothing and belongings. This inventory will be kept in their file, and they (or their family members/ representatives) can ask to see a copy at any time.
If a Resident or their family members/ representatives bring any new items into the home, please tell the Nurse in Charge before they put them in the Resident's room, and they will make sure your inventory is updated. This is essential as we can’t take responsibility for items we don’t know about.
When a Resident first arrive at the home, we may need them to bring their own continents aids (if they use them) such as incontinence pads, until their needs have been assessed by the community continents team.
We’re very happy for our Residents to bring items of furniture, ornaments, pictures etc for their rooms. To ensure our Residents' safety, we’ll check and approve these for their condition, suitability and safety.
We can only accept furniture which is flame retardant and covered in waterproof upholstery. This is in line with fire, health and safety and infection control regulations.
If there are any valuable items to be stored securely, please bring them into the home during office hours (Monday to Friday - 9.00am to 5.00pm) when we’ll be able to lock them in our safe.
Because most things are covered by Resident fees, there’s no need for our Residents to keep a lot of money to hand, although it might be useful to have a small amount to pay for things like cigarettes and toiletries. Our Residents' money can be kept in our locked and secure safe, and topped up when necessary.
We’ll keep a detailed log of their money, when it’s spent, and what for, in their personal account which is kept in our office. Resident (or their family members/ representatives) can ask to see this account at any time.
Unfortunately, we can’t be responsible for any money that’s lost, as our insurance policy doesn’t cover this. For this reason we advise our residents to only have a small amount of money on their person or in their room.
Our Smoking Policy
How to Complain
We receive all complaints positively, as they help us to improve our service to our Residents, and the other residents, and to monitor and improve our standards.
We will investigate all complaints with equal care, whether they are formal or informal, and we’ll make every effort to resolve them quickly and positively.
We realise that our Residents may not always be able to express their dissatisfaction in writing or verbally. Named Nurses and Named Carers are responsible for looking after their Residents' overall wellbeing and making sure they are content, and can help them to express any dissatisfaction they may feel. We hope that family members/ representatives and friends will also bring anything to our attention that they or their love one are not happy about.
Please see below for procedures and definitions. For more information, please see our website or speak with the Home Manager.
Situations that trouble residents or their families which have been communicated verbally to the Nurse or Care Coordinator are regarded as informal complaints. It is expected that such instances would be resolved swiftly where they happen by the staff member receiving the complaint.
If it isn’t possible to resolve the complaint in this way, the Home Manager will be informed so that they can resolve the issue.
All informal complaints are recorded in the Informal Complaints Log and followed up until they are resolved.
- dissatisfaction with the way in which an informal complaint has been dealt with;
- a situation, although resolved at source, keeps re-occurring;
- its seriousness or complexity – where abuse or neglect may be implied, we would raise a safeguarding alert.
Such complaints are usually received verbally or in writing and are regarded as formal complaints.
There are three stages to our formal complaint procedure:
The First Stage is internal, and addressed by the Home Manager. A written acknowledgement will be sent within five working days of the day we receive the complaint. The complaint will be investigated, and we will try to resolve it within 28 days. Should there be a delay, we will contact the person who has complained with an explanation for the delay.
The Second Stage is also internal, and is usually addressed by the Senior Management Team. If one is unsatisfied with the outcome of the First Stage, they can raise a further complaint, verbally or in writing to:
Shyam Desai, Operations Officer
Cedar Care Homes, Head Office, Mortimer House, Clifton Down Road, Clifton, Bristol, BS8 4AE
Tel: 0117 946 7216 Email: firstname.lastname@example.org
The Third Stage gives one option to raise their complaint with external agencies. While we can assure that we will do our utmost to resolve the complaint all involved are satisfied, we accept that one may wish to raise it externally without following our internal process. This can be done in the following ways:
1. If the Resident's care is funded or arranged by a council, a complaint can be made to the council.
2. If the care is paid for the Resident themselves, they can contact the following:
- Local Government and Social Care Ombudsman
- Care Quality Commission
LGO Advice Team
Tel: 0300 061 0614
CQC National Customer Service Centre,
City Gate, Gallowgate, Newcastle upon Tyne, NE1 4PA
Tel: 0300 061 6161
Email: enquiries @cqc.org.uk
Information Regarding Abuse
To achieve optimum wellbeing, it’s essential that our residents and their families know that they are safe and free from mistreatment or manipulation. This is especially true when they become vulnerable due to physical or psychological limitations.
We have a zero-tolerance policy towards abuse, regardless of the perpetrator. Our staff are fully aware of the different forms of abuse, and know how to recognise and report any instances.
We also want people in our care, or those close to them, to feel able to recognise and report such instances if they suspect or witness them. If an incident needs to be reported:
- in the first instance, please speak to the Home Manager or in their absence, to the Nurse in charge of the shift. Following initial enquires, the Home Manager will start the local protocols to deal with the complaint;
- if one feels it is more appropriate to report the matter externally, they can contact Head Office (details are provided in the Complaints Procedure and the Reporting of Abuse Procedure) or dedicated professionals in the local authority.
Our Residents (or their family/ representative) will have received our policies for dealing with allegations of abuse and the local protocols published by their local authority as part of the admission pack. These contain comprehensive guidance about the different forms of abuse, reporting protocols and what to expect if a complaint is made. Further information by following the web links detailed on the information leaflets. Alternatively, please do not hesitate to speak to the Home Manager if you have any queries.
End of Life and Funeral Arrangements
We know there’s never a good time to talk about end of life care and funeral arrangements. That’s why we ask for this information when our Residents first come to stay with us, to make sure we can honour their wishes in the future. This will include: who can make decisions on their behalf if they’re not able to; the funeral directors and arrangements they’d like to use; their wishes relating to resuscitation; and their religious and last-rite preferences. Giving us this information when they arrive means it’s easier to make difficult choices or decisions during sad and sensitive circumstances. It also helps us to support the family members/ representatives at these times.
When a Residents' family members/ representatives have confirmed the location, date and time of your funeral, we’ll let our staff know so that they can attend if they wish.
Unfortunately, we’re not able to release staff to attend funerals if they’re on duty, but they can attend in their own time.
We like to send a floral tribute and card, but please let us know if this isn’t acceptable for any reason.