Archived: Cornerways Residential Home

Cornerways is registered to provide personal care and accommodation for up to 20 people. There were 18 people using the service during our inspection, who were living with a range of health and support needs. Cornerways is a detached house situated within the town of Hythe and with close access to the town centre. The service is arranged over three floors, each person had their own bedroom apart from one room, shared by a married couple. Access to the first floor is by a shaft lift with stair lifts to the remaining floor, making stair free access to all areas of the service.

The service had a registered manager, who was present throughout the inspection. They shared their time between this service and another one owned locally by the same provider, where they are also the registered manager. 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 and associated Regulations about how the service is run.

Staff followed correct and appropriate procedures in the storage and dispensing of medicines. People were supported in a safe environment and risks identified for people were managed in a way that enabled people to live as independent a life as possible. People were supported to maintain good health and attended appointments and check-ups. Health needs were kept under review and appropriate referrals were made when required.

A robust system to recruit new staff was in place and made sure staff employed to support people were fit and suitable to be working at the service. There were sufficient numbers of staff on duty to make sure people were safe and received the care and support that they needed.

Staff had completed induction training when they first started work at the service. Staff were supported during their induction, monitored and assessed to check that they had gained the right skills and knowledge to support people in a way that met their needs. Staff continued to receive training and support. There were staff meetings, staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives.

People were protected from the risk of abuse because staff had received safeguarding training and were aware of how to recognise and report safeguarding concerns. Staff knew about whistle blowing and were confident they could raise any concerns with the provider or outside agencies if needed.

The care and support needs of each person were different and their care plan was individual to them. Personalised care plans, risk assessments and guidance were in place to help staff to support people. People's legal rights were protected as staff provided care in line with the Mental Capacity Act (2005). Staff followed the guidance of healthcare professionals where appropriate and we saw evidence of staff working alongside healthcare professionals to achieve best outcomes for people.

Staff encouraged people to be involved and feel included in their environment. People were offered varied activities and participated in social activities of their choice. Staff knew people and their support needs well, they treated people with kindness, compassion and respect. Staff took time to speak with the people they were supporting. People were offered a choice of nutritious meals, snacks and drinks were always available

There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff. People's privacy and dignity was respected.

People and relatives said they knew how to complain if necessary and that the registered manager was approachable. There was a clear complaints process in place

Staff felt there was good communication and were clear about their roles. They felt well supported by the registered and deputy managers. Feedback was sought from people, relatives and professionals about how the service was run.

A number of audits and checks were carried out each month by the registered and deputy manager, which were effective in identifying and addressing concerns and driving forward improvements.

Our previous inspection of Cornerways Residential Home on 16 and 17 June 2015 found breaches of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We took enforcement action and required the provider to make improvements. We issued two warning notices, the first in relation to the cleanliness and maintenance of the property and some equipment and the second in relation to systems and processes intended to assess and improve the quality and safety of the service provided. We also asked the provider to take action to ensure all risks were, as far as reasonably practicable, mitigated and to ensure that medicines were safely administered and care and treatment provided in a safe way; to ensure there were sufficient numbers of staff on duty and that care and treatment of service users was appropriate, met their needs and reflected their preferences.

At this inspection we found required improvement had been made in some areas. However, we identified other shortfalls where some regulations were not being met. We also made some recommendations for improvement.

Recruitment checks were incomplete because they did not ensure all staff employed were suitable to work at the service.

Systems and processes were not operated effectively to ensure complete records were kept in respect of each person, including a record of care and treatment provided to the person. Records were also not maintained about some fire safety checks.

Medicines were stored appropriately; records and people confirmed they received the right medicines at the right time.

Staff had received training to support the people they cared for and understood about the Mental Capacity Act and how to support people to make decisions.

The service was safe, clean, hygienic and well maintained; appropriate fire safety checks had taken place.

Equipment used at the home was serviced when needed and certified as fit for purpose and safe to use.

People’s health needs were well managed and referrals to outside healthcare professionals were made in a timely way.

People were supported by enthusiastic staff who received regular training and appropriate supervision. There were enough staff to meet people’s needs.

Staff were caring, compassionate and responsive to people’s needs and interactions between staff and people were warm, friendly and respectful. Staff spent time engaging people in communication and activities suitable for their current needs.

People enjoyed their meals, they were supported to eat when needed and risks of choking, malnutrition and dehydration had been adequately assessed and addressed.

People commented positively about the openness of the management structure and were complimentary of the staff.

We found two of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We saw that the provider had systems in place to obtain consent from people in relation to people's care and support.

People received care that met their needs and promoted their rights. Advice and guidance was sought from health and social care professionals to be able to meet people's needs effectively and promote their welfare and safety.

The service was suitably designed for the needs of the people who lived there. It was clean, homely and well maintained.

There were enough staff on duty to be able to meet people's needs effectively. People we spoke with told us that the staff responded quickly when they were called. There were systems in place to ensure staff were suitably skilled to be able to undertake their role safely and effectively.

The systems in place to regularly monitor the health and safety of the service were not always used effectively. The service fire risk assessment had not been reviewed in 2013, in line with Fire and Rescue Service requirements, taking into consideration a change to one person's fire door to their bedroom.

In our discussions with staff they demonstrated a thorough knowledge of the people living at the service. This was confirmed by our observations and in discussion with people.

Care records showed that people had been supported and encouraged to make decisions about their care and planning what went on in the home. We saw that people and their relatives were involved in planning and decision making. When people's needs changed, we found that records had been updated to reflect this.

Staff spoken with demonstrated good understanding of how to safeguard people from harm. Training records showed that staff received regular training to update their knowledge on abuse and safeguarding. Training records also showed that staff were suitably trained and supported in their role. This included training specific to the people living in the service for example, diabetes care and medication management.

Records showed the provider regularly assessed and monitored the quality of the service. We saw that people and their representatives were asked their views about the home in surveys.