Cornerstone Professional Care Ltd

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.

This is the first assessment for this service. This key question has been rated Good

Good: This meant people were safe and protected from avoidable harm.

This service scored 72 (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 did not always have a proactive and positive culture of safety. Lessons were not always learnt to continually identify and embed good practice.

The provider did not have a robust system to learn lessons from previous experiences to improve the service. For example, audits were not robust and the registered manager did not have full oversight of how audits are conducted and lessons learnt from any concerns. Staff conducted audits on their own work, and this was reviewed by unit managers who reported concerns to the registered manager. This meant that the registered manager did not have full oversight of the care plan and medicines quality systems. This could place people at risk, should the registered manager not be aware of any trends in areas such as medication errors.

However, our inspection did not find any errors due to poor auditing. The registered manager made changes following our feedback and has implemented an action plan that is robust and has provided us with assurance that audit systems will be improved.

A social work professional told us the service worked with them to ensure the continuity of people’s care. They said, “This is a good service. The [registered manager] always makes appropriate and timely referrals and seeks help when needed with good communication. They will really stick up for the people they service if extra support is needed.” Staff told us the relevant information was shared with them about people’s needs to manage risks and ensure continuity of care.

People, and others involved in their care, were involved in the assessment of individual needs and risks to their safety. This information was used to develop individualised care and risk management plans to ensure people received safe and appropriate care. Staff knew people’s care needs and associated risks well. Staff monitored people’s changing needs closely and reported changes to senior staff so appropriate referrals could be made to the relevant agencies.

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 and families told us that 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, “[Person’s name] are safe and well cared for. Staff know what to do if they are upset or unhappy about something.” Staff had received appropriate Safeguarding training and were able to tell us how to report any concerns as well as understanding their own responsibilities. The service did not have anyone living a under community Deprivation of Liberty Safeguards (DoLS) protection, however the registered manager had considered people’s needs during the initial assessment and at reviews with those who had a social worker.

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.

The registered manager and their senior team worked with people to understand and manage risks. A family member told us, “[Name of registered manager] always discusses risks with us, such as going outside and how they will manage any issues.” People had care plans reviewed with them and their families in a manner that was inclusive and easily understandable. For example, simple language was used in care plans, such as, ‘[name of person] may not want to wash every day, staff are to try to persuade them using language such as ‘how about just the face’. People told us that they ‘loved’ the fact that the service had regular staff and these staff got to know people well.

The provider made sure equipment, facilities and technology supported the delivery of safe care.

People told us that staff moved trip hazards out of the way during calls to ensure people could get around their home easily and safely. They also ensured medication was correctly stored in fridges where required or in a safe place such as a cupboard.

he 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 had enough time to 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. 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.

A relative told us, “[Person’s name] is very well looked after, by excellent staff who know their needs well.” A person told us, “The staff are caring, kind and very approachable. They are easy to talk to and make me laugh. I love to have a laugh and joke with them.” Another person told us, “I wish this company provided care to my husband who passed away. He would have really enjoyed the way staff look after us.”

Staff understood and managed risks. We saw from staff files that staff received competency reviews on an annual basis and all training was complete and detailed. However, some staff did not fully understand the ‘whistleblowing’ policy. Two care workers could not provide an example of where they could relay any concerns outside of the organisation they worked for. The registered manager told us that they will refresh the whistleblowing training for all staff. Staff were very supportive of the values of the service and the registered manager. One staff member said, “This isn’t just a job. It’s like my family. The management team work with us to get the best out of us for the people we support.”

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.

Staff and people told us that staff wore appropriate Personal Protective Equipment [PPE)when they completed care tasks such as providing food, medicines and personal care. They said that there was a sufficient stock of PPE available.

Where medicines were dispensed, 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.

Reviews of medicines were made by staff on a monthly basis including checking the Medicines Administration Records [MAR] for accuracy. The registered manager did not complete audits of medication, instead they completed staff competency reviews which included medication. We explained that although these competency assessments would help in managing medicines, separate audits may help the registered manager to understand any trends in medicines management that could potentially reduce risk. They agreed and implemented medication audits during the inspection period. People were prescribed ‘as needed’ (pro re nata PRN) medication by their doctor. However, not all these medications had PRN protocols in place providing dispensing staff with clear instructions on what signs to look for as well as how to monitor any increase/decrease of the use of these medications. However, we found that staff knew about medicines and were experienced in how to mitigate risk of medicines and read the leaflets accompanying medicines. One staff member told us, “If a person wanted PRN paracetamol often such as 3 times a day for a couple of day, I would discuss with them, their families and my manager about what is causing the pain and maybe there is a related health problem. I would also read the instructions and safety leaflet.”. The registered manager implemented a PRN audit and sent us updated PRN protocols during the inspection period.