Cornview

Cornview is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Care and support was provided for up to three people who have learning disabilities or autism. The primary aim at Cornview is to support people to lead a full and active life within their local community and continue with life-long learning and personal development. The home is a detached bungalow, within a residential area, which has been furnished to meet individual needs. At the time of the inspection there were three people living in the home. One person had their own en-suite bedroom which had been specially adapted to meet their needs. There were two other bathrooms located adjacent to other people’s bedrooms which they regarded to be theirs. There was a rear garden to which people had constant access.

The care service has been developed and designed in line with the values that underpin the 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 the service can live as ordinary a life as any citizen.

There was a registered manager in place. 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.

At our last inspection in January 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The provider had policies and procedures in place designed to protect people from abuse and staff had received safeguarding training. Risk assessments identified when people were at risk and action was taken to minimise the risks. People’s needs were met by suitable numbers of staff who knew people’s needs well. Medicines were stored safely and people received their medicines as prescribed.

People were supported by staff who had received relevant induction and training to enable them to support people they worked with. Staff supported people to eat and drink enough and to maintain a balanced diet. The environment met people’s needs. People had access to healthcare services when necessary. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by staff who cared about and valued them. People were supported to express their views and be involved in making daily decisions about their care and support. Staff spoke respectfully about people, were mindful of people’s rights to make choices and were aware of people’s need for privacy and dignity.

People were supported in ways which met their individual needs. People had support plans in place which covered many different aspects of their lives. People undertook a range of activities of their choosing. The provider had a complaints procedure in place.

The registered manager had a clear vision to run the home for the benefit of people living there. People, their relatives and staff were engaged and involved in how the home was run. The quality of care people received was continually assessed to ensure it was maintained. The service worked in partnership with other professional agencies.

Further information is in the detailed findings below.

At the time of the inspection there were three people living in the home. One person had their own en-suite bedroom which had been specially adapted to meet their needs. There were two other bathrooms located adjacent to other people’s bedrooms which they regarded to be theirs. There was a rear garden to which people had constant access.

The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 previous registered manager had just left the home, their last day being 31 December 2015. A registered manager from within the provider’s care group had already been appointed to replace them. The new home manager had already commenced the administrative process to become the registered manager of Cornview and was present during our inspection.

We observed staff provide reassurance when people were anxious and made them feel safe. One person required their own space and often sought tranquillity in their bedroom when their anxieties increased. On such occasions staff supported the person discreetly, ensuring they were safe in accordance with their support plan.

Staff had completed safeguarding training and had access to current guidance and legislation. Staff had identified and responded appropriately to potential safeguarding incidents to protect people from harm. People were safeguarded from the risk of abuse as incidents were reported and acted upon. People benefited from a safe service where staff understood their safeguarding responsibilities.

Staff were able to demonstrate their understanding of the risks to people’s health and welfare, and followed guidance to manage them safely. Risk assessments were in place to support people safely, whilst promoting their freedom of choice and independence. The provider managed environmental risks safely by ensuring all utilities were serviced regularly. The home manager and designated staff ensured the home complied with relevant legislation regarding fire safety, control of substances hazardous to health and infection control.

There were arrangements in place to keep people safe in an emergency. Staff understood these arrangements and knew where to access the information.

There were sufficient numbers of staff deployed with the necessary experience and skills to support people safely. The registered manager and positive support coordinator completed a daily staffing needs analysis in order to ensure that any changes in people’s needs were met by enough suitable staff.

Staff had undergone required pre-employment checks, to ensure people were protected from the risk of being supported by unsuitable staff. Staff had received an induction into their role, required training and regular supervision which prepared them to carry out their roles and responsibilities. People were cared for by sufficient numbers of well trained staff who were effectively supported by the registered manager and senior staff.

People received their medicines safely, in the way they preferred, administered by staff who had completed safe management of medicines training. Staff had their competency to administer medicines assessed annually by the registered manager. People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles effectively.

People were supported to make their own decisions and choices. Staff supported people to identify their individual wishes and needs by using their individual and unique methods of communication. People’s human rights were protected by staff who demonstrated clear understanding of consent, mental capacity and deprivation of liberty guidance and legislation. Records demonstrated that a process of mental capacity assessment and best interest decisions promoted people’s safety and welfare when necessary.

People can only be deprived of their liberty to receive care and treatment when this is in their best interest and legally authorised under the MCA 2005. The application procedures for this in care homes are called the Deprivation of Liberty Safeguards (DoLS). The home was working within the principles of the MCA 2005. Paperwork associated with DoLS applications demonstrated the provider had taken the necessary action to ensure people’s human rights were recognised and protected.

Staff supported people to promote their independence. The provider had deployed sufficient staff to provide stimulating activities for people and to access the community and protect them from social isolation.

People had access to information about how to make a complaint, which was provided in an accessible format to meet their needs. Complaints and concerns were taken seriously

People were provided with nutritious food and drink, which met their dietary preferences and requirements. Where people had been identified to be at risk of choking staff supported them discreetly to minimise such risks, protecting them from harm and promoting their dignity.

People’s dignity and privacy were respected and supported by staff who were skilled in using individual’s specific communication methods. Staff were aware of changes in people’s needs, and took prompt action to promote their health and wellbeing by making referrals to relevant health professionals.

We observed people appeared relaxed and happy in the company of staff who they readily approached for company and support when required. People were treated with kindness and compassion in their day-to-day care by staff who knew them well. The relationships between staff and people receiving support demonstrated dignity and respect at all times.

and used as an opportunity to improve the service. There had been two complaints since our last inspection, which had been investigated thoroughly and resolved to the satisfaction of the complainants.

The previous registered manager, home manager and positive support coordinator had developed the staff team to consistently display appropriate values and behaviours towards people. Staff told us they enjoyed working at Cornview because the management team made them feel valued and part of a team where everyone’s opinion mattered.

The provider had established an effective system to assess and monitor the quality of care people received and to ensure people’s positive lifestyles were maintained and improved.

Records accurately reflected people’s needs and were up to date. Detailed care plans and risk assessments were fully completed and provided necessary guidance for staff to provide the required support to meet people’s needs.

People living at Cornview had complex needs and were not able to tell us what they thought about the support and care provided. We were able to observe staff being responsive to the needs of the individuals in a respectful and supportive way that was in keeping with their care and support plans.

People's care plans detailed how they wanted their needs to be met and supported the choices they had made. People's health and social care needs were reviewed and met to promote their wellbeing.

Staff had received the training and support they needed to support the people who used the services. These included professional qualifications.

People and their relatives or advocates had opportunities to contribute their views about the quality of the service and who to contact should they have a concern or complaint about the services provided. The home had processes in place to promote the safety of the home and to monitor and improve outcomes for people who used the services.

We were able to observe staff being responsive to the needs of the individuals in a respectful and supportive way that was in keeping with guidance in the support plan. We saw staff supporting individuals to access different areas of their home which included their bedrooms or the dinning room.

Each person living at Cornview had a personalised communication folder. Each folder contained pictures to support the individual to make choices about their wishes and preferences.

Staff were quick in their response to individual's requests and we observed one person requesting a massage which staff responded to.

People were supported to access their local community with links being established between Cornview and local facilities.

The provider had effective monitoring systems in place to identify, assess and manage risks to the health, safety and welfare of people who use the service. We saw that senior management undertook regular checks to ensure the quality of service provision.

People were cared for by staff who were supported to deliver care and treatment safely and to appropriate standard. Staff we spoke with told us that they had access to regular supervision and training. They also told us they they felt comfortable with raising any concerns and that they felt supported and listened to.