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Inspection carried out on 2 August 2017

During a routine inspection

Craigneil is situated on Marine Road in Morecambe and facing the promenade. The home is a two-storey building and is registered to provide accommodation for a maximum of fifteen people. Accommodation is provided in 13 single and 1 double bedrooms.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

People who lived at the home told us they were happy with their care and liked the staff who looked after them. We observed care practices throughout our inspection visit and saw staff were kind and patient with the people in their care. One person who lived at the home said, “They have been very good to me, I like it here.”

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs.

The service had sufficient staffing levels in place to provide support people required. We saw staff had time to sit and talk with people in their care and organise activities to keep them entertained and occupied.

Medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had been consulted about their care and had agreed with the support to be provided.

Staff knew people they supported and provided a personalised service in a caring and professional manner. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

We saw people had access to healthcare professionals and their healthcare needs had been met. The service had responded promptly when people had experienced health problems.

People told us staff were caring towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.

People’s care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered.

The service had information with regards to support from an external advocate should this be required by them.

People told us staff treated them with respect and dignity at all times.

The service had a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits and relative surveys to seek their views about the service provided.

Inspection carried out on 1 April 2016

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 10 June 2015. After that inspection, we received concerns in relation to staffing levels, people’s safety and the management of the service. An additional concern raised was people did not have the opportunity to participate in organised activities. As a result, we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those/this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (Craigneil Residential Home) on our website at www.cqc.org.uk

We carried out an unannounced focused inspection of the service on 01 April 2016.

Craigneil is a two-storey building situated on Marine Road in Morecambe and faces the promenade. The home is registered to provide accommodation for a maximum of fifteen people who require nursing or personal care. At the time of the visit, 14 people lived at the home.

The service had 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.

During this inspection, staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

The provider had recruitment and selection procedures in place to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who used the service.

Staff responsible for assisting people with their medicines were trained to ensure they were competent and had the skills required. Medicines were safely kept and appropriate arrangements for storing medicines were in place.

Comments we received demonstrated people were satisfied with the care they received. The registered manager and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people in their care.

People had the opportunity to participate in a range of activities.

A complaints procedure was available and people we spoke with said they knew how to complain. Staff spoken with felt the registered manager was accessible, supportive and approachable and would listen and act on concerns raised.

The registered manager was unavailable on the day of our inspection. We spoke with the registered manager after the inspection visit.

Inspection carried out on 10 June 2015

During a routine inspection

This inspection visit took place on 10 June 2015 and was unannounced.

When we last inspected the service we found breaches of legal requirements. This was because staffing levels were not sufficient to meet the assessed needs of people. We also found people were not supported and monitored by staff to eat and drink safely at meal times. Effective systems were not in place to monitor the quality of service provided.

The registered manager responded by sending the Care Quality Commission (CQC) an action plan detailing how they had addressed the breaches identified. We found during this inspection visit the improvements the registered manager told us they had made had been maintained and legal requirements had been met.

Craigneil is situated on Marine Road in Morecambe and facing the promenade. The home is a two-storey building and is registered to provide accommodation for a maximum of 15 people. At the time of our inspection visit there were 11 people who lived there. The majority of bedrooms were for single occupancy although there was one double bedroom for people who had made a positive choice to share. Bedrooms were located on the ground and first floor. There was sufficient communal space with two adjoining lounges and a dining room.

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.

During our inspection visit we looked at how the home was staffed. We found sufficient staffing levels were in place to provide the support people required. We saw staff members were responsive when people required assistance. Call bells were answered quickly and people requesting help were responded to in a timely manner. One person visiting the home said, “My [relative] is completely safe in the hands of these wonderful staff. They are very attentive and always available when needed.”

People were happy with the variety and choice of meals available to them. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met.

Care plans we looked at confirmed the registered manager had completed an assessment of people’s support needs before they moved into the home. We saw people or a family member had been involved in the assessment and had consented to the support being provided. People we spoke with said they were happy with their care and they liked living at the home.

The environment was well maintained, clean and hygienic when we visited. No offensive odours were observed by the Inspector. The people we spoke with said they were happy with the standard of hygiene in place. One person we spoke with said, “This is a lovely place to live and I am very comfortable.”

We found medication procedures in place were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept and appropriate arrangements for storing were in place. People told us they received their medicines at the times they needed them.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices. People we spoke with told us they felt safe and their rights and dignity were respected.

People told us they were happy with the activities arranged to keep them entertained. One person said, “They are always doing something with us there is never a dull moment.”

The service had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Discussion with the registered manager confirmed she understood when an application should be made and in how to submit one. This meant that people would be safeguarded as required.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included questionnaires which were issued to people to encourage feedback about the service they had received. The people we spoke with during our inspection visit told us they were satisfied with the service they were receiving.

Inspection carried out on 23 October 2014

During a routine inspection

We inspected The Craigneil on the 23rd October 2014. This was an unannounced inspection which meant the staff and the provider did not know we would be inspecting the home.

Craigneil can accommodate up to 15 people, who require nursing or personal care and who are elderly. At the time of our visit there were 14 people living in the home.

Craigneil is situated on Marine Road in Morecambe and facing the promenade. The home is a two storey building and is registered to provide accommodation for a maximum of fifteen people. Accommodation is provided in 13 single and 1 double bedrooms. There is a separate lounge used as a quiet room and a communal lounge/ dining area on the ground floor.

The home had a registered manager in place. A registered manager is a person who has registered with the Care Quality commission to manage the service. They share the legal responsibility for meeting the requirements of the law; as does the provider.

The last inspection was in July 2013 when we found all the outcomes we inspected to be compliant with the regulations.

We spent time in the communal areas of the home, including the lounges and dining areas. This helped us to observe the daily routines and gain an insight into how people`s care and support was managed.

We found the registered manager had breached Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The staffing levels in the home were not sufficient to meet the assessed needs of people. We saw the staffing levels during our inspection were inadequate. There were two care staff on duty. Staff took their breaks together. This meant the staffing levels were not always sufficient to monitor and support people adequately. You can see what action we told the provider to take at the back of the full report.

Although we found there were suitable arrangements in place to protect people from the risk of harm and abuse, we read of a recent incident that should have been reported to the local safeguarding authority. This meant people were not always being protected against the risks of harm or abuse. We asked the registered manager to report the incident to the local safeguarding authority. You can see what action we told the provider to take at the back of the full report.

The registered manager was not up to date with the policies and guidance in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLs). The MCA and DoLs provide legal safeguards for people who may be unable to make decisions about their care. We spoke with the registered manager to check their understanding of this legal process. The registered manager told us that a recent planned Mental Capacity Act training course she had booked had been cancelled. Although she was aware of the legislation and some recent changes, she was unable to explain how this could affect the people she cared for.

Although some staff told us they felt very well supported by their registered manager, this was not the case for all staff we spoke with. The staff training matrix was not up to date and one staff file was missing. This meant we could not establish if there was equal access of opportunity for all members of the staff team to receive personal development and supervision. Staff were not supported to take their breaks away from their caring role. Although staff we spoke with showed they were very caring, and enjoyed their work, it was evident from our discussions that staff could find aspects of their work stressful.

The registered manager spoke highly of her staff team and told us how much she valued their support. The staff team we met had all worked for a long time at the home. There was not a high staff turnover. The registered manager and staff told us they were very well supported by the local doctors and healthcare team. This enabled them to manage the changing needs of the people they cared for.

People we spoke with were positive regarding the care they received. One person told us, "The staff are extremely caring. My balance is poor and I need support to use the stair lift. My daughter made a good choice when she chose this home. I feel very safe and comfortable here"

At lunchtime the “surprise meal” was left uneaten by many people. Only two people were offered an alternative choice. We received mixed comments from people regarding their meals at the home.

One person told us, “Why on earth do they do it? I think they are cutting down. I should have gone out and got some sandwiches .Up the road they are beautiful sandwiches.” However a second person commented, “I`ve no urge to complain about anything. I am well fed and watered. I am quite happy here and well looked after.”

Inspection carried out on 23 July 2013

During an inspection in response to concerns

We spoke to people living at the home who said they were helped and supported to express their views about what they do, how they spend their time and the type of care and support they needed. One person said that they had been involved in making decisions about their care, and had discussions with the registered manager about how to deal with healthcare issues and the activities they taken part in during the day. They said that the registered manager had been happy to support them to go out on a daily basis to go shopping and sightseeing. People living at the home said that they felt safe, and they were aware of the ways in which to raise complaints or issues about their care and support. One person said that they looked out for others living at the home who were unable to speak up. They said, "If I felt someone was not being looked after, or being abused then I would ring the police or tell their family." We spoke with the relatives of one person using the service they told us they felt suitable staff were employed at the service. They described staff as helpful and kind. People living at the home also confirmed that the staff were supportive.

Inspection carried out on 14 January 2013

During a routine inspection

We spoke individually with three people living at the home.They told us they were happy living at the home and that they liked the staff team. A more in-depth discussion took place with a visiting relative who told us that they were more than satisfied with the care and support provided by the staff. This person told us, “I feel very content and happy with the way my relative is cared for. My relative is safe here, well looked after and pampered. It's a brilliant place” We observed that people were comfortable and relaxed in their surroundings. It was also clear that there was a positive relationship between the staff team and the people they supported.

Reports under our old system of regulation (including those from before CQC was created)