35 Cranbrook Road

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

The staff who supported people were not always being properly supervised and supported in their work. This meant there was a risk staff could be providing care that was not safe or suitable for people. We asked a senior manager about this. They recognised there was work needed to ensure all supervisions were completed.

Some care plans and risk assessments had not been updated and reviewed to make sure they were accurate and up to date.There were audit systems in place however the registered manager’s audits had not identified the shortfalls we found. These audits were meant to be completed to improve the care and service.

People felt they were well supported and their full range of needs had been assessed.

Care plans and risk assessments were in place to support staff so people's individual needs could be met and risks minimised.

People’s medicines were managed safely by staff who were trained and competent to do this. To support staff there were medicines policies and procedures. This information was up to date and easily available for staff. There was also good practice guidance.

If there was a major emergency there were procedures and contingency plans in place. Staff had plenty of personal protective equipment (PPE) such as gloves and aprons. An infection control policy and procedure were in place and staff had completed training in this area

People told us positive things about life at the home. One comment was “It’s nice.” Safe recruitment procedures were in place and staff were supported to fulfil their role with training and learning updates.

The staff and management team worked with other health and social care professionals. For example, when needed community psychiatric nurses supported people at the home.

People knew about their care plans. No one we asked said they wanted to be included in regularly reviewing and updating them with the staff. However, records showed some people had been involved in this process.

People were supported by a staff team who had built up positive relationships with people and their relatives. They understood how to meet each person’s needs and knew their wishes and preferences. There was rare use of agency staff and this was to ensure people received continuity of care.

People's privacy and dignity was respected and staff were kind and caring.

People's dietary needs were identified and met. People spoke positively about the meals.

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

People took part in range of activities and spoke positively about these. People were encouraged to maintain contact with relatives and friends.

There was a complaints procedure in place .People knew how to make their views known if they were unhappy in anyway.

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, (report published March 2017)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up - We will request an action plan from 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 35 Cranbrook Road on our website at www.cqc.org.uk.

People were safe whilst living at Cranbrook Road. There were sufficient numbers of staff to ensure that people’s needs were met. Staffing was flexible in order to meet people’s needs. Some people were independent in taking their medicines and staff supported them in this. Other people required staff to administer medicines for them. This was managed safely. Risk assessments were in place to ensure that staff had guidance in the safest ways to support people.

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 support this practice. There was information in people’s care plans about their capacity to make decisions. Nobody in the home required a Deprivation of Liberty Safeguards (DoLS) authorisation and so people were free to leave the home as they wished. Staff received good training and support to help them carry out their roles. People had plans in place to support them manage their mental health needs.

Staff were caring and supported people to be independent. Issues relating to equality and diversity were considered in people’s care planning. People were able to maintain relationships with their families.

The service was responsive. People’s individual needs were met and well described in their care plans. People were able to make complaints and were encouraged to do so. People were independent in following their own interests and activities; however there were opportunities to take part in organised events if people wished to.

The home was well led. Staff were positive about working in the home and felt well supported in their work. There were systems in place to monitor the quality and safety of the home. This included gathering feedback from people in the home.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were effectively supported by staff with their mental health needs at 35 Cranbrook Road. Care plans and risk assessments set out how to promote people's independence and how to support them to stay safe in the home and the community.

People told us they felt well treated by the staff who supported them. One person told us that the support worker on duty was, 'a calm oasis who has centred me to a better place'. Another person told us 'they are all kind'.

The provider had put in place safeguarding procedures that helped to keep people safe from potential abuse, and staff we spoke with understood how to safeguard the people they supported.

Is the service effective?

People's care and support needs were planned and assessed with their involvement. People's plans of care clearly set out the type of support that people needed to effectively meet their range of needs. Mental health needs, spiritual needs, communication needs and dietary needs had been identified in care plans where relevant.

People were supported to be able to enjoy a varied and nutritious diet. People were also encouraged by the staff to help to prepare and cook meals. This helped people to be actively involved in the day today running of the home.

Where people had specific dietary needs their care plans accurately reflected how to meet them.

People told us that they lived a varied and fulfilling life in the home and the community and were able to take part in activities of their choosing. One person told us about the art class that they attended on a regular basis. Another person told us they regularly went out shopping and for lunch with their keyworker from the staff team.

Staff were provided with a variety of regular training opportunities to ensure that they were competent to the needs of people who used the service. There was a system of staff supervision in place that ensured staff were supported and developed. This helped ensure that the staff performance continually improved.

Is the service caring?

People were supported by kind and attentive staff. We saw that the two support workers we met were patient and attentive in manner with people. Two people helped a support worker to cook lunch. The support worker was encouraging and supportive in manner. One person commented, 'they are all wonderful'. Another person said, 'it's not too bad here'.

We saw confirmation that people's preferences, interests and diverse needs had been clearly recorded in their care plans. Care and support had been provided in accordance with people's wishes. For example, people were offered additional one to one staff time and support at times of the day that they preferred.

Is the service responsive?

People who used the service, their relatives, friends and other professionals completed a regular satisfaction survey about the care and support that was provided. When shortfalls were identified we saw evidence that action was taken to ensure that these were promptly addressed.

People knew how to make a complaint if they were unhappy. The three people that we spoke with said that they felt able to speak to the registered manager at any time if they did have a concern.

There were systems to ensure that people were able to make their views known about the service. Regular in house meeting were held and people were encouraged to talk about things that mattered to them about the way the home was run.

The provider had introduced a service user committee made up of people who used their services. One person told us that the manager had discussed this with them. They said it was a way for people to make their views known to the person in charge. The people we spoke with told us they had not yet decided whether they wanted to join the committee.

There was evidence that the manager and staff learned from events such as accidents and incidents, complaints, and concerns about the service. This helped to minimise risks to people and also ensured that standards were continually improved.

Is the service well-led?

The views of people who used the service were actively sought by the provider. Two people told us they had met the chief executive who had come to the home to meet people on at least three occasions. One of the people told us that they were a, 'very nice fellow'.

The staff and people who used the service spoke highly about the registered manager. One person told us that they were 'wonderful in every sense and very very kind'. A member of staff told us they had seen people grow in confidence and independence since the current registered manager had taken over the running of the home.

There were systems in place to ensure that the service people received was checked and monitored so that it was safe and suitable for them.

Everyone who we spoke with had positive views to share with us about the care and support they received at the home. One person told us, 'I do like it here I'm very happy here'. Another person told us, 'the staff are very good they are all very nice', another person said "It's a good house a cosy house and I feel wanted here" ,

People who used the service were effectively supported to live a varied and fulfilling life within the community.

People's care plans and their risk assessment records were detailed and informative. They set out how to support people effectively with their mental health needs and how to promote their independence. This meant staff had guidance so that they knew how to give people suitable care and assistance.

People who used the service liked and appreciated their home environment. The environment was safe and suitable for people's needs.

People were supported by staff who were properly supervised to ensure they were providing suitable care.

There was a suitable system in place to quality check the service people were receiving. People who used the service were actively involved in this process.

We were told that the registered manager had left the home in June 2012 and that the home was being managed by the registered manager of one of the provider's other homes. This person was in the process of applying to become the registered manager of both Cranbrook road and the other home which was situated nearby.

We did not speak to people in detail during this inspection, but two people we spoke with told us that they liked living at the home and they liked the new manager.