Archived: Cranmore House

We spoke with seven people, five staff members and two representatives for the provider.

The provider had appointed representatives to manage the service on their behalf. They had only been in day to day management for just over a week when we inspected. We saw that some improvements had already been made. New care records were in the process of being implemented so that staff had the information needed to meet people's needs and keep people safe. These improvements needed to be in-bedded and sustained so people received safe and effective care.

We saw that some activities had taken place so people's wellbeing was promoted. Most interactions we saw between people living there and staff were polite. However we also saw some staff practice that was not caring and did not up hold the dignity and respect of the people living there.

The training and support staff needed so that they could do their job competently and ensure that people were safe had not been provided.

At this inspection we only monitored compliance with the two warning notices. We did not look at progress with meeting the two compliance actions that had also been made following the inspection on 25 July 2013. Additional inspections will take place to monitor compliance with these.

We spoke with the acting manager, five staff and four people living at the home and a visitor.

We observed the way that staff interacted with people. Staff were respectful to people and spoke kindly to people. We saw that people were not rushed and staff gave assistance to people when they needed it. One person we spoke with told us, "I am fine and the staff are good".

We looked at the communal areas of the home, toilets and bathrooms and saw that the home was clean and systems were in place to prevent the risk of infection.

The provider had made progress with meeting the warning notices. Quality assurance systems were in the process of being implemented and improvements had been made so that people were benefitting from a service where risks were managed.

We carried out the inspection to monitor whether the provider had complied with a previous compliance action that we made in May 2013. We had also had concerns shared with us by Birmingham City Council.

We saw that interactions between people and staff were friendly and polite. Two people told us, 'The staff are great' and 'I can't fault the staff'. One person told us, 'I am bored' and another person said, 'I don't really have anyone to speak with here'. During our visit we saw no activities taking place, although two people enjoyed spending some time in the garden.

We saw records that identified risk to people and we were told what staff must do to keep people safe. However we saw that this was not carried out in practice so people were placed at risk of harm.

We saw that parts of the home were not clean and systems were not in place to prevent the risk of infection.

Staff had not had all the training they needed to meet people's needs and keep people safe.

Quality assurance systems had not been fully implemented and were not effective in identifying areas that had needed improvements and action had not been taken to minimise risks to people.

We saw that people were involved in their care planning and making choices about what they wanted to eat and drank. We saw people being supported to do some activities supported by staff.

The home assessed, planned and delivered care that met people's individual needs. There were appropriate risk assessments in place to maintain the safety of people.

The home took steps to prevent abuse by ensuring staff had the appropriate training. This helped staff recognise the signs of abuse, understand the safeguarding processes and whistle blowing procedures.

We saw appropriate recruitment procedures were in place to ensure people's health and welfare needs were met by competent staff. The manager had started to implement regular supervision and appraisal of staff.

The home was ensuring that the premises protected people's rights to privacy, dignity and safety.

The home had started to develop a quality assurance system to monitor the quality of service that people received. However, they were not robust enough to ensure continual improvement in the home.

The home did not assess, plan and deliver care that met people's individual needs. Care plans were not reviewed regularly and risk assessments were not always in place. Where there were risk assessments in place they lacked information as to how these should be managed so staff did not have the information they needed to meet people's needs in a way that they preferred

Staff spoken with did not always have had a good understanding of people's individual preferences and what their likes and dislikes were in respect of daily activity so that people received care in the way they prefer.

The premises did not always ensure that peoples rights to privacy, dignity, choice and safety was protected.

There was no record of any staff training including safeguarding. However, staff had some understanding of how to safeguard people from harm. Staff felt confident that if they had to report any abuse, action would be taken to protect people.

Despite some of the concerns, people were very complimentary about staff and the efforts they make to meet their needs. People told us they were happy living at the home and felt safe. One person said "I feel safe here, staff are very nice". Relatives told us they had no concerns and were happy with the care provided. One relative we spoke with said 'I have no concerns at all'.