We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:' Is the service safe?
' Is the service caring?
' Is the service responsive?
' Is the service effective?
' Is the service well led?
Below is a summary of what we found. The summary is based on our discussions with five people who used the service, three staff members and two family members. In addition we looked at three people's care and support plans.
Is the service safe?
Risk assessments were in place to ensure that, as far as possible, people were safe in the home and that staff were safe in their working environment. Where risks to people had been identified measures had been taken to minimise or remove them. Appropriate vetting of staff combined with on-going staff support and appraisal meant that the provider took reasonable steps to ensure that vulnerable adults were protected from the risk of abuse. We looked at staff rotas and found that there were enough qualified, skilled and experienced staff to meet people's needs throughout the day and night. Staff were up to date with their safeguarding training.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to all care services. At the time of the inspection no applications had needed to be submitted. Proper policies and procedures were in place so that people who could not make decisions for themselves were protected. Relevant staff had been trained to understand when an application should be made, and how to submit one.
Is the service caring?
People we spoke with said that staff treated them with respect and consideration. They felt that staff listened to them and took time to explain things. People also told us that they were consulted about the care and support they received. We observed that people received encouragement, had questions answered politely and were given time to think about what it was they wanted to say or ask.
People's needs were assessed and care and support was planned and delivered in line with their individual care plans. The care plans we looked at were personalised and detailed and provided a good level of information for staff providing the care.
Is the service responsive?
The provider had a system in place to deal with concerns or complaints. We found that these had been dealt with in a timely manner. People knew how to make a complaint if they were unhappy. The complaints process was displayed in the entrance hall, making it easily accessible to people and visitors. Where shortfalls or concerns were raised these were addressed by the provider.
People told us that the provider responded to their changing needs in a timely manner. People's needs were assessed and reviewed on a monthly basis or as and when needed. Where changes occurred, the service referred to health professionals for advice and guidance if required. All changes were well documented and recorded.
One person we spoke with told us, "It's uniqueness is its family environment, it has a warm and inviting atmosphere."
People who used the service and their family members or representatives, were asked for their views about the care provided and these were acted on by the provider.
Is the service effective?
People using the service that we spoke with said, or indicated to us, that the care and support provided was of good quality. From our observations we saw that care and support was effective and consistent. The staff demonstrated an in-depth knowledge of people living in the home.
People were supported to be as independent as possible. One person told us, "I'm off on holiday tomorrow, [the carer] helped me pack my bags and made sure I didn't forget anything."
We saw that staff knew the people they were supporting and caring for and that the people receiving the care and support were at ease in the presence of staff. We noted that if something was not right that staff responded quickly to resolve matters.
People told us, or indicated to us, that they liked living at Cranleigh and that staff were kind and caring.
Staff explained how they were able to communicate with people who were not able to express themselves verbally.
Is the service well led?
Views of people using the service and, where possible, their families were obtained. Staff told us that they felt supported and had received sufficient training to carry out their role effectively. They added that if they felt they needed further or additional training or support that they were confident this would be arranged by the provider.
There were quality monitoring systems in place and audits and spot checks took place to ensure that people received a good service.
Staff were clear about their roles and responsibilities. They spoke of how they worked as a team with the needs of the person central to the work they did.