Background to this inspection
Updated
12 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We visited the service on 26 November 2018 and the inspection was unannounced. The inspection team consisted of one adult social care inspector and one specialist advisor who had a background in mental health needs.
Before our inspection we reviewed all the information we held about the service. We also examined notifications received by the CQC. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescales. We contacted professionals in local authority commissioning teams, safeguarding teams, clinicians and Healthwatch. Healthwatch are a consumer group who champion the rights of people using healthcare services.
During the inspection we spoke with five people who used the service. We observed interactions between staff and people who used the service throughout the inspection. We spoke with eight members of staff: the manager, the clinical lead, the nurse on duty, two support worker staff, the domestic assistant, the cook and the handyman. We looked at three people’s care plans, risk assessments, nine people’s medicines records, staff training and recruitment documentation, quality assurance systems, meeting minutes and maintenance records. Following the inspection we contacted three family members.
Updated
12 December 2018
Cragston Court is a care home that provides nursing and personal care and support for up to 20 adults with long term mental health needs. At the time of our inspection there were 17 people living at the home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The inspection took place on 26 November 2018 and was unannounced.
The service did not have a registered manager in place at the time of inspection. 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. The new manager was able to demonstrate they had begun the registration process with CQC.
People who used the service felt safe and at home in a welcoming and calm environment. Staff helped to ensure people felt at ease in their surroundings and their individualities were respected.
All staff demonstrated an understanding of people’s needs and knew how best to reduce the anxieties people faced. Specific risks were well managed and monitored through risk assessments which were regularly reviewed and contained input from external healthcare professionals. Risks to people’s finances were mitigated by robust procedures in place.
All aspects of medicines management were safe, including storage and disposal, administration and ongoing monitoring of ‘when required’ medicines. Areas where practice could be improved were proactively identified and addressed. Staff were suitably trained and knowledgeable with regard to medicines management.
There were sufficient staff to ensure people were safely supported.
The premises were well maintained and clean throughout.
Effective systems were in place to ensure the accurate documentation and update of people’s care needs. Staff understood these systems well and liaised effectively with external healthcare professionals.
People experienced good health and wellbeing outcomes thanks to the knowledge and actions of staff and their timely involvement of external professionals.
Staff received a range of mandatory training, which was refreshed regularly and appropriate to the needs of people who used the service. Training was well monitored and managed.
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.
The premises were well suited to people’s needs, with a range of quiet lounges and dining areas and a central outdoor garden space.
People were extremely complimentary about the care they received from staff and relatives were similarly impressed. Staff knew people extremely well, were able to anticipate their needs and concerns, and demonstrated genuine warmth towards them.
People were encouraged and enabled to take part in the planning of their care and the running of the service.
Activities were meaningful and varied and planned with people’s involvement. All staff helped organise and deliver these.
Residents’ meetings occurred regularly and were a forum for raising any ideas or concerns people may have about the running of the service.
Staff morale was high and the team worked well together.
The culture was strongly focussed on the needs of individuals and ensuring they had the opportunity to achieved good health and wellbeing outcomes in an environment they felt at home in. The new manager had embraced this culture and was keen to ensure the strengths of the service were maintained. All staff confirmed the management of the service was open, collaborative and approachable.
Further information is in the detailed findings below.