We carried out a review of the data available to us about Crann Mor Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Crann Mor Nursing Home, you can give feedback on this service.
Crann Mor Nursing Home is a care home providing personal and nursing care for up to 24 people. At the time of the inspection 19 people were living at the home. The home is set out over two floors and is located in a residential area of Woking, Surrey.
People’s experience of using this service and what we found
There were a range of checks in place to ensure the environment and equipment in the home were safe. We identified improvements could be made to how the risks associated with water temperatures were taken and recorded. We observed some radiators were uncovered and the risks associated with people coming into contact with them had not been assessed. Whilst the lead nurse reassured us there was no immediate risk to people, they told us they would ensure a risk assessment was completed.
We had not been notified by the provider of all events in line with regulatory requirements. The systems in place to monitor the service had not identified all of the shortfalls in the service.
Areas of the home were worn and in need of redecoration. The provider had an ongoing plan to address this.
People felt safe at the home and with the staff who supported them. There were adequate numbers of staff to meet people’s needs and keep them safe.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff respected people’s choices and preferences.
People were cared for by staff who were kind and compassionate. Staff were happy in their jobs which helped to provide a warm and relaxed environment for people to live in. People had built good relationships with staff and during the inspection we heard laughter and good-humoured banter.
People’s healthcare needs were identified and met. Staff worked with a range of healthcare professionals to meet people’s needs.
People were supported by caring staff who worked towards promoting their dignity and independence.
People felt confident to raise any concerns. People, their relatives and staff commented positively about the management of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
A registered manager was in post. 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.
Crann Mor Nursing Home is registered to provide the regulated activity of accommodation for persons who require personal care to a maximum of 24 people including some people living with dementia.
People and their relatives told us they felt the home was safe. They told us that staff were extremely kind and they had no concerns in relation to not being kept safe. Staff had received training in relation to safeguarding and they were able to describe the types of abuse and the processes to be followed when reporting suspected or actual abuse. The provider ensured that full recruitment checks had been carried out to help ensure that only suitable staff worked with people at the home.
Medicines were managed in a safe way and recording of medicines was completed to show people had received the medicines they required. Risks to people had been identified and documentation had been written to help people maintain their independence whilst any known hazards were minimised to prevent harm.
Staff had received training, supervisions and annual appraisals that helped them to perform their duties. New staff commencing their duties undertook induction training that helped to prepare them for their roles.
There were enough staff to ensure that people’s assessed needs could be met. It was clear that staff had a good understanding about people’s life histories, preferences and how to attend to people’s needs.
Where there were restrictions in place, staff had followed the legal requirements to make sure this was done in the person’s best interests. Staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way.
People were not prevented from doing things they enjoyed as staff had identified and assessed individual risks. The registered manager logged any accidents and incidents that occurred and discussed these with staff.
Staff supported people to eat a range of foods. Those with a specific dietary requirement were provided with appropriate food. People had access to external health services and professional involvement was sought by staff when appropriate to help maintain good health.
Staff showed kindness and compassion and people’s privacy and dignity were upheld. People were able to spend time on their own in their bedrooms and their personal care needs were attended to in private. People took part in a variety of activities that interested them. People’s relatives and visitors were welcomed and there were no restrictions of times of visits.
Documentation that enabled staff to support people and to record the care they had received was up to date and regularly reviewed. People’s preferences, likes and dislikes were recorded.
If an emergency occurred or the service had to close for a period of time, people’s care would not be interrupted as there were procedures in place. There was an on-call system for assistance outside of normal working hours.
A complaints procedure was available for any concerns and this was displayed at the home. No complaints had been received since the inspection of 2016.
Quality assurance audits to ensure the care provided was of a standard people should expect had been undertaken. Any areas identified as needing improvement were attended to by staff.
Staff informed that they felt supported by the registered manager and they had an open door policy and were approachable.
Documentation that enabled staff to support people and to record the care they had received was up to date and regularly reviewed. People and their relatives were involved in their care.
The provider undertook quality assurance audits to ensure the care provided was of a standard people should expect. Any areas identified as needing improvement were attended to by staff. People, relatives and associated professionals had been asked for their views about the care provided and how the home was run.
Crann Mor Nursing Home is registered to provide accommodation for persons who require nursing or personal care and who may be living with dementia for a maximum of 24 people. At the time of our inspection there were 21 people living at the service.
At the time of our visit a registered manager was in post. 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 premises and equipment used at the service had not been appropriately maintained. We found parts of the environment required repair and cleaning.
The environment did not support the independence of people living with dementia as there was a lack of signage in the key areas of the building including people’s bedroom doors.
We recommend that the provider researches and implements relevant guidance on how to make environments used by people who live with dementia more ‘dementia friendly’.
The home’s safeguarding procedures had not been reviewed since 2013 and had not been updated to include the latest national guidelines.
We recommend that the provider reviews their arrangements to keep people safe in line with current legislation and best practice.
People living at the home may have had their freedom of movement unnecessarily restricted. This was because the provider had not followed the Mental Capacity Act 2005 as decisions made were not specific to individual people.
The provider had failed to ensure people had their assessed needs met by staff. People had not received appropriate support, which included encouragement as well as physical support, when they needed it.
Formal processes for actively involving people in making decisions about their care and treatment were not in place.
We recommend that the processes for the involvement of people in the planning of their care and support in line with good practice are implemented at the home.
The registered provider had not maintained effective systems that were robust to assess, monitor and improve the quality and safety of the home.
People’s medicines were managed safely. Records and documentation were in place to ensure that people received their medicines as prescribed by their GP.
There were enough staff deployed to meet people’s needs. The provider carried out appropriate checks to help ensure they employed suitable people to work at the home.
Staff received training and regular supervisions that helped them to perform their duties. New staff received induction to the home which included training. However, staff had not always put their learning into practice that would ensure they delivered effective and responsive care to people.
Care records provided information to staff about people’s food and nutrition that also included people’s food preferences. However, People’s meal choices were limited and their preferences and dietary needs were not always taken into account.
People were supported by staff who were kind and friendly. There was a stable staff group employed at the home and this helped build positive relationships with people.
People were supported to attend to their appearance, many ladies were wearing jewellery that complemented their co-ordinated outfits and some gentlemen were freshly shaved.
People told us that they were treated with kindness and that positive, caring relationships had been developed between them and staff.
People told us there were activities at the home that they could choose to join in if they wanted to, although this was an area for improvement. We have made a recommendation about the provision of activities and occupation for people living at the service.
People and their relatives knew how to raise a concern or make a complaint. Compliments had been received from people’s relatives.
People expressed satisfaction with the management of the home. One person told us of the registered manager, “I see him every day”. A member of staff said of management, “It’s very good. The home runs very well”. We found, despite people’s positive views, this was an area that required improvement.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.