Cranhill Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accident and incidents were recorded and analysed, with leaders taking appropriate action to reduce risk of recurrence. For example, where a person experienced frequent falls, referrals were made to health professionals and systems were put in place to reduce the risk of falls.

The service maintained an effective system for tracking accidents and incidents, enabling the registered manager to maintain oversight of trends, identify risks, and ensure appropriate actions were taken. Leaders told us incidents were discussed during team meetings to ensure staff were aware of lessons learned and any changes to processes or practices.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Effective processes were in place to ensure people were admitted safely. One relative said, “Cranhill were accommodating, they talked us through everything before [Relative’s name] came in. They changed [Relative’s name] doctors’ surgery, discussed it with us and talked through their reasoning.” Staff told us information was shared with them about people prior to their admission. This meant staff were familiar to people’s needs prior to their admission, enabling care to be planned and delivered effectively.

The home had a system in place to ensure continuity of care when people needed to go to hospital.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living in the home.

Effective processes were in place to report and monitor safeguarding incidents. Staff received safeguarding training and confirmed the actions they would take if they had any safeguarding concerns. Information was available throughout the home about where to contact if anyone had any safeguarding concerns.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The registered manager was working within the principles of MCA and had applied for assessments and renewals of DoLS when required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Leaders told us care plans were reviewed monthly, and that people and relatives were involved in any discussions about changes to care and risk management and care records confirmed this.

Care plans clearly described the support people needed and included detailed information about what was important to and for each person. Risks were assessed in a way that promoted independence. For example, one person enjoyed maintaining a vegetable patch in the garden, which supported their emotional and psychological wellbeing. The risks associated with this activity had been assessed and measures were put in place to enable the person to take part safely. We observed staff supporting the person to engage in this activity in a safe and positive way.

The provider did not always detect and control potential risks in the care environment.

On the day of the inspection, we saw carpets were threadbare in communal areas and identified some trip risks. This was addressed by the registered manager during the inspection. The registered manager said they had plans to replace the carpets this year. Some areas of the home appeared cluttered. For example, equipment used to transfer people was left in the dining room. Which may present a trip risk. The registered manager said there were challenges in finding appropriate places to store equipment in the home. One relative felt uneven flooring in their relative’s room may present a trip risk. The registered manager said there been no record of incidents relating to the flooring.

However, most people and their relatives spoke positively about the environment. One person said, “The environment is perfect, surrounded by trees, in good weather I can sit outside.” A relative said, “It feels like home and is comfortable, Although the carpets need changing, it’s a friendly, welcoming environment.”

Regular checks regarding the safety of the environment took place, including fire safety equipment checks and window restrictor checks. Repairs or replacements had been made quickly to broken equipment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People living at the service and their relatives gave positive feedback about the staff. One person said, “Carers are high quality. They understand my needs.” A relative said, “I think the service is run by competent staff who are kind and caring.”

Although supervisions were planned, the registered manager said sometimes they were overdue due to operational demands.

Staff told us they received regular training and had supervision from senior staff.

While one staff member noted that formal supervision was not always frequent, they continued to receive regular feedback and felt able to raise any concerns with the registered manager or deputy manager. They told us these concerns would be listened to and addressed appropriately.

New staff said they completed an induction and were supported by experienced colleagues to get to know people and understand the routines of the home.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People using the service and relatives told us the home was clean, well maintained, and no concerns were raised about infection control practices.

The service maintained oversight of cleanliness through regular infection prevention and control (IPC) audits. A designated IPC lead provided oversight of infection control practices and ensured staff completed relevant training.

We found the home to be generally clean and free from unpleasant odours. However, we found some less accessible areas were not as clean as they could be, which could increase the risk of infection. For example, there was a build-up of dust and debris behind radiator covers, and a cleanable chair cover was damaged exposing the foam underneath, making it difficult to cleaneffectively. These issues were addressed by the registered manager at the time of the assessment.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Not everyone had a medicines care plan in place. This meant there was not a consistent approach to managing people’s medicines safely.

Some records for ‘when required’ (PRN) medicines were incomplete. Risks associated with some topical creams containing paraffin which is a known fire risk had not been fully assessed. And documentation did not always show what action had been taken in response to patient safety alerts. We also found that medicines fridge temperature monitoring processes needed strengthening to ensure medicines were always stored in line with guidance. The provider responded positively to out feedback and took action to address these issues, including introducing new care plans, improving recording processes and strengthening monitoring arrangements. While systems and training were in place to support safe medicines management, further improvements were needed to ensure these were consistently effective in practice.

However, people generally received their medicines safely and as prescribed. Staff were trained to administer medicines and understood people’s individual needs and preferences. Medicines were stored securely, and records showed people’s allergies were identified.