Background to this inspection
Updated
11 September 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team included a lead inspector, a second inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who has used this type of care service.
Service and service type:
Cranleigh Paddock is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The inspection was unannounced.
What we did:
Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification tells us about important issues and events which have happened at the service. The provider had completed a Provider Information Return (PIR). This is information we request on at least an annual basis about what the service does well and improvements they plan to make.
During the inspection we spoke with six people who used the service and three relatives. We spoke with the registered manager and the deputy manager, three members of the care team and members of the kitchen and maintenance staff. We reviewed the care records of three people. We also looked at staff recruitment and training and other records relating to the management of the service such as medicines administration records, audits and staff rotas.
Following the inspection, we received feedback from a health and social care professional.
Updated
11 September 2019
About the service: Cranleigh Paddock Care Home is a purpose built care home in a residential area of Lyndhurst. The home accommodates up to 32 older people who have support needs associated with old age or dementia. Accommodation is provided at ground floor level and is divided into four units, each of which accommodates up to eight people. There were 24 people living at the service at the time of this inspection.
People’s experience of using this service:
The provider had not always ensured risks to people and staff had been adequately managed. They had not acted in accordance with all of the recommendations made in the 2015 legionella risk assessment and had not followed national guidance.
People confirmed they were treated by staff with kindness and compassion. People’s comments included: “Everyone is lovely and they smile at me a lot”. “This is a very happy place, everyone gets on well together”. “The place has a good atmosphere here, all the time”.
People’s privacy and dignity needs were understood and respected, including during physical or intimate care. We observed that staff showed concern for people’s wellbeing and responded to their needs quickly.
People’s needs were assessed and staff had a clear understanding of people’s care plans.
People and when appropriate their families or other representatives were involved in discussions about their care planning. People were encouraged to provide feedback on the service provided both informally and through quality questionnaires.
Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.
People were supported to maintain good health. Any health concerns were addressed promptly and referrals sought from appropriate professionals when needed.
People told us they enjoyed their meals and received any support they needed. The service catered for people’s individual needs, including specialist pureed meals which mirrored the visual appearance and colours of food.
People felt confident that staff had the necessary knowledge and skills to meet their needs. A system was in place to track the training that each member of staff attended. There was a staff supervision structure that included observation and monitoring of care practices and annual appraisals.
There were safe systems for the management, administration and storage of medicines, so that people received their medicines as prescribed, in a way and at a pace that met their needs and preferences.
Robust recruitment procedures were in place to ensure that only staff who were suitable to work in a social care setting were employed. People confirmed that staff were available when they needed care and support.
Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns.
People were confident they could raise concerns or complaints and that these would be dealt with.
There was an open, inclusive and empowering culture within the service. A system of regular audits of the quality and safety of the service took place. The registered manager had a plan for the continuous development and improvement of the service.
Rating at last inspection: Good. Last report published 22 December 2016.
At this inspection the overall rating for the service has changed from Good to Requires Improvement. We found the evidence did not continue to support a rating of ‘Good’ in all areas and we have rated the service ‘Requires improvement’ in the ‘Safe’ and ‘Well led’ key questions.
Why we inspected: This was a planned inspection based on the rating of the service at the last inspection in October 2016.
Enforcement: We have identified a breach in relation to assessment of environmental risks at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up: We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk