Cranmer Court

Cranmer Court is a residential care home providing personal and nursing care to up to 62 people. The service provides support to people aged 65 years and over, some of whom are living with dementia. At the time of our inspection there were 36 people using the service.

The home is comprised of a ground floor, first floor and second floor. Each floor has a communal dining room and lounge, and there is an activities room and garden access on the ground floor.

People’s experience of using this service and what we found

People were supported with their medicines and encouraged to be eating and drinking enough for a balanced diet. People were kept safe from the risk of infection and improvement had been made to the general environment for people living with cognitive impairments.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by kind and caring staff. Staff had been well trained and recruited following safe recruitment procedures. People were treated with respect and staff ensured they understood people correctly if they had any additional communication needs.

People were taking part in activities in line with their hobbies. People also were confident to raise any issues or concerns with staff and the registered manager.

Staff were supported by the registered manager and the registered manager had good oversight of the home. For example, regular quality audits were completed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 08 July 2020). A number of recommendations were made at our last inspection. We recommended that staff support people with their medicines in line with their communication needs; that the provider use agency staff whilst recruiting new permanent staff; that all mental capacity assessments were reviewed; that the environment of the home was improved to be more stimulating for people with cognitive impairment; to ensure quality audits were thorough and that complaints procedures were correctly followed. At this inspection we found the provider had acted upon all recommendations and made improvements to all areas previously highlighted.

Why we inspected

We inspected this location to follow up on previous recommendations and to review the previous rating. The inspection was prompted in part due to concerns received about medicine errors. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Cranmer Court is a nursing care home providing personal and nursing care to people with a range of needs such as dementia and Parkinson’s Disease. The care home accommodates up to 62 people in one purpose built building. At the time of the inspection, the service was supporting 62 people.

People’s experience of using this service and what we found

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Staff did not always take people’s communication needs in to account when delivering care, and the environment required further work to ensure it met the needs of those with progressing cognitive impairments.

Vacancies within the staffing team meant that people were often left unattended without interaction in communal areas and care received was task focused. The provider’s quality assurance audit had not identified this issue and the affect it was consequently having on staff’s morale and energy levels due to them covering a large amount of staff vacancy gaps and sickness. It also meant the registered manager did not always have the time required to complete required documentation, such as complaint records. We have made recommendations in these areas.

Despite this, people and their relatives felt comfortable to raise concerns with the registered manager, and that appropriate action was taken when they did. Staff felt they had input in to the input into the running of the service and the registered manager was approachable. This was echoed by people and their relatives.

Risks to people were appropriately recorded and monitored, and lessons learnt were accidents had occurred to prevent reoccurrence. Medicines were managed safely, and staff were aware of their responsibility to keep people safe from harm and abuse.

Safely recruited staff were up to date with their mandatory training, and had access to additional training to further enhance their effectiveness in their role. Staff were aware of and prepared food in line with people’s dietary needs. There were effective communication systems amongst staff, and close working relationships with health care professionals to ensure people’s health needs were attended to.

People received personalised care from staff who knew them well. Although staff were busy and often task focused due to this, they ensured meaningful exchanges were had with people when they had time to do so. There were a wide range of meaningful activities for people to take part in, and one to one sessions took place for those who did not want to or were unable to leave their rooms. The service was part of the gold standard framework for end of life care, which aimed to deliver best practice and high quality care in this area.

People and their relatives felt staff were compassionate and welcoming, respecting people’s privacy and dignity. Staff encouraged people to make day to day decisions around their care and remain as independent as safely possible.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 29 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We have made recommendations around staffing levels, people’s communication needs, adhering to the principles of the Mental Capacity Act 2005, the environment, quality audits and ensuring complaints were recorded. 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.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good

People felt safe Their care records contained up to date risk assessments to keep them safe and retain their independence. People were protected against the risks of potential abuse because the provider followed safe recruitment practices and staff knew how to safeguard people. People were supported by sufficient staff to meet their individual needs and medicines were administered safely. The service had a business continuity plan, and people had Personal Emergency Evacuation Plans (PEEPsso that if needed they could be safely supported to evacuate the home.

Staff worked in accordance with the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles. People’s nutrition and hydration needs and preferences were met, and people’s health care needs were monitored and any changes in their health or well-being prompted a referral to their GP or other health care professionals.

Staff were caring and knew people well. People were encouraged to be independent. Staff promoted people’s privacy and dignity, and people and their relatives were able to have a say in the running of the home.

Care plans were detailed and contained information on people’s lifestyles and preferences. They included details on people’s routines and what support people liked to receive. People’s needs were assessed and their care regularly reviewed. People had access to a range of activities planned to meet their interests, and were able to choose what activities they took part in. People knew how to complain and had their complaints responded to.

There was a registered manager in place who promoted a positive culture and supported their staff. Staff were involved in the running of the home. Audits were completed frequently, were thorough, and their use made improvements to the service people received. People and those important to them had opportunities to feedback their views about the home and quality of the service they received.

Further information is in the detailed findings below.