Cranmer Court provides residential and nursing care home for a maximum of 62 people with physical health needs. Two of these people were receiving rehabilitative support from external community staff in partnership with the homes staff. The main focus of the home is providing palliative and end of life care. The home uses the Gold Standards Framework (GSF) in End of Life Care to ensure people receive high quality care at the end of their lives.

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.

Cranmer Court is a residential home which provides nursing care and accommodation for up to 62 older people with physical health needs. A focus of the home is providing palliative and end of life care. They have attained Beacon status from the Gold Standards Framework (GSF) in End of Life Care. One person said “If you have to leave your home to be somewhere else, this is the place to be. I feel as if they treasure me.”

Respite care is also provided (Respite care is short term care which gives carers a break by providing care away from home for a person with care needs).

On the day of our inspection there were 54 people living in the home. This inspection took place on 6 July 2015 and was unannounced.

The home had a registered manager in day to day charge. 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.

People told us care staff treated them dignity and they felt safe. We saw staff had written information about risks to people and how to manage these in order to keep people safe. Staff had received training in safeguarding adults and were able to tell us they knew the procedures to follow should they have any concerns.

Care was provided to people by a sufficient number of staff who were appropriately trained and recruited. People did not have to wait to be assisted. One staff member said “The training is so good here; it has given me confidence in supporting people.”

Processes were in place in relation to the correct storage and auditing of people’s medicines. Medicines were administered and disposed of in a safe way.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. The registered manager and staff explained their understanding of their responsibilities of the Mental Capacity Act (MCA) 2005 and DoLS and what they needed to do should someone lack capacity or needed to be restricted to keep them safe. However the registered manager had been submitting DoLS unnecessarily for people who had capacity based on guidance from the provider.

People were provided with homemade, freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day or night. The registered manager said that people could regularly go out for lunch if they wished. One person said “I go out for lunch as often as possible with my friend.”

People were treated with kindness, compassion and respect. Staff took time to speak with the people who they supported. We observed positive interactions and it was evident people enjoyed talking to staff. People were able to see their friends and families as they wanted and there were no restrictions on when people could visit or leave the home.

People and their families had been included in planning and agreeing to the care provided. We saw that people had an individual plan, detailing the support they needed and how they wanted this to be provided. Staff ensured people had access to healthcare professionals when needed. For example, details of doctors’ and opticians’ visits had been recorded in people’s care plans.

People were put at the heart of care, enabling each person in the final steps of life to be recognised earlier, listened to and a proactive plan developed to provide care in line with their wishes and preferences.

People’s views were obtained by holding residents’ meetings and sending out an annual satisfaction survey. Complaint procedures were up to date and people and relatives told us they would know how to make a complaint if they needed to.

The provider had effective quality assurance systems in place, including regular audits on health and safety, infection control, dignity, care plans and medicines. The registered manager met CQC registration requirements by sending in notifications when appropriate. We found both care and staff records were stored securely and confidentially.