Cornerleigh

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People had detailed, person-centred care plans for specific health conditions. These plans reflected individual needs, preferences and communication styles. Records showed staff reviewed care plans regularly to keep information up to date and relevant to people’s current needs.

There was mixed evidence of how consistently people, and their relatives were involved in care plan reviews. Some records showed people had signed their support plans and risk assessments, and care plans included photographs of people engaging in activities they enjoyed, demonstrating that preferences were recorded and considered. People and relatives told us they were involved in reviews. A relative told us, “I came in recently for a review. They always ask for my opinion. They’re very good with anything like that. They show me progress reports and keep me updated.” This indicated involvement was meaningful where it took place.

Care planning processes generally reflected people’s needs and were regularly reviewed. This supported staff to deliver care that was responsive and aligned with people’s assessed needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

We observed staff supporting people safely at mealtimes. Staff followed modified diets in line with International Dysphagia Diet Standardisation Initiative (IDDSI) guidance and prepared food and fluids in accordance with people’s assessed needs. People gave positive feedback about the quality and variety of food. One person told us, “The food is very nice. You never go hungry. There’s variety.”

While nationally recognised tools such as Malnutrition Universal Screening Tool (MUST) were not routinely used to identify malnutrition, staff demonstrated a strong understanding of people’s needs and had developed detailed health plans where risks were identified. For example, for 1 person at risk of malnutrition, staff monitored weight regularly, made referrals to a dietitian and supported the use of prescribed supplements to maintain a healthy weight.

Positive Behaviour Support (PBS) plans were in place and were reviewed and updated when people’s needs changed, in line with best practice guidance. Staff used these plans to guide consistent responses to behaviour that may challenge, supporting positive outcomes for people.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Records showed effective communication between staff, professionals and external services. Care records included referrals and input from healthcare professionals, demonstrating joined-up working. Staff shared information through handovers, communication books and team meetings to support continuity of care. Staff also used a key worker system with monthly key worker meetings, where actions and outcomes were recorded. In addition, staff used the provider’s internal communication platform to share updates and important information in a timely way.

Hospital passports were up to date and included people’s current health, care, communication and wellbeing needs. This ensured essential information could be shared promptly if people required input from other services, supporting safe transitions and continuity of care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and, where possible, reduce their future needs for care and support.

People had personalised health action plans which clearly identified their healthcare needs and the level of support required. Staff supported people to attend routine health checks, including optician and dental appointments, and specialist reviews such as diabetic eye screening, mental health and autism reviews where required. Records showed health appointments were documented, and any follow-up actions were completed in a timely way, supporting continuity of care.

Staff knew people well and supported them to make healthier lifestyle choices. For example, 1 person living with diabetes was encouraged to take part in shopping and develop healthier eating habits. Another person was supported to maintain a healthy lifestyle through regular exercise. Staff supported them to take an active role in tracking their progress, which helped to keep them motivated. These approaches supported people to maintain their health, independence and wellbeing, and promoted positive day-to-day experiences.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff completed a range of clinical monitoring tools, however, records did not always clearly demonstrate outcomes. For example, 1 person’s body map indicated ongoing monitoring was required. Although staff had completed associated health records and the wound had healed, this was not clearly recorded to evidence the outcome. This reduced the provider’s ability to consistently evidence improvements in care.

Despite gaps in recording, staff understood people’s needs well and supported improvements in health and wellbeing and people experienced positive outcomes. For example, 1 person with a history of self-harm was supported to engage in making jewellery and ornaments. Staff identified that wearing bracelets reduced self-harming behaviours to the arms and as a result, the person’s wounds healed, and they had not self-harmed in this way for over six months. This demonstrated effective, person-centred intervention in practice.

Another person who required insulin had detailed care plans and risk assessments in place, and staff completed regular blood glucose monitoring with oversight from district nurses. This supported safe management of their condition and contributed to stable health outcomes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Staff had completed applications for Deprivation of Liberty Safeguards (DoLS) and carried out Mental Capacity Act (MCA) assessments and best interest decisions. However, records were not always clear, detailed or decision specific. For example, 1 person’s MCA assessment and best interest documentation covered multiple decisions rather than being specific to each decision. Another person’s MCA assessment did not clearly demonstrate how information had been shared, understood, retained or communicated. In addition, some best interest decisions were recorded without a corresponding MCA assessment. This meant decision-making processes were not consistently evidenced in line with legal requirements.

We also found gaps in consent records relating to media use. One person had indicated they were happy for photos to be taken and shared, but their consent form did not outline the benefits or potential risks, had been signed by the service rather than the person, and did not include a review date. For another person, a media consent form had been signed by family members, but no MCA or best interest assessment had been completed to support this decision. This meant it was not always clear how consent had been lawfully obtained.

The manager had already identified the need to improve MCA and best interest recording prior to the inspection and was taking action to address this. In practice, staff supported people to make day-to-day decisions and encouraged choice. People told us they were involved in decisions about their care, and we observed staff offering choices such as who they wanted support from and what they wanted to eat. This demonstrated that consent was generally respected in day-to-day practice.