About the service:

Cranwell Court is a ‘care home’. It provides care and support for up to seven people living with learning disabilities or autistic spectrum conditions. The service comprises of a six-bedded house and a self-contained annexe flat. At the time of the inspection, four people were being supported by the service.

People’s experience of using this service:

People’s support focused on them having as many opportunities as possible to gain new skills and become more independent. This supported the principles of ‘Registering the Right Support’ and other best practice guidance. These ensured that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Feedback from everyone was positive about how the registered manager and staff supported people in a kind and person-centred way. People said their needs had been met because of this. There was evidence the service had been effective in achieving good care outcomes for people. This was because the support provided enabled people to live happy and active lives.

People were protected from harm by staff who were confident in recognising and reporting concerns. Potential risks to people’s health and wellbeing were assessed and minimised. There were enough staff to ensure people’s needs were met safely. Where required, people were supported well to manage their medicines. Staff followed effective processes to prevent the spread of infection.

Staff had the right skills to meet people's needs effectively. Staff were well supported and had information to meet people’s assessed needs. Staff supported people to have enough to eat and drink, and to access healthcare services when required. This helped people to maintain their health and well-being.

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 were fully involved in making decisions about their care and support. People were involved in planning and reviewing care plans. People told us staff respected and promoted their privacy, and dignity.

Information in people's care plans supported staff to deliver person-centred care that met people’s needs. The service worked in partnership with other professionals to ensure people received care that met their needs. There was a system to ensure people’s suggestions and complaints were recorded, investigated, and acted upon to reduce the risk of recurrence. The service did not currently provide end of life care.

Audits and quality monitoring checks were carried out regularly to continually improve the service. The provider had systems to enable people to provide feedback about their experiences of the service. People's experiences of the service were positive. Staff felt fully involved in ensuring the service met its regulatory requirements.

Rating at last inspection:

At the last inspection, the service was rated Good (report was published in May 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor all information we receive about the service and schedule the next inspection accordingly. For more details, please see the full report which is on the CQC website at www.cqc.or.uk.

This inspection took place on 30 & 31 March & 08 April 2016 and was unannounced.

The inspection was carried out by one inspector.

Cranwell Court provides care and support for up to ten adults with mental health needs and learning disabilities. Accommodation is provided in a six bedded house and a four bedded annexe. Occasionally, they also support people whose treatment is in accordance with the requirements of the Community Treatment Order (CTO) of the Mental Health Act 1983. It is part of Brookdale Healthcare Limited. On the day of our inspection 8 people were using the service.

There was a registered manger in post. 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 felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs.

Effective recruitment processes were in place and followed by the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and ongoing training. They were well supported by the registered manager and the unit manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff gained consent before supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professional when required, including dentist, opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well.

People and relatives where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests.

A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found.

Is the service safe?

People told us they felt safe. We saw that the provider ensured people were cared for in an environment that was safe and well maintained. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The food was stored and prepared in a way that protected people against the risks associated with food poisoning.

Is the service effective?

Detailed care plans were in place, and people told us their needs were being met. Staff received training to support people with various care needs. They also sought additional support from other health and social care professionals, to ensure positive care outcomes for people using the service. The service provided people with adequate and nutritious food and drink that ensured they maintained good health.

Is the service caring?

People were supported by kind and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people they supported. People told us the staff were caring. One person said, "The staff are always helpful."

Is the service responsive to people's needs?

We observed that staff responded promptly to people's needs. We saw that care plans had been updated when people's needs changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and people were supported to access a variety of activities of their choice. They had a complaints procedure that enabled them to respond appropriately to any complaints people may raise.

Is the service well-led?

The service had a registered manager in post. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service, and took account of these to improve the service.

When we visited Cranwell Court on 18 April 2013, we spoke with people who used the service about their experiences in the home, and we observed staff interactions with them. One person said, "It's lovely, they keep me safe here."

We observed positive engagement between staff and people who used the service, and noted that people's consent was sought before care and support was delivered. People were encouraged and supported to make their own decisions, and where people lacked the capacity to make decisions for themselves, appropriate processes had been followed to ensure best interest decisions were made on their behalf. We could see how diagrams and pictures had been used to support this process for some individuals.

People had care plans and risk assessments in place so that care could be delivered safely and with continuity, and robust medication systems ensured that people received their prescribed medication on time and in a way that suited their needs.

People we spoke with told us they were happy with the staff that supported them, and we found the recruitment systems were sufficient to ensure the staff employed were suitable to work in this environment.

During our visit on 20 November 2012, people told us that they liked living at Cranwell Court. One person told us how their particular interests were encouraged and met by the service, including supporting them in tending an allotment in the grounds. We observed that people were offered support at a level which encouraged independence and ensured that their individual needs were met, in both the main house and the neighbouring annex.

Staff were friendly and polite in their approach to people and interacted confidently with them, respecting the individual's dignity whilst ensuring their needs were met.

During our visit to Cranwell Court on the 02 June 2011, we received a variety of comments from people who use the service.

Some people told us that they felt safe at Cranwell Court and had no concerns about the way they were treated by staff. Others said that they were generally happy, they were involved in their care planning and encouraged to make their own decisions. For example one person proudly showed us around their allotment where they spent much of their time working.

However they also told us that they ‘sometimes get in trouble and shouted at’, but did not expand on that comment.

Another person told us, “I go out a lot and just do my own thing", however they said that they often felt frustrated and ignored, for example when we arrived at 5pm, they were waiting to speak to the manager and told us that they had been waiting since 2.30pm. They told us they found it difficult to trust anyone.

We were told that people were not often restrained here, however one person told us that they had been restrained about a year ago and they thought this had been inappropriate.

During our visit on 27 September 2011, we spoke with two people and they both told us that the staff were kind and that they provided help when they needed it. One person told us that they were aware of the content of their care plan, including the arrangements for physical intervention if needed.

During our visit to Cranwell Court on the 02 June 2011, we received a variety of comments from people who use the service.

Some people told us that they felt safe at Cranwell Court and had no concerns about the way they were treated by staff.

Some people said that they were generally happy at Cranwell Court, and that were treated well and encouraged to make their own decisions. For example one person proudly showed us around their allotment where they spent much of their time working. However they also told us that they ‘sometimes get in trouble and shouted at’, but would not expand on that comment.

Another person told us that “I go out a lot and just do my own thing", however they said that they often felt frustrated and ignored, for example when we arrived at 5pm, they were waiting to speak to the manager and told us that they had been waiting since 2.30pm. They told us they found it difficult to trust anyone.

They told us that people are not often restrained here, however one person told us that they had been restrained about a year ago and they thought this had been inappropriate.

Two people said that they had been involved in their care plans, and were aware of the support staff should be giving them. A third person told us that they were happy with the support they received.