CQC report explained · a residential care home
What the CQC found at Cranbourne House
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
What inspectors found, September 2023
Requires Improvement; inspectors found risks and management systems were not always handled safely or reliably.
This was an unannounced focused inspection on 14 June 2023 and 26 June 2023. Inspectors observed care, spoke with people, relatives and staff, and checked care, medicine, recruitment and management records.
The home was rated Requires Improvement overall, with Safe and Well-led also rated Requires Improvement. Risk management was unreliable when people were distressed or agitated. Incidents were not always recorded, investigated quickly or reviewed so lessons could be learned.
There were also positive findings. Care plans were detailed, people were supported with activities and staff were usually kind. Infection prevention had improved since the last inspection, and the previous breach in this area had been resolved. The home remained Requires Improvement for the second consecutive inspection.
Detailed care plans
Care plans reflected people's individual needs, preferences and positive risk-taking.
“Risks associated with people's care were person-centred and regularly reviewed.” from the report
Person-centred activities
People were supported to take part in activities suited to them.
“People were enabled to carry out person-centred activities.” from the report
Improved infection control
The previous infection prevention and control breach had been resolved. Inspectors were assured about infection prevention, protective equipment and managing outbreaks.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12(1)(2).” from the report
Safe recruitment
The provider carried out appropriate checks before staff started work.
“Staff were recruited safely. The provider carried out appropriate checks to make sure staff were suitable before they started working at the service.” from the report
Incidents and risks
seriousIncidents affecting people's safety were not always reviewed or monitored. This meant risks might not be identified and addressed promptly.
“Incidents that affected the safety and welfare of people using the service were not always reviewed and monitored which meant the provider did not do all that was reasonably practicable to mitigate risks.” from the report
Weak oversight
seriousThe home's systems did not reliably identify or manage risks. Records about behaviour were completed inconsistently and were not always reviewed.
“The provider did not ensure robust systems and processes were in place to assess, monitor and mitigate all risks relating to the health, safety and welfare of people who used the service.” from the report
Inconsistent records
needs fixingRecord keeping did not always support good care. Some wording used in care records was inappropriate and some positive behaviour support refresher training was overdue.
“Record keeping did not always support high quality care and was inconsistent.” from the report
Pain relief timing
needs fixingStaff did not always leave the recommended gap between doses of pain relief. The manager acted immediately when inspectors raised this.
“We saw staff did not always leave the recommended gap between the administration of doses of pain relief.” from the report
- 01How are incidents and concerns recorded, including those mentioned in daily notes and handovers?
- 02How do you check that incidents involving distress or agitation are investigated quickly and that lessons are shared?
- 03How are behaviour monitoring charts completed and reviewed now?
- 04Has all overdue positive behaviour support refresher training been completed?
- 05What progress has been made with the planned electronic care planning and reporting system?
This was a focused inspection of Safe and Well-led only; the other question ratings were carried over from the last comprehensive inspection on 24 July 2019. This explanation was written from the published report of 16 September 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2021
Heathcotes Cranbourne House was rated Requires Improvement; inspectors found infection-control failures and inconsistent leadership, although care was kind and person-centred.
This was an unannounced focused inspection after concerns that people might not be protected from abuse. Inspectors looked only at Safe and Well-led. They visited the home, observed care, spoke with people, relatives, staff and professionals, and checked care, medicines and management records.
The home was not always safe because some staff did not follow COVID-19 infection-control guidance. Masks were not always worn properly, fabric masks were used, and inspectors did not see the enhanced cleaning that managers said was taking place. This was a breach of Regulation 12.
There were also concerns about teamwork, communication and whether recent improvements had become established. However, medicines were generally managed safely, staffing levels and recruitment were suitable, and people received respectful, individualised care. The overall rating fell from Good at the previous inspection to Requires Improvement.
Person-centred support
People had detailed care plans and were supported with dignity, privacy, independence and their own interests. They were involved in daily life at the home and in planning activities.
“People received person-centred care which promoted their dignity, privacy and human rights.” from the report
Suitable staffing
Inspectors found enough staff on duty to support people safely. Recruitment checks were in place to ensure staff were suitable.
“Recruitment procedures were in place to ensure only staff suitable to work in a care setting were employed.” from the report
Medicines
Medicines were organised and people received them when they should. Staff were trained and their competence was checked.
“Medicines systems were organised, and people were receiving their medicines when they should.” from the report
Safeguarding awareness
Staff understood different types of abuse, knew how to report concerns and were aware of whistleblowing arrangements.
“They understood the different forms of abuse and were able to tell us how they would report concerns.” from the report
Infection control
seriousSome staff did not follow the provider's COVID-19 policy or government infection-control guidance. Masks were not always worn correctly, and inspectors did not see cleaning taking place during the visit.
“Staff did not always follow the provider's COVID-19 policy or infection prevention and control guidelines set out by the government.” from the report
Inconsistent staff practice
needs fixingSome staff had limited knowledge of people's detailed care plans. This meant support was not always consistent.
“However, some staff had limited knowledge of the detailed information in people's plans. This meant people were not supported consistently.” from the report
Teamwork and communication
needs fixingStaff reported continued examples of cliques and poor communication. Inspectors could not be sure that the provider's recent changes had become part of normal practice.
“Changes had been introduced but we could not be assured this had been embedded into future practice.” from the report
Medicines records
minorSome recently introduced medicines had handwritten records that were not double-signed. The manager said this would be addressed.
“Where medicines had been recently introduced there were some hand-written entries. They had not been double signed.” from the report
- 01What specific changes have been made to mask use, cleaning checks and infection-control supervision since the inspection?
- 02How do you now check that staff understand and follow each person's detailed care plan?
- 03What evidence can you show that the changes to rotas, handovers and staff supervision have improved teamwork?
- 04How are handwritten medicines records checked and double-signed when new medicines are introduced?
- 05How will the management change and handover be monitored to make sure leadership remains consistent?
This was a focused inspection of Safe and Well-led only; the other key-question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 5 January 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Cranbourne House
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- August 2019GoodSafe: GoodWell-led: Good
- November 2018
Registered with the Care Quality Commission on 14 November 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £980 to £1,250 a week. 87 can care for a couple. 12 years' experience on average.
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