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Inspection Summary


Overall summary & rating

Good

Updated 22 December 2018

We undertook this unannounced inspection on 13 and 15 November 2018. The last comprehensive inspection of the service was carried out in August 2017, and a focussed inspection was carried out in February 2018.

At the last comprehensive inspection, we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Shortfalls related to safeguarding people and obtaining their consent, staff training and insufficient staff to support people. Audits did not always identify shortfalls found during the inspection. Following the last comprehensive inspection, we asked the provider to make improvements to the service. At this inspection, we found that improvements had been made.

Cranhill is a 'nursing home'. People in nursing homes receive accommodation and nursing care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Cranhill Nursing Home provides care for up to 31 people. At the time of our inspection there were 19 people living there. The communal areas of the service were all on the ground floor. Bedrooms were available on all floors and an elevator and stair lifts enabled people to access each floor. Some bedrooms were en-suite, and some were large enough to enable couples to share a room.

A registered manager was in post at the time of our inspection. 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 were supported by adequate numbers of staff to meet their needs, however agency staff supported shortfalls in staffing numbers. At the time of the inspection, the provider was trying to recruit to fill vacant posts. The provider followed effective procedures to ensure prospective staff were suitable to work in the service, and checks were also carried out on staff who had worked at the service for many years.

Staff were trained in a range of relevant subjects, although some training records required reviewing and updating. Staff usually received regular supervision and appraisals, and the staff we spoke with were positive about the service.

Care records were clear, although some needed more detailed information about people’s needs and preferences. Individual risk assessments were in place, although some of these also needed checking for consistency. Care plans were reviewed regularly to ensure they continued to meet people’s needs. Relatives told us that they were consulted with and informed about people’s care.

Systems and processes were in place to protect people from the risk of harm. Staff had received training and told us about their responsibilities in making sure the service was safe. The principles of the Mental Capacity Act 2005 were being followed and the provider had made safeguarding referrals to the local authority appropriately.

People's medicines were administered as prescribed and managed safely by suitably trained staff.

Policies, procedures and checks were in place to manage health and safety. This included the management of incidents and accidents.

A wide range of audits and monitoring tools were in place. This included regular checks of pressure mattress settings, call bell responses, health and safety, medicines and falls. Shortfalls and themes had been identified and action plans put in place to continually monitor and improve the quality of the service.

Inspection areas

Safe

Good

Updated 22 December 2018

The service was safe.

People were supported by staff, systems and processes which kept them safe.

People�s medicines were managed safely.

Risks to people were assessed and monitored to ensure people were safe.

Effective

Good

Updated 22 December 2018

The service was effective.

Staff received training and supervision to ensure they provided effective care for people. There were some gaps, but the provider planned to address these.

Staff supported people's choices and the service was following the principles of the Mental Capacity Act.

People were supported to stay healthy and well. The service made appropriate and timely referrals to relevant health professionals when required.

Caring

Good

Updated 22 December 2018

The service was caring.

Staff demonstrated respect for people who used the service in the way they interacted with and spoke about people.

People and their relatives were confident in the abilities of staff, and told us that they were kind and patient.

Staff had a good understanding of people�s needs and preferences, and were compassionate and caring.

Responsive

Good

Updated 22 December 2018

The service was responsive.

Care records were clear, although some care plans required more information and updating.

People received care and support that was personal to them, and this was usually provided by staff who knew them well.

People and their relatives felt able to make a complaint, and were confident that any concerns would be fully investigated.

Well-led

Good

Updated 22 December 2018

The service was well-led.

Systems to monitor and review safety and the quality of care were in place and effective.

The provider was open and receptive to feedback and was keen to improve the service.

People, relatives and staff spoke positively about the manager.