Cranbrook House, a domiciliary care agency in Redbridge, improved from Requires Improvement to Good overall, resolving a previous Regulation 12 breach by implementing comprehensive risk assessments and strengthening governance systems. All five key questions were rated Good, with inspectors finding person-centred care, well-trained staff, effective safeguarding processes, and a supportive management culture.
Strengths
· Sufficient risk assessments in place covering medical conditions, falls and skin integrity, resolving previous Regulation 12 breach
· Staff trained in safeguarding and understood how to protect people from harm and report concerns
· Pre-employment checks carried out including DBS, references, identity and right to work verification
· Systems in place to monitor timekeeping and minimise missed or late calls, with rotas issued in advance
· Staff completed induction, Care Certificate, regular supervisions and appraisals
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Staffing and recruitmentGood
safe: Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staff; continuous learning and improving careGood
well-led: How the provider understands and acts on the duty of candourGood
First inspection of this small domiciliary care agency found a breach of Regulation 12 because risk assessments were not in place for people with significant health conditions, falls or skin risks. While care was rated Good for effective, caring and responsive domains, governance audits had failed to identify these shortfalls, leading to Requires Improvement ratings for Safe and Well-Led.
Concerns (4)
criticalCare planning: “people with a history of heart attacks, breathing difficulties, diabetes and Parkinson diseases did not have a risk assessment in place.”
criticalCare planning: “one person was at risk of falls and skin complications, but risk assessments had not been completed to ensure these risks were minimised.”
moderateGovernance: “quality assurance processes were not robust to identify shortfalls and take prompt action to ensure people were safe at all times.”
moderateStaff competency: “staff were able to tell us the signs and symptoms of some health conditions but not others.”
Strengths
· Pre-employment checks including criminal record checks, references and identity verification carried out
· Staff completed Care Certificate training, induction with shadowing, and regular supervisions
· Staff were kind, compassionate and treated people with dignity and respect
· Care plans were person-centred with an 'All about me' section and reviewed regularly
· Safeguarding procedures and staff training in place; staff understood responsibilities
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of Life CareGood
well-led: Planning and promoting person-centred, high-quality care and support; and how the provider understands and acts on duty of candour responsibilityRequires improvement
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Continuous learning and improving careGood
well-led: Working in partnership with othersNot rated