We carried out a review of the data available to us about Cranlea on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cranlea, you can give feedback on this service.
We found the following examples of good practice:
• The home had sufficient supplies of appropriate PPE which was stored hygienically and kept safe. Staff were provided with separate areas to put on, take off and dispose of PPE safely.
• There was no cross working of staff between care homes. Staff were careful to maintain social distancing and wore appropriate PPE in line with current government guidance.
• Staff demonstrated a good knowledge of how to safely support people that had tested positive or were showing symptoms of COVID-19.
• The senior staff explained the quality systems they had in place to check the service was providing safe care.
• All staff, including catering and housekeeping staff had undertaken training in infection prevention and control. This included putting on and taking off PPE, hand hygiene and other Covid-19 related training.
Further information is in the detailed findings below.
Cranlea is a residential care home providing personal and nursing care to 37 people aged 65 and over at the time of the inspection. The service can support up to 39 people in one large adapted building.
People’s experience of using this service and what we found
People and relatives we spoke with were very happy with the support they received from staff. Staff were kind and caring with people and treated them with dignity and respect. People praised staff for their caring attitude towards them, comments included, “Staff here are top notch” and “They (the staff) are second to none really, smashing all of them.”
People were engaged socially and with activities throughout the day. Staff ensured people’s needs were met and carried out regular reviews. People had their needs fully assessed. Care plans were detailed and helped staff to deliver person-centred care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The premises were nicely decorated and were safe for people living at the home. Medicines were managed safely and administered inline with national best practice. Risks people may face had been fully assessed, mitigated and steps were in place for staff to follow to keep people safe.
The registered manager had worked to improve the service and regularly asked for feedback from staff, people, relatives and visitors to find new ways to develop the service. There was a robust quality assurance system in place to monitor and improve the care provided.
Staff were provided with on-going training to make sure they had the knowledge and skills to deliver a high standard of care. New staff were safely recruited and provided with an induction. The registered manager and deputy managed carried out regular supervisions with staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 01 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Cranlea provides personal care for up to 39 older people and people living with dementia.
At the last inspection, the service was rated good overall. At this inspection we found the service remained good.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Systems were in place to protect people from avoidable harm or risk. Staff received safeguarding training and were knowledgeable about their role in keeping people safe. Risks to people, staff and visitors were assessed and regularly reviewed. The service took action to minimise risks where appropriate in order to keep people safe from avoidable harm.
Robust recruitment processes were in place to ensure staff members were suitable to work with vulnerable people. Staffing levels were based on the dependency levels of people living at the home and were reviewed on a regular basis. Our observations and feedback during the inspection were that staffing levels continued to be appropriate to safely meet people’s needs throughout the day and night. Recent changes to staffing to reduce falls had improved this issue.
Appropriate systems were in place for the management of people’s medicines. People were encouraged to maintain their independence, for example through retaining responsibility for managing their own medicines if possible. Medicines were stored and managed correctly by staff who were trained and monitored to manage this safely.
Staff were supported through the provision of training, formal supervision and annual appraisals. Staff confirmed they felt well supported in their roles and spoke positively about the registered manager and their leadership and management of the home.
The service worked within the principles of the Mental Capacity Act 2005. People’s capacity to make decisions about their care and treatment was assessed and where appropriate, “best interest” decisions were made on their behalf. These involved relevant healthcare professionals as well as people’s friends and family members as appropriate.
People were very complimentary about the kind and caring nature of the staff team. Staff had developed strong, caring relationships with the people they supported and were very knowledgeable about their individual needs, likes and dislikes.
People’s needs were assessed prior to them joining the service. Detailed, person-centred care plans were produced which guided staff on how to care for people. These included details of any preferences people may have. People and their representatives were actively involved in their care planning and were also encouraged to voice their opinions about the service in general.
The services activities co-coordinator was noted for their pro-active approach. They had developed a diverse range of alternative activities such as art, music and dementia friendly activity, for groups and for individuals. We noted they were passionate and original in their work.
People’s needs were reviewed on an on-going basis and action taken to obtain the input of external professionals where appropriate. Systems were in place to ensure people had sufficient to eat and drink and to access other healthcare professionals in order to maintain their health and wellbeing.
A range of systems were in place to monitor and review the quality and effectiveness of the service. Action was taken to address what areas for improvement were identified. Complaints were taken seriously and records maintained of the action taken by the service in response to any form of dissatisfaction or concern. The registered manager was seen by people, relatives and staff as an excellent leader and key to the services quality of care.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2012, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
This was an unannounced inspection carried out on 22 and 23 July 2014. Prior to this we last visited the service in August 2013, where we found the service was meeting all regulations inspected.
Cranlea provides personal care for up to 39 older people and people living with dementia. At the time of our inspection there were 35 people living at the home.
A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
People told us they felt safe living at Cranlea. The staff members we spoke to were knowledgeable about the safeguarding procedures and could talk us through examples of abuse and what to look out for and how they would report it.
The registered manager and senior staff were knowledgeable about the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager had completed an assessment tool to assess who would require a DoLS application in accordance with the new guidelines and was working with the local authority to process these.
We looked at the recruitment files for three staff and noted all appropriate checks were completed prior to staff starting work. Staff told us they received sufficient training for their role. We saw regular staff supervisions and team meetings were in place. The registered provider was in the process of rolling out a new appraisal system.
We spent time observing the dining experience and saw, where required, people were assisted during meal times by staff. We saw people were offered choices and those that did not want the prepared meals were able to specify what they wanted. People we spoke to told us the food was always nice.
Everyone we spoke to told us they had experienced positive care and support they received at Cranlea. We observed positive interactions between staff and people and that there was a very communal feel and a lot of activities were organised if people wanted to get involved.
We noted the service employed an engagement co-ordinator and a wide variety of activities were available to people on a daily basis, both in and out of the home. We saw that the home participated in a number of external pilots and projects, one of which looked at how engagement opportunities could help people with dementia.
People told us they were aware of how to raise a complaint. Staff told us they recorded all areas of concern identified no matter how small. We saw that all complaints were recorded in the complaints log. Details of the action taken and outcome were also included with a copy of investigation notes and written response where applicable.
All staff we spoke to told us the registered manager was approachable and they felt the home had a clear staffing structure. All staff members spoke very highly of the management team and told us they felt well supported in their role.
We saw there were extensive audits and observations conducted on a regular basis by all levels of management to check the quality of the service that was provided. The registered manager told us an action plan was produced for any areas of development and we saw that this had a priority key, so it was clear to see what needed to be actioned first. The team leaders and care manager told us how they appreciated being involved in the audit process.
People were protected from the risk of infection because appropriate guidance had been followed. The registered manager had taken steps to ensure the home complied with the latest guidance on how to prevent the spread of infections.
People were cared for, or supported by, suitably qualified, skilled and experienced staff. People who used the service were protected from harm because the provider had carried out checks to make sure staff were suitable to work with vulnerable adults.
People experienced care, treatemnt and support that met their needs and protected their rights.
People were not fuly protected from the risk and spread of infection. There was a lack of clarity regarding whether the home was fully compliant with the Department of Health's publication: Code of Practice for health and adult social care on the prevention and control of infections. This increased the risk that the systems in place might not be sufficient to prevent, detect and control the spread of infections.
People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.
People were cared for, or supported by, suitably qualified, skilled and experienced staff. However, the failure to obtain full employment histories for some staff meant that people were being cared for by some individuals who had not undergone comprehensive recruitment checks to confirm their suitability.
Comments and complaints people made were responded to appropriately.
We spoke with one person about their medicines and the care they received. This person said 'Staff are fantastic. If I need painkillers I can get them quickly. They always change the patch, to help with my angina,at the right time each day.'
People's care needs had been fully assessed and identified needs met with detailed care plans. People were involved in this process and were able to influence how their care was given. People's safety and welfare were included in their care plans, and these were regularly updated. People's comments included, "I'm quite satisfied with my care. The carers are very friendly, and I'm happy here", and, "It's a relaxed place. Staff are never impatient".
The provider had taken all reasonable steps to prevent people living in the home being abused. Staff had been given the necessary training and where abuse was suspected had responded appropriately. People felt safe living in the home. One relative told us they had never seen anything untoward in the home.
Staff had been given all necessary training to meet the needs of those people living in the home, and their own professional development. They were given regular supervision and appraisal of their work.
People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. Quality systems were in place to identify where improvements were needed.