The inspection took place on 5 and 6 December 2018 and was unannounced on the first day and announced on the second day.
Crabwall Hall is a ‘care home’. 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.
Crabwall Hall is a two-storey care home in the village of Mollington which is 2 miles from Chester city centre. Accommodation consists of 43 single bedrooms all of which have ensuite facilities. At the time of our inspection there were 39 people living at the home.
The home had a registered manager in post. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection the home was rated good. At this inspection we found the home remained good. The home is rated good as it met all the requirements of the fundamental standards.
Safe and robust recruitment procedures were in place and sufficient staff are employed to meet people’s assessed needs. All staff had completed an induction and had undertaken training to meet the requirements of their role. Staff had regular supervision and attended staff meetings.
The registered provider had safeguarding policies and procedures in place that staff fully understood. Staff had received training and were able to describe what abuse may look like and actions they would take if they had any concerns.
People’s needs were assessed before they moved into the home and this information was used to develop person specific risk assessments and care plans. These documents were reviewed regularly and updated when changes occurred. People were offered choice and their independence was promoted where possible.
People’s needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment stage and care planning development.
Medicines were ordered, stored, administered and disposed of in accordance with best practice guidelines. Staff that administered medicines had all received training and had their competency regularly assessed. The registered provider had medicines policies and procedures in place that offered up-to-date guidance to staff. Medicine administration records (MARs) were fully completed and regularly audited for accuracy.
People were supported by staff with their food and drink needs. When people had been identified as having specific assessed dietary needs staff had guidance available to them to support this. People spoke positively about the food and drink at the home.
We observed people being treated with dignity and respect. Positive interactions between people and staff were observed throughout our visit. Staff were caring and demonstrated kindness to the people they supported.
Activities were available for people to participate in if they chose to and they told us they enjoyed these.
Governance systems were in place and included regular audits of key areas across the home. The information from the audits was analysed to identify areas for development and improvement and these areas were actioned in a timely manner. Accidents and incidents were analysed to identify trends and patterns within the home. Health and safety checks, equipment testing and servicing and fire checks were regularly undertaken.
The Care Quality Commission as required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and report on what we find. We saw that the registered provider had guidance available for staff in relation to the MCA. Staff had undertaken basic training and demonstrated an understanding of this. The registered provider had made appropriate applications for the Deprivation of Liberty Safeguards (DoLS). Care records reviewed included mental capacity assessments and best interest meetings.
A complaints procedure was in place and people and their relatives told us they knew how to raise a concern or complaint.
The registered provider had up to date policies and procedures in place that offered guidance to staff within their role and employment.
The registered provider had displayed their ratings from the previous inspection in line with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.