CQC report explained · a residential care home
What the CQC found at Tigh Cranntail
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found detailed risk assessments, safe medicines systems, suitable staffing arrangements and effective infection prevention.
- Effective?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- The service was consistently managed and well-led. Inspectors found positive leadership, quality checks and an open culture, but some supervision records lacked detail.
What inspectors found, September 2021
Tigh Cranntail was rated Good; inspectors found safe, person-centred care and strong leadership, with some supervision records needing more detail.
This was an unannounced, focused inspection on 17 August 2021. It examined Safe and Well-led after concerns about governance and restraint at another service run by the provider, and concerns raised by the Local Authority.
Inspectors found people were protected from abuse and avoidable harm. Risk assessments and care plans were detailed, medicines were managed safely, and staff understood how to support people, including when physical intervention was needed as a last resort. Infection control arrangements were also found to be effective.
The home was led by an experienced and approachable manager. Relatives, staff and professionals gave positive feedback. The service had quality checks and improvement plans, although some supervision records contained very little information.
The overall rating remained Good. Safe improved from Requires Improvement to Good. Well-led remained Good. Effective, Caring and Responsive were not inspected during this visit, so their previous ratings were used in the overall rating.
Detailed risk planning
People had individual risk assessments and support plans. These explained the risks and the support staff should provide while promoting independence.
“People had detailed and person-centred support plans and risk assessments which were monitored and kept under review by the management team.” from the report
Safe medicines support
Staff were trained and checked before administering medicines. Medicines used when needed were monitored, and some psychotropic medicines had been reduced or stopped.
“Staff administering medicines were trained and their competencies were observed on five different occasions until they were signed off as competent to administer medicines.” from the report
Positive leadership
Staff, relatives and professionals were positive about the management. The manager was described as approachable and available to listen to concerns.
“Staff, external professionals and relatives were satisfied and complimentary about the leadership within the service.” from the report
Learning from incidents
Incidents, including restraint and medicines used when needed, were reviewed for patterns. The management team took action to reduce the chance of problems happening again.
“Incidents including the use of PRN medicines and physical restraint were regularly reviewed and analysed by the management team.” from the report
Infection prevention
Inspectors were assured that infection prevention arrangements were in place, including PPE, testing, cleaning and visiting procedures.
“We were assured that the provider was using PPE effectively and safely.” from the report
Supervision records
needs fixingSome staff supervision records had enough detail, but others contained very little information. The manager said senior staff would receive extra support and training.
“Some supervision records had sufficient details, where other supervision records lacked details and contained very little information.” from the report
Use of agency staff
minorThe service had experienced staffing issues and was using regular agency staff. Those staff received an induction and shadowed permanent staff, but families may want to check how this affects consistency.
“The service had experienced some staffing issues but had managed this by having regular and consistent agency staff.” from the report
- 01What has been done to make sure all staff supervision records contain enough detail?
- 02How many agency staff are currently working here, and how is consistency maintained for residents?
- 03How do you decide when physical intervention is needed, and how do you review each use?
- 04How are medicines used when needed monitored for effectiveness and possible underlying health issues?
- 05What was included in the weekly reports sent to the Local Authority, and is that reporting still required?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried over. This explanation was written from the published report of 18 September 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.
What inspectors found, July 2019
Rated Good overall; inspectors found kind, person-centred care, but medicines were not always managed safely.
This was the home's first inspection. It was unannounced and took place on 30 May 2019. One inspector spoke with staff and relatives and reviewed care records, medicines records, staff files and management records.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were rated Good. Safe was rated Requires Improvement because some medicines records were incomplete and checks had not found the errors.
Inspectors found comprehensive care planning, skilled and caring staff, good support for choice and independence, and strong involvement from families. The home supported people with learning disabilities or autism and had nine residents at the inspection.
Kind and skilled staff
Inspectors found that staff were caring, knowledgeable and committed. They worked creatively to help people achieve positive outcomes.
“People received caring and compassionate support from staff who had the appropriate skills and knowledge to carry out their role.” from the report
Personalised support
Care plans covered people's needs, preferences, communication and goals. Staff kept records updated when people's needs or treatment changed.
“Care records were 'live' document's which were constantly updated following changes in people's care successes with treatment plans, challenges or other incidents.” from the report
Strong staff training
Staff had induction, regular supervision and specialist training matched to the complex needs of the people living at the home.
“Staff had a comprehensive induction and training plan and shadowed more experienced staff when recruited to the service.” from the report
Incomplete medicines records
seriousSome medicines records were missing signatures, including two entries with no signatures. Staff initials were used without a matching sample of initials, making it difficult to identify who had given medicines.
“Some medicine requires two staff to sign when any medicine is administered.” from the report
Medicines audit did not identify errors
seriousThe home's audit system did not check the medicines that required two signatures. This meant the recording problems had not been identified through routine checks.
“However, this area of medicine was not included in the audit.” from the report
Recruitment records needed improvement
needs fixingThe appropriate DBS and identity checks had taken place, but the records were held at head office and it was not initially clear how the checks had been verified.
“Safe recruitment procedures were followed but some improvements were needed with regard to noting that DBS and proof of identity.” from the report
- 01What has changed to make sure every medicine administration record has the correct signatures or identifiable initials?
- 02How does the current medicines audit check medicines that need two staff signatures?
- 03How are DBS and identity checks now recorded so they can be clearly verified?
- 04How are people's care records kept up to date when their needs, treatment or behaviour changes?
- 05How are people and their families involved in decisions about activities, healthcare and care plans?
This was an unannounced inspection covering all five CQC questions, including the care provided and the home's premises, and it was the service's first inspection. This explanation was written from the published report of 9 July 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.
Every inspection of Tigh Cranntail
2 rated inspections over 2 years: the service has held its Good rating throughout.
- September 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019GoodSafe: Requires improvementWell-led: Good
- July 2017
Registered with the Care Quality Commission on 25 July 2017.
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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75 live-in carers within about an hour of Nottinghamshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 63 can care for a couple. 10 years' experience on average.
“Ernest is an amazing professional carer who delivers care from the heart.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.