Craven Nursing Home Limited

We found the following examples of good practice.

The systems in place allowed people to be admitted to the home safely. Each unit was separated to prevent cross infection. There was no movement of residents between units and staff movement was kept to a minimum.

There was clear signage on the correct use of PPE and handwashing techniques and staff had received appropriate infection control and prevention training.

A detailed risk assessment was in place for ensuring safe visits, this included a booking system, to allow for social distancing, visitor agreement form, health screening and use of PPE.

Local restrictions on visiting were in place at the time of the inspection and alternative measures such as video calls were being used. The home had also purchased a purpose built outside visiting pod to allow safe visits when national restrictions allowed.

The home sent regular updates to family members to update them on current visiting restrictions in the home with assurances about how they were managing.

The environment was very clean. Additional cleaning was taking place including of frequently touched surfaces.

Further information is in the detailed findings below.

Craven Nursing Home Limited is registered to provide personal and nursing care for up to 68 people, some of who were living with dementia. At the time of the inspection there were 52 people living at the service.

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

People were complimentary about the care they received. People told us they felt safe living at the service, and that staff were kind and caring. Relatives felt their loved ones were well looked after and safe living at the home.

Staff were aware of the processes for reporting concerns and the manager had fully investigated all of these. People received their medicines safely and on time. There were relevant risk assessments in place for people and the environment.

The home was clean and appropriately adapted to support people with a range of needs. Corridors and communal areas were wide to allow for wheelchair access, and the home was decorated nicely.

There were enough staff on duty to support people safely in line with their assessed needs. Staff were recruited safely.

Staff had completed all relevant training and, new staff received a comprehensive induction. Staff were supported through regular supervisions.

People were provided with a good choice of food and drinks. Staff were knowledgeable about people’s dietary requirements, likes and dislikes.

Care plans were written clearly to include key information about the support people required, these were evaluated regularly. People continued to receive support to maintain good health which included regular visits from health professionals.

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.

Staff provided end of life care to people, and there were various compliment cards received from relatives thanking staff for their support. We spoke with a professional who told us “End of life care is delivered well; the service holds a reputation for delivering good care”.

People were able to discuss any concerns or ideas they may have. The manager was accessible and continued to operate an open-door approach. Effective quality assurance systems were in place.

The registered manager positively led the service, there were ongoing improvements planned to enhance the services being delivered.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

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

This comprehensive inspection took place over two days. 24 February 2017 was unannounced and 9 March 2017 was announced. At the last inspection in December 2014 the service was rated as Good.

There was a registered manager in place. 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 told us they felt safe at the service. Staff were confident about how to protect people from harm and what they would do if they had any safeguarding concerns. There were appropriate systems in place to make sure that people were supported to take medicines safely and as prescribed. Risks to people had been assessed and plans put in place to keep risks to a minimum.

There were a sufficient number of staff on duty to make sure people’s needs were met. Recruitment procedures made sure that staff had the required skills and were of suitable character and background.

Staff were supported by a comprehensive training programme and supervisions to help them carry out their roles effectively. Staff were led by an open and accessible management team.

The manager and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). 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 provided with sufficient amounts of food and drink. Where people required support with eating or drinking, this was appropriately provided, taking into account people’s likes and dislikes.

People told us that staff were caring and that their privacy and dignity were respected. Care plans showed that individual preferences were taken into account, although the information about this in care plans sometimes lacked detail. Care plans gave directions to staff about the support people required to have their needs met. People were supported to maintain their health and had access to health services if needed.

People received good care at the end of their lives. Staff were well trained in this area and sensitive to the needs of people, their friends and relatives.

People’s needs were regularly reviewed and appropriate changes were made to the support people received. People had opportunities to make comments about the service and how it could be improved.

The registered manager had good oversight of the service and there was a clear ethos of care. The registered manager had made improvements at the service since they started in post. There were systems in place to look at the quality of the service provided and action was taken where shortfalls were identified.

People who used the service told us they were happy with the care and support they received. People told us care was 'Excellent', 'Extremely good' and 'Just what you need'.

There was enough equipment to promote the independence and comfort of people who used the service. People were protected from unsafe or unsuitable equipment.

There were effective recruitment and selection processes in place. People were supported by suitably qualified, skilled and experienced staff. Staff were referred to in positive ways; they were described as 'Kind' and 'Thoughtful.' People told us they felt well looked after. One person told us, "They go out of their way to make sure I am comfortable." Without exception, people gave us the impression that their experiences at The Craven were positive and that they received a good standard of care.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

Subsequent to our inspection in October 2012, we had also received information of concern on 28 January 2013. We were told that people were not being provided with adequate food provision and that there was little choice at mealtimes. We were also told that the weekend staffing levels fell below the required numbers, resulting in people not receiving proper care and attention.

We therefore also reviewed the food provision and staffing levels at this visit. We found that the food provision was good. We also found that staffing levels were consistent over a 24 hour, seven day cycle. The staffing levels were found to be adequate and that peoples needs were being met.

People using the service talked with us about the food and the staffing levels. One person told us, 'The meals are very good.' Another person said, 'The quality of the food is variable, but overall it is alright.' Everyone we spoke with told us the staffing levels were good and that they did not have to wait for attention.