Cranwell Court

Cranwell Court is a care home providing personal care to five older and younger adults who may be living with learning disabilities and autism. The service can support up to seven people. People had their own bedrooms and shared facilities such as the kitchen, the garden and lounge areas.

People’s experience of using this service and what we found

People and relatives were positive about the support they received at the service. A relative told us, ‘‘Cranwell Court is exactly the right service for [family member]. The registered manager and the staff team do a fantastic job.’’

People were supported by staff who had good knowledge of safeguarding and how to keep people safe from abuse. Risks to people had been assessed and action were taken to mitigate risks as far as practicable. People received support with their anxieties and behaviours that may challenge others and staff were trained to support people in this area. There were enough suitably trained staff to support people and recruitment checks were completed in line with legislation. Staff supported people safely with their medicines. The service was clean, and staff followed good infection control procedures. Incidents and accidents were reviewed, and actions were taken if there was any area for improvement.

The registered manager promoted a positive culture at the service and staff were supported to empower people to achieve their goals. The registered manager and senior staff completed audits to monitor the quality of the service and acted if improvements were needed. Feedback was collected from people, relatives and the staff team and used to inform what happened at the service. The registered manager and staff team worked well with health professionals and external stakeholders to ensure that people received the correct support.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were kept at the centre of their support and all the decisions made about their care. Staff and managers had a passion for promoting people’s independence. There was a focus on supporting people to live their lives free from restrictions and restrictive practices. People were supported to celebrate their achievements and achieve good outcomes.

Rating at last inspection

The last rating for this service was good (published 24 May 2019).

Why we inspected

We received concerns in relation to risk management and the way in which staff supported people when they needed support with behaviours that may challenge others. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cranwell Court on our website at www.cqc.org.uk.

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.

We found the following examples of good practice.

¿ Staff were provided with designated areas for their arrival at and departure from the service, where Personal Protective Equipment (PPE) was available and hand sanitiser provided. Staff were seen to be maintaining social distance and adhering to the PPE guidance and protective measures in place.

¿ The service had been providing 'garden visits' with robust infection control procedures in place. Visits were limited and were by appointment only, with times allocated to avoid potential infection transmission with other visitors.

¿ Procedures and guidance had been developed by the registered manager which had been successfully implemented at the service. All COVID-19 related risks were assessed and staff in high risk groups, including those returning to work following shielding, had individual risk assessments in place.

¿ People’s wellbeing had been prioritised. Staff had put in place strategies for managing people’s anxieties in relation to COVID-19.

Further information is in the detailed findings below.

Cranwell Court is a ‘care home’. It provides care and support for up to seven people living with learning disabilities or autistic spectrum conditions. The service comprises of a six-bedded house and a self-contained annexe flat. At the time of the inspection, four people were being supported by the service.

People’s experience of using this service:

People’s support focused on them having as many opportunities as possible to gain new skills and become more independent. This supported the principles of ‘Registering the Right Support’ and other best practice guidance. These ensured that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Feedback from everyone was positive about how the registered manager and staff supported people in a kind and person-centred way. People said their needs had been met because of this. There was evidence the service had been effective in achieving good care outcomes for people. This was because the support provided enabled people to live happy and active lives.

People were protected from harm by staff who were confident in recognising and reporting concerns. Potential risks to people’s health and wellbeing were assessed and minimised. There were enough staff to ensure people’s needs were met safely. Where required, people were supported well to manage their medicines. Staff followed effective processes to prevent the spread of infection.

Staff had the right skills to meet people's needs effectively. Staff were well supported and had information to meet people’s assessed needs. Staff supported people to have enough to eat and drink, and to access healthcare services when required. This helped people to maintain their health and well-being.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were fully involved in making decisions about their care and support. People were involved in planning and reviewing care plans. People told us staff respected and promoted their privacy, and dignity.

Information in people's care plans supported staff to deliver person-centred care that met people’s needs. The service worked in partnership with other professionals to ensure people received care that met their needs. There was a system to ensure people’s suggestions and complaints were recorded, investigated, and acted upon to reduce the risk of recurrence. The service did not currently provide end of life care.

Audits and quality monitoring checks were carried out regularly to continually improve the service. The provider had systems to enable people to provide feedback about their experiences of the service. People's experiences of the service were positive. Staff felt fully involved in ensuring the service met its regulatory requirements.

Rating at last inspection:

At the last inspection, the service was rated Good (report was published in May 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor all information we receive about the service and schedule the next inspection accordingly. For more details, please see the full report which is on the CQC website at www.cqc.or.uk.

This inspection took place on 30 & 31 March & 08 April 2016 and was unannounced.

The inspection was carried out by one inspector.

Cranwell Court provides care and support for up to ten adults with mental health needs and learning disabilities. Accommodation is provided in a six bedded house and a four bedded annexe. Occasionally, they also support people whose treatment is in accordance with the requirements of the Community Treatment Order (CTO) of the Mental Health Act 1983. It is part of Brookdale Healthcare Limited. On the day of our inspection 8 people were using the service.

There was a registered manger in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs.

Effective recruitment processes were in place and followed by the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and ongoing training. They were well supported by the registered manager and the unit manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff gained consent before supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professional when required, including dentist, opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well.

People and relatives where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests.

A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Is the service safe?

People told us they felt safe. We saw that the provider ensured people were cared for in an environment that was safe and well maintained. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The food was stored and prepared in a way that protected people against the risks associated with food poisoning.

Is the service effective?

Detailed care plans were in place, and people told us their needs were being met. Staff received training to support people with various care needs. They also sought additional support from other health and social care professionals, to ensure positive care outcomes for people using the service. The service provided people with adequate and nutritious food and drink that ensured they maintained good health.

Is the service caring?

People were supported by kind and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people they supported. People told us the staff were caring. One person said, "The staff are always helpful."

Is the service responsive to people's needs?

We observed that staff responded promptly to people's needs. We saw that care plans had been updated when people's needs changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and people were supported to access a variety of activities of their choice. They had a complaints procedure that enabled them to respond appropriately to any complaints people may raise.

Is the service well-led?

The service had a registered manager in post. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service, and took account of these to improve the service.

We observed positive engagement between staff and people who used the service, and noted that people's consent was sought before care and support was delivered. People were encouraged and supported to make their own decisions, and where people lacked the capacity to make decisions for themselves, appropriate processes had been followed to ensure best interest decisions were made on their behalf. We could see how diagrams and pictures had been used to support this process for some individuals.

People had care plans and risk assessments in place so that care could be delivered safely and with continuity, and robust medication systems ensured that people received their prescribed medication on time and in a way that suited their needs.

People we spoke with told us they were happy with the staff that supported them, and we found the recruitment systems were sufficient to ensure the staff employed were suitable to work in this environment.

Staff were friendly and polite in their approach to people and interacted confidently with them, respecting the individual's dignity whilst ensuring their needs were met.