Cranham Court Nursing Home

Updated 14 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014

This unannounced comprehensive inspection took place on 24 and 25 October 2017 and was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed all the information we held on the service, such as previous inspection reports and notifications. A notification is information about events that by law, the registered persons should tell us about, such as safeguarding alerts and serious incidents. We also obtained feedback from the local authority and the local Healthwatch, for their views on the service.

During our inspection, we spoke with six people and with six relatives. We made observations of care being provided. We spoke with two nursing staff, two care staff, the registered manager, the training administrator, three care staff and an activity coordinator.

We looked at 12 care plans and other records relating to people’s care, such as fluid charts and medicine administration records. We also looked at six staff files, accident and incident records, training records, quality assurance audits, health and safety procedures and other records kept in the service.

Updated 14 December 2017

This unannounced inspection took place took place on 24 and 25 October 2017.

Cranham Court Nursing Home is a care home located in Upminster, Essex. People in care homes receive accommodation and nursing or personal 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.

Cranham Court Nursing Home is registered to provide nursing care to older people, some of whom have dementia or palliative care needs. The service accommodates 68 people across two separate units, each of which have separate adapted facilities. The Main and Extension unit is a nursing and residential facility and the Woodlands unit, specialises in providing care to people living with dementia.

On the day of our inspection, 61 people were using the service in total.

The service had a registered manager in post. 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.

Each unit was managed by a registered nurse. They were supported by the the registered manager, who was also known as Matron.

At our last comprehensive inspection on 1 November 2016, we found the provider did not meet legal requirements to ensure the service was safe or well led. This was because care and treatment was not provided to people in a safe way and the provider did not always operate effective systems to monitor risks to people’s health, welfare and safety.

The provider wrote to us to let us know what action they were taking to meet these requirements.

We visited the service again on 4 May 2017 to look at the progress of their action plan and found there were still some improvements required as there was a continuing breach of health and social care regulations. We wrote to the provider and sent them a Warning Notice to be compliant by 4 August 2017.

At this inspection, we found that the service was compliant and was now meeting legal requirements.

We saw that improvements had been made and the service was now safe. People told us they felt safe living at Cranham Court Nursing Home.

Medicines were managed safely and administered by staff who were trained to do so.

The premises were safe, clean and regularly maintained. There were enough staff on duty. However, the provider was currently relying on agency staff to fill in for staff on leave, vacancies or any sickness absences. The provider was in the process of trying to recruit more permanent staff. The provider had safe recruitment procedures in place and carried out checks on new employees.

Risks to people were identified to ensure they remained safe. It was not always clear how the risks were managed and we have recommended that these are more clearly set out.

Staff had received training on safeguarding adults and were able to describe the actions they would take if they had any concerns about possible abuse. The provider also had a whistleblowing policy, which staff were aware of and they knew how to report any concerns they had.

Staff were supported with regular training, meetings and supervision. Staff work performance was reviewed on a yearly basis and they were encouraged to develop their skills.

The provider had systems in place to support people who lacked capacity to make decisions for themselves. Staff received training in the Mental Capacity Act 2005 and were knowledgeable about the processes involved in assessing people’s capacity.

Staff ensured people had access to appropriate healthcare, when needed and people's nutritional needs were met.

Staff were aware of people’s preferences, likes and dislikes. People were treated with dignity and their choices were respected, although we found that some people’s personal health information was displayed inappropriately. We have made a recommendation about this.

People were involved in the planning of their care and received care and support to ensure their individual needs were met. Some people’s care plans were incomplete with regards to their personal histories, thoughts and preferences. We have recommended that efforts are made by the provider to ensure they are completed more thoroughly to ensure they remain person centred.

People were encouraged to participate in activities and remain as independent as possible. However, the activities programme was not always sufficient and no activities took place during our two day inspection. We have made a recommendation about reviewing the structure of activities to ensure a more stimulating environment.

People and their relatives were able to make complaints and the registered manager investigated these.

Staff felt supported by the management team. Their responsibilities and requirements when providing care were discussed in staff meetings.

The registered manager had systems in place to monitor the quality of the service provided to people and made further improvements when required.