Cornelius House

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 assessment we rated this key question good. At this assessment the rating has remained 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.

The registered manager had created an environment which focused on learning from incidents, fostering an open culture within the staff team who knew how to raise concerns. Staff told us they were confident issues they raised would be listened to and acted upon. One staff member said, “If something happens like a person has a fall, we have a procedure to follow, we check they are safe, then inform the shift leader who does post falls observations and contacts health professionals if needed, then we document what happened so we can review the details and look for a way to reduce the risk of the fall happening again.” A robust process was in place supporting the registered manager to review incidents and/or safety events which were then investigated, the system provided the registered manager with insights into trends and patterns helping them to focus their attention on areas affecting people’s safety. Lessons learnt were shared with the staff team alongside health professionals where appropriate and people’s care documents were promptly updated to reflect any changes. The provider proactively utilised external safety audits to drive continuous improvement, creating robust action plans to rectify compliance gaps and systematically monitoring progress to ensure actions had been completed.

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.

People were included in decisions about their care and the support they received, including when their needs changed. One person said, “They ask me how I am and if I need anything changing, if changes are made all of the staff seem to know about them.” Health professional input was sought when needed to promote people’s wellbeing, through speech and language therapists, GPs and others, depending on the support required. The registered manager listened to guidance provided by health professionals and updated people’s care documents, so staff had access to current information to inform the support they provided. The provider’s system had audits in place prompting the registered manager to carry out checks on people’s care documents which helped maintain accurate records, The system also alerted the registered manager to any missed actions in relation to people’s care helping to promote consistency in care delivery.

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.

Safeguarding policies and procedures were in place and available for staff to follow, staff understood their responsibilities around safeguarding and had received training. Staff told us, “It’s about making sure residents are safe including the environment, we need to make sure no unnecessary restrictions are in place and protect people from abuse if we see it. If you notice something isn’t right, it should be reported.”

The registered manager reported safeguarding concerns to the local safeguarding team and notified the Care Quality Commission (CQC) of any allegation of abuse providing oversight of the service from other professionals and CQC. People gave us consistent feedback about how they felt safe living at the service, one person said, “I feel very safe here.” And another person said, “The staff are very kind, and I know all of them, I feel safe and well looked after.”

Staff effectively mitigated safeguarding risks related to self-neglect by identifying where an individual’s daily presentation differed from their initial assessment. Staff utilized a personalized approach to sensitively engage the person, securing their consent and involvement to adjust their support plan. This tailored care enhanced the individual's safety, dignity, and overall well-being. One staff member said, “It’s about finding the right approach for each person. When we noticed their independence didn't match their current needs, we worked together to make changes they were happy to accept.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. The registered manager submitted Deprivation of Liberty Safeguards (DoLS) applications promptly to protect people who lacked capacity to consent to their care. People experienced the least restrictive care possible. Staff consistently met DoLS conditions, such as arranging annual medication reviews, to ensure care remained safe and lawful.

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.

People told us they had been involved in managing their specific risks around health conditions alongside other daily life risks. One person said, “I’m not as steady on my feet as I used to be, but I have a walking frame I use, and the staff know how to help me stay safe by having it close to me and keeping the place tidy, so I don’t trip.”

Staff knew the people they were supporting well and explained how risks affected people differently. Staff said, “For some people falling is a high risk, we can reduce the risk by walking with them and promote using walking frames and sticks, keep walking aids close to them so they can reach it when they need it.” The Registered Manager implemented a robust and comprehensive system for assessing people’s risks, ensuring each protocol was both highly detailed and contextually driven. Rather than issuing generic safety measures, the manager explicitly documented the clinical or behavioural "why" behind each individual risk, providing staff with the essential background needed to understand people’s unique hazards and risks around these hazards.

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 environment was checked for risks through an auditing process and where defects were found these were highlighted and rectified with action recorded. Staff could also raise concerns about the environment directly with the registered manager and senior members of the staff team; a maintenance log was kept of any issues reported.

Equipment used to support people with reduced mobility to change position was checked for safety compliance, in line with the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER). Other areas of the service had been checked for safety compliance by external providers with certificates in place for gas safety, electrical wiring and Legionella testing.

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 consistently told us about the quality of the training they were provided and how this gave them the information they needed to fulfil their roles. Training included dignity and personalised care, basic life support, equality and diversity, falls, balancing risks, learning disabilities and moving people safely among others. Staff also explained how they were supported to undertake professional qualifications including Diplomas in Adult Social Care. A staff member said, “I have recently become the oral care champion, and they have started me on a training course to increase my knowledge in this area.” A system was in place to track training levels which showed a high-level of compliance within the team. The registered manager and senior staff members completed assessments of staff competencies in various areas of practice, including manual handling, infection control and medication among others providing them with assurances training had been understood and used in practice.

An induction process was in place supporting new staff to get used to their roles, which included a shadowing period where they observed established staff supporting people with care alongside an opportunity to complete training before providing people with care unsupervised. A structured supervision process was in place ensuring all staff had the opportunity to discuss their strengths and any challenges they were facing in their roles which was overseen by the registered manager.

The registered manager recruited the staff team in line with the providers policy and used the provider’s dependency tool to inform staffing levels. Low staff turnover ensured people received consistent care from an experienced, familiar team. The provider successfully retained vital skills within the workforce by supporting long-term employment. Staff reported high job satisfaction, speaking unanimously about excellent opportunities to develop their skills and advance their careers.

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.

We observed the environment to be exceptionally clean and free of clutter whilst maintaining a homely feel. A dedicated domestic team had been recruited, who had access to the cleaning materials and followed a cleaning schedule. A staff member said, “We all play our part in keeping the home clean, it’s important for everybody’s health and wellbeing.” Staff had access to personal protective equipment (PPE) and had received training in infection prevention and control. An auditing system was in place showing high compliance levels. A dedicated staff champion for infection prevention and control was in place strengthening practice and adding additional oversight. Part of the champion’s role was to observe staff use of PPE ensuring this matched good practice and look for areas where practice could be improved.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

We observed medication administration reflecting good practice in line with the principles of the National Institute for Health and Care Excellence (NICE) guidelines. During medicines administration, staff approached people in a manner which supported their dignity and explained what the medicine was for. A person said, “They know what they’re doing and very professional about it.”

Staff were knowledgeable about people’s health conditions; the reason medicines were prescribed and their preferences. This included how people prescribed anticoagulant medicines required staff to respond following a fall. Training was in place and staff had their competency checked to ensure training was effective. A staff member commented, “I had full medication training and then shadowed an experienced team member before my competency was checked, we do this check yearly.” Another staff said, “After all of the training and shadowing I felt confident to support people with medication.” An electronic system was being utilised which staff described as, “Easy to follow.” This system flagged any missed or overdue medication helping to provide consistency in people’s experience. Detailed guidance ensured staff administered PRN (as-required) medicines consistently and safely.

An auditing process was in place which captured errors and identified themes supporting the registered manager to investigate; learning had been shared with the wider team to improve practice and reduce risks from reoccurrence.

The provider had identified areas where improvements could be made to the storage of medication and actioned this by creating a dedicated medication storage room which staff described as, “It’s better now we have everything in one place and helps to keep it organised.”