CQC report explained · a residential care home
What the CQC found at Cranleigh
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Staff understood safeguarding, risks were generally assessed, medicines were managed safely and there were enough staff. One person did not have a falls risk assessment.
- Effective?
- Good
- People received suitable assessments, staff training and support to access healthcare. Mental capacity assessments had not always been completed, although care was being provided in line with the Mental Capacity Act.
- Caring?
- Good
- People described staff as kind and caring. Inspectors saw warm interactions, respect for privacy and support for people's choices and independence.
- Responsive?
- Good
- People had personalised support and were helped to maintain hobbies, relationships, holidays and community activities. Some care plans did not contain the most up-to-date information, and end of life preferences were not recorded in care plans.
- Well-led?
- Good
- The home had experienced leadership, monthly quality checks, regular meetings and an open approach to feedback. Inspectors found staff committed to person-centred care.
What inspectors found, May 2019
Cranleigh was rated Good; inspectors found safe, kind and person-centred care, with some records needing improvement.
This was a planned inspection of the whole home. One inspector reviewed information held by the CQC, two care files, three recruitment files and other records. They spoke with two people living there, the manager and two staff members.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable safeguarding arrangements and a clean, well-maintained environment.
People were supported to make choices, stay independent and take part in hobbies, holidays and community activities. Staff were described as kind and caring, and the home had systems for monitoring quality and acting on shortfalls.
Inspectors identified some gaps. Capacity assessments had not always been completed, one person did not have a falls risk assessment, some care plans were not up to date, and end of life preferences were not recorded in care plans. The overall Good rating was unchanged from the previous inspection.
Person-centred support
People received support designed around their choices, needs and interests. They were helped to live as independently as possible.
“People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them.” from the report
Kind and respectful staff
People spoke positively about staff. Inspectors observed warm, empathic interactions and respect for privacy.
“There was a friendly atmosphere in the home and our observations showed staff engaged with people in a warm and empathic way.” from the report
Safe medicines and staffing
Medicines were stored, checked and audited. Staff received medicines training and there were enough staff to meet people's needs.
“Medicines were stored securely and stock checks of people's medicines were carried out weekly to ensure people had received them correctly.” from the report
Community involvement
People were supported to continue hobbies, attend local activities, visit family and take holidays.
“People were also supported to take part in their local community.” from the report
People's involvement
People took part in care decisions and regular meetings about the home. They could give feedback and were involved in some staff interviews.
“People had regular meetings, one person said, "We have resident's meetings, we talk about any problems, about holidays, where we'd like to go.” from the report
Capacity assessments
needs fixingMental capacity assessments had not always been completed to show which decisions people could make for themselves. The manager said these would be completed.
“People's capacity to make decisions had not been assessed.” from the report
Falls risk record
needs fixingOne person did not have a falls risk assessment. Inspectors said the person was nevertheless being supported in a way that reduced the risk.
“Individual risks to people had been identified and detailed assessments were in place but we found a falls risk assessment was not in place for one person.” from the report
Care plan updates
needs fixingSome care plans did not contain the latest information about people's care needs. Families should ask how records are reviewed when needs change.
“Some people's care plans did not always contain the most up to date information about their care needs.” from the report
End of life preferences
minorCare plans did not record people's end of life preferences, although the manager knew some people's wishes and discussions had taken place after a bereavement.
“There was nothing in people's care plans about their end of life preferences however, the registered manager was able to tell us about the end of life wishes for some people.” from the report
- 01Have all residents now had mental capacity assessments for decisions they may not be able to make themselves?
- 02How do you record and review falls risks, particularly for the person who did not have a falls risk assessment?
- 03How often are care plans updated when a person's needs change?
- 04How do you record each person's end of life wishes and make sure these are reviewed?
- 05How often are staff supervisions held now, given that the manager planned to make them more frequent?
This was a planned inspection of the whole home, covering all five CQC questions and both the premises and care; the previous overall rating was Good. This explanation was written from the published report of 3 May 2019 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, October 2016
Cranleigh was rated Good overall; inspectors found kind, safe and person-centred care, but the home needed to improve its checks on quality and medicines competence.
The inspection was announced and took place on 11 August 2016. One inspector spoke with three people living in the home, the manager and two support staff. They reviewed three care records, medicines records for three people and records about how the home was managed.
Inspectors found that people felt safe and were treated with kindness. Staff understood safeguarding, recruitment checks were completed, medicines were stored and given safely, and there were enough staff. People were supported with food, healthcare, activities, choices, independence and contact with family and friends.
The main weakness was how the home checked its own quality. There was no formal audit programme for care plans, medicines or environmental risks, and staff meetings and some resident meetings were not regular. The overall rating was Good, with Safe, Effective, Caring and Responsive rated Good. Well-led was rated Requires Improvement.
Individual risk planning
Risks were assessed in a person-centred way and updated when people's needs changed. People were involved in discussing their risk assessments.
“Risk assessments were person centred and specific to people's individual needs.” from the report
Kind and respectful care
People told inspectors they were happy and cared for. Staff were observed talking and laughing with people and treating them respectfully.
“During our inspection we saw staff sitting and talking and laughing with people in the lounge.” from the report
Personalised support
Care plans recorded people's needs, preferences and the support staff should provide. People were involved in planning their care.
“Care plans were person centred and gave staff detailed guidance on how these needs were to be met.” from the report
Activities and community life
People were supported to choose activities and maintain links with their local community. They attended activities including a day centre and a monthly disco.
“People were supported to maintain links with the local community and attend regular activities of their choice.” from the report
Weak quality checks
needs fixingThe home had no formal auditing programme for care plans, medicines or environmental risks. Incidents were recorded but not analysed for patterns, so wider problems might not be identified.
“We found that the service did not have any systems in place to monitor the quality of the service.” from the report
Limited staff supervision
needs fixingSome staff had not received formal supervision during the year and staff said they had not received it for several months. They still felt supported by the manager.
“We looked at the supervision records for staff and noted from the records that some staff had not received any supervision this year.” from the report
- 01What formal checks are now used to monitor care plans, medicines and environmental risks?
- 02How do you record and review staff competency in handling and administering medicines?
- 03How often do staff receive supervision, and how is this recorded?
- 04How are incidents reviewed to identify patterns or repeated risks?
- 05How often are meetings held with people living in the home and with staff?
This was an announced inspection covering all five key questions, with three care records, medicines records for three people and management records reviewed. This explanation was written from the published report of 6 October 2016 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 Cranleigh
2 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 January 2011.
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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