Cranbourne House

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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.

Accidents and incidents were reported by staff and action was taken to mitigate the risk of events happening again. The provider had robust management structures to assess safety risks, including a positive behaviour support team who were skilled in reviewing any events and provided support to people, if required, and the staff team. Risks associated with closed cultures had been identified and were monitored. People had access to professionals, family and friends outside of the service they could raise concerns about their care with. There was a clear process in place for raising concerns and complaints.

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.

Continuity of care was maintained by ensuring staff had access to clear records. People had hospital passports in an accessible format, which meant if they needed medical support important information about their health and support needs was available to other professionals. The staff team worked proactively with people to ensure reasonable adjustments were in place when they needed to attend planned health appointments. There were good links with the local GP. People were consistently supported if they were distressed. Care plans were in place to support people to have a good day, and strategies were in place to prevent distress.

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.

There were clear processes in place to manage safeguarding events and the registered manager worked collaboratively with the local authority to support people safely. Staff had received safeguarding training and understood how to recognise and report poor care and abuse. Where people were subject to Deprivation of Liberty safeguards (DoLS) the service had made applications to the local authority and there was clear monitoring in place. DoLS ensure if a person is restricted in a way that deprives them of their liberty in a care home, it is only done when it is in their best interests, is necessary for their safety, and all other options have been considered.Where restrictive practices were being used, they were legally justified and proportionate. There was a clear commitment to minimising restrictions for people and they were regularly reviewed to promote people’s choice and independence. People and relatives told us they felt safe. Comments included, “[Name of person] feels safe and would tell me if they felt otherwise.”

The provider worked with people to understand and manage most 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.

Risks to people’s health, safety and wellbeing were assessed and regularly reviewed. Key risks such as fire, complex behaviours and nutrition and hydration were assessed and monitored. Staff told us they were kept up to date about any changes in people’s needs through good communication. Staff knew people well and understood there were times when people became distressed and took steps to understand why a person was distressed and what support they needed to express their emotions. We observed care being delivered in line with people’s care plans, which promoted their independence and choice. People were supported and empowered to take risks in areas they wanted to and to enhance their lives. When people’s needs changed or staff picked up changes in people’s mood or communication styles care plans and risk assessments were reviewed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The home was tidy, well maintained and generally safe and there were systems in place to ensure health and safety checks were completed. However, some required checks on hot water outlets and window restrictors had not been robust. We did not find any evidence of harm to people. We discussed this with the registered manager, and they took immediate action to keep people safe. People had been consulted about the environment to ensure adaptations and reasonable adjustments could be made to meet their individual sensory needs. People told us this had enhanced their quality of life. There were a range of communal spaces, a welcoming conservatory, a sensory room and an accessible garden.

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.

Safe staffing levels were in place, and this was confirmed by staff, people and relatives. Comments included, “There is always enough staff, and they support in the home and community. This makes [name of person] feel safe and secure.” Recruitment was managed safely and all the required checks were carried out before people commenced in their role. Where people needed one to one support this was clearly recorded on rotas. Staff had the induction, support and training to be able to carry out their role. Training was coordinated to ensure it was flexible and met the specific needs of the people who were living at Cranbourne House. Staff had received regular effective supervision. Not all staff had received an up-to-date appraisal. However, the provider confirmed they had recently updated their appraisal formats and plans were in place to roll this out with all staff imminently.

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.

Processes were in place to ensure people were protected from the risk of infection. The service was clean and tidy, and staff followed good practices to keep people safe.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medication records were clear, accurate and well completed. Detailed checks and audits were in place. People's medicines were reviewed in line with STOMP (Stopping Over Medication of People with a learning disability, autism or both). STOMP is a national NHS England programme focused on reducing the inappropriate prescribing of psychotropic medications to individuals with learning disabilities and/or autism. The registered manager told us people’s medication to be taken ‘as and when required’ had been reduced as staff understood the triggers and signs when they became anxious and were able to use alternative strategies to support and alleviate this. This was corroborated by people’s medication administration records. Staff received training to administer medicines, and their competency was regularly assessed.