Cornerleigh

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 service managed safety incidents well. Staff recognised and reported accidents, incidents and concerns appropriately and escalated these to the relevant person without delay. Records showed incidents, including slips, trips and falls, were consistently documented on an electronic system, with clear details of what had happened and the actions taken in response. This demonstrated appropriate follow-up and managerial oversight.

The provider embedded learning from incidents. A member of staff told us, “We talk about incidents in team meetings, so everyone learns from them.” Records confirmed lessons learned were shared through team meetings, debriefs and supervision sessions. This supported staff to reflect on practice, reduce the risk of recurrence and helped people receive safer care.

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.

Staff completed comprehensive pre-admission assessments which considered people’s needs, risks and preferences. Staff carried out transition planning meetings, so care was planned and delivered safely from the outset. This ensured people’s needs were understood before admission and reduced the risk of unsafe or inappropriate placements.

People and those important to them told us they received relevant information to support planned, safe and person-centred transitions. One person was supported to move out of the service in a phased way, which helped them build confidence before moving fully into their new home. Another person told us that staff supported them to manage anxiety by providing regular updates about progress towards a placement closer to their family. This showed staff responded to individual needs and promoted emotional wellbeing during periods of change.

Staff supported continuity in people’s daily care. Staff organised care and planned ahead for activities, which meant people experienced consistent support and reduced anxiety during periods of transitions between activities during their daily lives. This supported positive outcomes and helped people feel safe.

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.

The service had effective safeguarding systems in place. Staff identified, recorded and responded to safeguarding concerns using a safeguarding tracker, which supported oversight and ensured appropriate action was taken. Safeguarding and DoLS policies were up to date and reflected current guidance, which supported consistent practice across the service. Staff had completed up-to-date safeguarding training, which supported their ability to recognise and respond to concerns appropriately.

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. We found that 5 people were subject to DoLS and were supported safely by staff, with a further 4 people awaiting assessment and authorisation. Staff demonstrated a good understanding of DoLS and the principles of the Mental Capacity Act 2005, including the importance of using the least restrictive options when supporting people.

People told us they felt safe. One person told us, “It’s lovely here. I feel happy and safe.” This demonstrated safeguarding systems were effective in protecting people from harm and supporting a positive experience of care.

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 staff knew their needs and supported them safely. People were encouraged to take positive risks to support independence and wellbeing. One person with mobility restrictions expressed a wish to access a swimming pool. Staff worked with the person and relevant healthcare professionals to support this safely, and the activity was implemented with positive outcomes. This showed staff balanced safety with promoting independence and choice.

The service had effective systems to assess and manage risks to people. Risk assessments covered areas including choking, community access, laundry use, finances and restrictive practice. Assessments were detailed and considered triggers, potential risks and control measures to reduce harm, which supported consistent and safe care.

Risk assessments were regularly reviewed and updated when people’s needs changed. This ensured information remained current and supported safe decision-making. Staff used this information to guide day-to-day support and promote safe but independent living, which helped people achieve positive outcomes.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The service had gaps in environmental risk management. During inspection, we identified that not all windows had appropriate restrictors in line with Health and Safety Executive guidance, including some on the first floor. This meant environmental risks were not always fully mitigated. The provider took immediate action to complete a full audit of all window restrictors and implemented an interim risk assessment, which found that people using the service were not at significant risk of harm as they demonstrated awareness of window safety. Window restrictors were fitted the following day, reducing any ongoing risk.

Systems for monitoring environmental safety were not consistently effective. Staff did not always record water temperature checks for legionella control in line with guidance. However, there were no concerns identified in relation to water safety, and no evidence of harm to people. The provider acted promptly to reinforce expectations with staff and strengthen oversight of these checks.

However, there were also areas of good practice in relation to environmental safety. Equipment servicing and safety checks were up to date. People had detailed and personalised emergency evacuation plans to guide staff in the event of a fire. Equipment used to support people’s mobility was regularly checked and maintained to ensure it remained safe for use.

While environmental governance and oversight were not fully effective, harm to people had not occurred and the provider responded immediately during the inspection and demonstrated a proactive approach to improvement. They implemented actions to address the concerns identified, including strengthening audit processes, completing environmental checks and progressing plans to improve environmental safety. These actions reduced the likelihood of risks continuing.

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.

People told us staff were available and responsive when support was needed. One person told us, “Yes, I think there’s enough staff.” At the time of inspection, staffing levels within the service were sufficient to meet people’s assessed needs. This showed the provider maintained safe staffing levels despite changes in external provision.

The provider followed safe recruitment processes. Recruitment records confirmed staff had completed appropriate pre-employment checks, in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, before they started work. This helped ensure staff were suitable to work with people.

Staff were supported to deliver safe and effective care. Staff told us they felt supported by managers, were confident in their roles and maintained competence in practice. Mandatory training was up to date and aligned with people’s needs and risks. Staff received regular supervision, competency assessments and annual appraisals in line with provider policy, which supported safe and consistent care.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. During inspection, we identified concerns in the storage and management of sharps and clinical waste, which increased the risk of cross-contamination.

A sharps bin was located in a person’s room without a documented risk assessment or clear infection prevention and control guidance to support safe storage, handling and disposal. Clinical and general waste bins were stored in an unenclosed external area accessible to the public, and a bin was overflowing. While no impact on people was identified, these arrangements did not fully mitigate infection risks.

However, the provider had infection prevention and control policies, risk assessments and an up-to-date infection prevention and control annual statement in place. Staff had completed relevant training and demonstrated an understanding of infection prevention and control principles.

The service was generally clean and free from malodours. People and relatives gave positive feedback about cleanliness. One person told us, “Staff come and clean my room every day.” A relative told us, “The place always looks clean and tidy.” This showed the environment was maintained to a visibly clean standard.

The provider took immediate action during the inspection. They reviewed sharps storage arrangements, waste management processes and implemented plans to strengthen infection prevention and control oversight.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning. Overall, medicines management systems were not consistently robust enough to ensure safe and well-governed practice.

Medicines governance and record keeping were not always robust. We identified that PRN (when required) protocols did not consistently include clear directions on maximum doses or time intervals between doses. This meant staff may not always have clear guidance to support consistent decision-making when administering PRN medicines. However, there was no evidence that people had been over or under medicated, and staff were able to describe how they made safe decisions based on their knowledge of people’s needs.

Some medicine administration record (MAR) entries and transcriptions were unclear. For example, a person’s MAR chart had been amended by hand to change a medicine from regular to PRN use. The manager confirmed this had been agreed with the general practitioner and provided evidence of this instruction. However, this information was not readily available alongside the MAR chart, which meant staff could not always easily access or evidence prescribing decisions at the point of administration. We found the person was receiving their medicines as prescribed.

Medicines administration and monitoring systems were not consistently applied. Transdermal patches were not always applied in line with manufacturer guidance, which could increase the risk of inconsistent medicine absorption or skin irritation. However, we saw no evidence of adverse effects and staff demonstrated a good understanding of how to apply and monitor these medicines safely.

Medicines were generally stored securely, and best practice guidance, including stopping over medication of people with a learning disability, autism or both (STOMP), was followed. This indicated that day-to-day practice was safe, despite weaknesses in supporting documentation and systems. The provider had recognised the concerns and had begun taking action to strengthen medicines management systems, including improving the accessibility of prescribing information, clarifying PRN protocols and strengthening audit and oversight processes.