Archived: United Response - Cornish Close Respite Unit

Cornish Close Respite Unit was last inspected in February 2013 when it was found to be meeting all but one of the standards reviewed. A follow up inspection was carried out in June 2013 and the service was judged to have reached compliance in that standard.

Cornish Close Respite Unit is registered to provide emergency respite services for a maximum of six adults with learning disabilities. People may also mental or physical disabilities. At the time of our inspection, three people were using the respite service. There were plans in place for two of the people to move to a nearby house to be supported to live more independently in the future. The service was proposing to change the registration conditions of the respite unit to include support for people with dementia. The service was working closely with the local authority in relation to this.

We were told that the registered manager had been absent since August 2015. We had not been notified of this. 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. The provider had put interim measures in place in the absence of the registered manager.

Some people we spoke with had limited verbal communication. However, everyone clearly indicated they felt safe, were happy living in the service and liked the staff.

Staff had received training in safeguarding vulnerable adults and could clearly describe the action they would take if they suspected any abuse had taken place.

Two incidents had occurred immediately prior to the inspection, one of which had been reported to the local authority as a safeguarding concern. Both incidents reflected that practices at the service were not always safe .

We found that medicines were safely administered and staff received training in the administration of medicines. .

The home was clean and tidy and there were effective health and safety checks in place. Staff used personal protective equipment (PPE) such as gloves and aprons when undertaking personal care tasks and administering medicines.

The service had a safe system in place for the recruitment of new staff. There was a reliance on using agency staff at the service; however, the same people had been used for consistency. One person we spoke with employed by an agency had worked in the service for over three years. The company also had their own pool of bank staff and had recently recruited someone from this to a permanent position.

An induction programme was in place for new staff to complete required training courses and shadow existing staff. One person was eligible to be signed up to the Care Certificate and the service was liaising with head office in respect of this. Staff confirmed that they had completed training courses relevant to their role.

People’s care records and risk assessments contained personalised information about their needs The support plans we looked at included risk assessments, which identified any risks associated with people's care and had been devised to help support people to take positive risks to increase their independence.

We saw that the service had facilities to support people with a range of needs, including the availability of track hoists in bedrooms and bathrooms, although these weren’t currently required.

If people’s needs changed a system was in place to liaise with the person, their family and other professionals to update care plans and risk assessments. Where required people’s health and medical needs were met, with access to GPs and other health professionals.

We found that the service was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards. People’s respite support was assessed and agreed with the person, their families and the local authority commissioning team prior to admission to Cornish Close Respite Unit. In the event of an emergency admission a support plan and risk assessments were supplied to the service.

During our inspection we saw that staff were kind and caring. People were given time to do things at their own pace and offered encouragement from staff. We also saw that staff knew the people they were supporting well.

We saw that activities within the service and in the community were available for people if they wanted. An outside courtyard area was available for people and trips out were arranged.

Staff told us that the upper management structure was currently blurred, given the long term absence of the registered manager, but they felt supported by the team manager of the unit. Regular team meetings were held and staff were able to raise any issues or concerns..

A system was in place for responding to complaints. We were told by relatives and staff that the team manager was approachable and would listen to their concerns.

There was evidence of some audits being undertaken at the service but we identified that overall, the systems in place to assess, monitor and improve the quality and safety of the service were not sufficiently robust.

During this inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we have told the provider to take at the back of the full version of the report.

We carried out this inspection to check that the provider had taken action since our last inspection on 28 February 2013.

During our last inspection we found minor concerns that care plans did not have sufficient information recorded about people's care needs and how they should be supported. Consequently, they did not clearly demonstrate the plan of care being provided. Sometimes only minimal information was recorded in the care plans and risk assessments did not identify any associated risks.

During our inspection on 27 June 2013 we found the provider had made improvements to the documentation and more information was now included about how people should be supported. Risks had been identified more clearly and information was recorded on how these risks should be managed.

Staff consulted with a range of health care professionals for advice and support around people's individual care needs and a range of social activities were provided. This meant people's welfare was protected and their needs were met. One person told us, 'If I'm not well I speak to the staff and they get my doctor. I didn't feel well the other day, but the staff sorted it out.' Another person said, 'When I'm not happy I talk to the staff and they make me feel better.'

The manager was aware of her responsibilities around managing allegations of abuse and staff knew how to report suspected abuse to a senior member of staff. None of the staff we spoke to had any concerns about the safety and welfare of the people they supported or the care practices of their colleagues. During the inspection we noticed that staff interacted with the people who used the service in a relaxed and friendly manner.

Appropriate checks were carried out before staff began working at the unit. Staff were well supported and provided with a range of training to support their learning and development.

An initial assessment of a person's needs took place before a service was provided. This gave people an opportunity to express their views of the care they needed. If they were unable to do this, then health care professionals, family members and independent advocates were consulted with.

A range of person centred activities were provided and people's spiritual and religious needs were assessed and met.

Staff knew to report any signs or the suspicion of abuse to a member of staff immediately. None of the staff had any concerns to raise.

Staff said they enjoyed their work and felt well supported in their role. They said they worked well as a team and received good support from the manager.

Quality assurance systems were in place in relation to all aspects of the running of the service. The unit has just been awarded a Dignity in Care award by Manchester City Council. This meant that Cornish Close has been assessed as providing a service which promotes people's dignity.

Manchester contract and commissioning team had no concerns to raise about this service.