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Inspection Summary


Overall summary & rating

Good

Updated 18 August 2018

Cranford Residential home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Cranford Residential Home can accommodate up to 26 people in a detached property situated in the seaside town of Exmouth. The home consists of two floors with a passenger lift providing level access to each floor. There is a main communal lounge, dining area and seating in the large entrance where people could spend their time as they chose. The home has a large landscaped garden which people could use if they chose.

This comprehensive inspection took place on 11, 17 and 19th July 2018. The first and second day of the inspection was unannounced. This meant that the provider and staff did not know we were coming. At the time of this inspection there were 24 people using the service. Three of these people were staying at the service for a period of respite (planned or emergency temporary care provided to people who require short term support).

We had previously carried out a comprehensive inspection in May 2017. At that inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches related to there not being effective and consistent systems to check some of the safety equipment at the home. The recording of how some risks to people's health were managed was inconsistent. Improvements were needed in how activities were provided, recruitment procedures and how staff were supported. Following the inspection we were sent an action plan which set out the actions the provider was going to take. At this inspection we found the provider had made the improvements and were no longer in breach of these regulations.

There was a new registered manager who registered with CQC in May 2018 (at the last inspection they were working as the acting manager). A registered manager is a person who has registered with CQC 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. Everyone praised the registered manager and the improvements they had made at the home. People said they were happy to approach the registered manager, staff and the provider if they had a concern, and were confident that actions would be taken if required.

The registered manager had put in place a comprehensive quality monitoring system at the service. There were regular audits and checks of the premises and equipment to keep people safe.

Safe recruitment procedures were in place and appropriate pre-employment checks were undertaken. The provider used a new computerised care system where staff completed risk assessments which could be audited by the management team to ensure appropriate action had been taken. Staff were also able to record the support and monitoring checks undertaken on this system.

Staff were well supported. They received regular supervision sessions which gave them the opportunity to discuss their concerns and future development. Staff said they felt involved with the development of the service with regular staff meetings.

A staff member was responsible for co-ordinating activities and there was a varied timetable of events. They were new to their role and with the registered manager’s support had plans to develop activities further. The registered manager had ensured people and their families had been kept informed about changes at the service and asked for their views regarding future developments.

People and their relatives were happy with the way care was delivered and happy with the staff approach. Staff interacted positively with people and had a good knowledge of their care needs. People were cared for without discr

Inspection areas

Safe

Good

Updated 18 August 2018

The service was safe.

Safe recruitment procedures were in place.

The premises and equipment were managed to keep people safe.

People were protected from risk. Staff had completed individual risk assessments for people to assess how to reduce risks as much as possible.

Staff were able to demonstrate a good understanding of what constituted abuse and how to report if concerns were raised.

Medicines were safely managed.

There were sufficient staff levels to meet people's needs.

Infection control processes were in place.

Effective

Good

Updated 18 August 2018

The service was effective.

Staff felt supported and had regular supervisions.

Staff had received an induction when they came to the service. Staff received appropriate training to meet people’s needs and were undertaking higher qualifications to further develop their skills.

Staff understood their responsibilities in relation to the Mental Capacity Act (MCA) (2005) and Deprivation of Liberty Safeguards (DoLS). Appropriate applications had been made to the DoLS team and best interest decisions were being made where people lacked capacity.

People were supported to maintain their health and wellbeing and their nutritional needs were met.

Caring

Good

Updated 18 August 2018

The service was caring.

People were happy with the care they received. Relatives were welcome to visit at any time and were involved in planning their family member's care.

Staff relationships with people were strong, caring and supportive. Staff spoke confidently about people’s specific needs and how they liked to be supported.

Staff treated people with dignity and promoted independence wherever possible.

Responsive

Good

Updated 18 August 2018

The service was responsive.

Care plans on the computerised care system contained information to help staff support people in a person-centred way.

Staff were committed to ensuring people experienced end of life care in an individualised and dignified way.

People’s social needs were met and they were encouraged to follow their interests.

There were regular opportunities for people, and those that mattered to them, to raise issues, concerns and compliments.

Well-led

Good

Updated 18 August 2018

The service was well led.

Staff spoke positively about the registered manager and how they were developing the service.

The registered manager had put in place a comprehensive quality assurance system. There were audits and surveys in place to assess the quality and safety of the service people received.

People’s views and suggestions were taken into account to improve the service. Feedback was sought from people using the service and their relatives and any issues identified were acted upon.

Staff meetings took place every two months and staff felt able to discuss any issues with the registered manager.