Cranley Gardens

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People and relatives were encouraged and supported to raise safety concerns with staff and managers. Staff understood the importance of reporting safety concerns. A staff member told us, “The [registered manager] is always telling us to speak up and raise issues.” Systems were in place to support staff to report and record safety concerns and events when these arose. Managers investigated safety concerns and events and used the learning from these to support staff to continually improve their practice, reduce risk and keep people safe. The registered manager told us, “We try to acknowledge that mistakes can be made but we can learn from these and improve.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Information was obtained from people, and others involved in their care, about people’s individual needs and risks to their safety. This was used to develop individualised care and risk management plans to ensure people received safe and appropriate care and support from the moment they started to use the service. A healthcare professional, who supported one of the people using the service, told us staff consistently followed the person’s care and risk management plans which enabled the person to safely carry out an activity that they enjoyed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People were comfortable and at ease with staff, and with each other, at the service. The atmosphere at the service was calm, relaxed, friendly and homely. Staff were attentive and alert to any changes that might indicate people needed support for any anxiety or discomfort they might be experiencing. A relative told us, “I think they are very good at keeping [family member] safe.” A healthcare professional said, “It really feels like a home and it’s my favourite place to go there. It's a real home and they live like a family and people are relaxed but kept safe.” Staff and managers understood how to safeguard people and systems were in place to help them make timely referrals to the relevant persons and agencies. Managers worked proactively with the relevant agencies, when a concern was raised, and took appropriate action to safeguard people from further risk, when this was required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff made sure risk to people was mitigated so that people remained safe when taking part in activities and events of their choice, at home and in the community. When at home, people moved freely around and spent their time as they wished, with no unnecessary restrictions. Staff were aware of where people were and remained present and available in case people required their assistance. People’s records contained current information and guidance for staff on how identified risks should be managed to keep people safe. A staff member told us, “The risk assessments are in people’s care plans…the risk assessments tell us what the risks are to people and what we should do to keep them safe.” Systems were in place to ensure risks to people were continually assessed, monitored and reviewed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider had made improvements since our last inspection and no longer in breach of regulations. Restrictors had been placed on first floor windows which reduced the risk of people falling from height. The garden was now more secure and reduced risk to people who needed support to stay safe in the community. Fire safety had improved as fire risk assessments were undertaken annually and managers ensured recommendations were acted on to maintain people’s safety. The environment was free from unnecessary slip or trip hazards. Safety systems and equipment was maintained and serviced at regular intervals.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff were trained and supported to meet the range of people’s individual needs, in line with their choices and preferences. A relative told us, “They seem to have a good team there.” Another relative said, “I think the staff team are better and know what they are doing.” Staff had enough time to undertake their duties and provide people with the care and support they needed. Managers made sure people received care and support from the same staff where possible to maintain consistency in people’s care and support and daily routines. Staffing rotas were planned based on people’s dependency and individual needs. Staff were supported with their learning and development needs and encouraged to continually improve in their role. The provider operated safe recruitment practices and only suitable staff were employed to work at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People were supported to live in a clean, hygienic environment. A healthcare professional told us, “It’s very clean and there are no issues with that.” Staff received relevant training and knew the processes to follow to minimise the risk and spread of infection. Staff had access to resources and equipment to help them reduce infection risks. Staff maintained cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks. The provider’s infection prevention and control policy was current and reflected national guidance.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines safely and as prescribed. Medicines stocks, balances and records showed people consistently received the medicines prescribed to them. Staff received relevant training and were clear about their roles and responsibilities in relation to the safe management and administration of medicines. There were regular audits of medicines at the service. This included checks of staff’s practice to ensure they remained competent and safe to administer and manage medicines.