About the service:

Crann Dara is a residential care home for people with learning disabilities. The home can accommodate up to seven people. At the time of the inspection there were six people living at the home. People at the home had a range of disabilities.

People’s experience of using this service:

People were not supported or cared for as they should have been. Although staff were aware of risks to people’s safety, the risks were not always monitored or managed properly. There were frequently days when there were not enough staff to safely care for the people living at the home. Medicines were not always managed safely or audited to ensure quality compliance.

Best practice and guidance was not always followed or adhered to. The care service had not been developed, designed or maintained in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using this service were not able to live as ordinary a life as any citizen.

People were not always supported to see medical professionals routinely. People did not have access to a range of apetising options for meals. People’s rights were not protected as the service did not comply with legislation. People were not cared for by staff who received frequent training.

People were not always treated with respect, compassion or kindness. There was little person-centred care which enabled people to take part in meaningful activities. People had no information regarding their end of life care preferences.

The home was not managed or led well. The processes in place to monitor the quality of the service were ineffective. There was no plan or strategy to improve or develop the service. The registered manager didn’t work with agencies, organisations or staff to deliver high quality, person-centred care.

People were supported by staff who respected their independence and privacy. People had access to a large, open home which was surrounded by a beautiful garden.

During our inspection we found seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and made one recommendation. You can see what action we told the provider to take at the back of the full version of the report. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Rating at last inspection:

This service was rated ‘Good’ in July 2016

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

Enforcement

The overall rating for this service is ‘Inadequate’ and the service has therefore been placed in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enfor

The inspection took place on 4 August 2016 and was unannounced. This was a comprehensive inspection.

Cran Dara is registered to provide accommodation with personal care for up to seven people. On the day of our inspection there were seven people living at the home. Cran Dara supports people with learning disabilities; some people also had physical disabilities.

The home had a registered manager 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.

Staff understood their role in safeguarding people. They had received training and demonstrated a good understanding of how they would protect people from abuse of potential harm. Staff routinely carried out risk assessments and created plans to minimise known hazards whilst encouraging people’s independence.

We found that policies and procedures were in place to keep people safe in the event of emergencies. People had individual plans to keep them safe in the event of an emergency and there were contingency plans in place.

People were administered their prescribed medicines by staff who had received medicines training. Medicines were stored safely and systems were in place to ensure medicine stock could be monitored and audited.

Staff training was tailored to the individual needs of people who live at the home. Staff told us that they had good access to training and people and relative told us that staff were effective in their roles.

Staff provided care in line with the Mental Capacity Act (2005). However, we noted one instance where records required updating.

Staff followed the guidance of healthcare professionals where appropriate and we saw evidence of staff working alongside healthcare professionals to achieve outcomes for people.

People told us that they enjoyed the food and we saw evidence of people being provided with choice and also being involved in writing menus.

Staff treated people with dignity and respect. All caring interactions that we observed were positive and staff demonstrated a good understanding of how to respect people’s dignity.

Information in care plans that reflected the needs and personalities of people that we spoke to. People had choice about activities they wished to do and staff encouraged people to pursue new interests.

People were given the opportunity to provide feedback on the care they received through residents

meetings and keyworker sessions. We saw evidence that issues raised by people were responded to by management.

Staff told us that they were well supported by management and had regular supervision. People and relatives told us that they had a positive relationship with the registered manager.

People’s records were kept up to date and stored securely.