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Reports


Inspection carried out on 10 January 2018

During a routine inspection

Cordwainers provides accommodation and personal care to a maximum of eight people who live with a learning disability and/or associated health needs, who may experience behaviours that challenge staff. At the time of inspection eight people were living at the home.

This comprehensive inspection took place on 10 and 11 January 2018. The inspection was unannounced, which meant the staff and provider did not know we would be visiting.

At our comprehensive inspection of Cordwainers on 11 and 12 November 2015, we judged the service required improvement in the key question area of safe. We found there were insufficient staff deployed to meet people’s needs. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At our focused inspection on the 25 July 2017, we found that the provider had followed their action plan and had taken action to improve the safety of the service to meet the regulation. The provider had ensured there were sufficient staff deployed at all times to meet people’s assessed needs.

At the conclusion of the focused inspection we undertook to review our rating for safe at the next comprehensive inspection. At this comprehensive inspection we found the improvements to safety through increased staffing levels had been sustained and embedded. We found the service was safe. At the inspection in November 2015 the service was rated 'Good'. At this inspection we found the service remained 'Good'.

The service did not have a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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. The registered manager had recently left the home and had cancelled their registration with the CQC. The new home manager had commenced the process to become the registered manager of the service and was being effectively supported by a mentor who was an experienced registered manager from the care group.

People were kept safe from harm and staff knew what to do in order to maintain their safety. Risks to people were assessed and action was taken to minimise potential risks. Medicines were managed safely and administered as prescribed.

The provider operated thorough recruitment procedures to ensure staff were safe to work with the people. There were always enough staff to provide care and support to meet people’s needs.

Staff understood the importance of food safety and prepared and handled food in accordance with required standards. Staff maintained high standards of cleanliness and hygiene within the home.

People were supported by staff who had the skills and training to meet their needs. The home manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were involved in making every day decisions and choices about how they wanted to live their lives and were supported by staff in the least restrictive way possible.

Arrangements were made for people to see their GP, specialist nurses and other healthcare professionals when they needed to do so. People were supported to have a healthy balanced diet and had access to the food and drink of their choice, when they wanted it. The physical environment was personalised to meet people's individual needs.

People were supported by regular staff who were kind and caring. There was a warm and positive atmosphere within the service where people were relaxed and reassured by the presence of staff.

People's independence was promoted and support workers encouraged them to do as much for themselves as possible. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their huma

Inspection carried out on 25 July 2017

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 11 and 12 November 2015. A breach of legal requirements was found in relation to regulation 18 (staffing) of the Health and Social Care Act 2008 (Regulated Activities) 2014. There were insufficient numbers of staff available to meet people’s assessed needs.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 25 July 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cordwainers on our website at www.cqc.org.uk.

Cordwainers provides accommodation and personal care for up to eight people who have learning and physical disabilities. At the time of our inspection there were seven people living in the home.

The service had a 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 2008 and associated Regulations about how the service is run.

At our focused inspection on the 25 July 2017, we found that the provider had followed their action plan which they told us would be completed by 08 March 2016 and legal requirements had been met. The provider had taken action to ensure sufficient staff were available to meet people’s assessed needs.

Inspection carried out on 11 November 2015

During a routine inspection

This inspection was carried out on 11 and 12 November 2015 and was unannounced.

Cordwainers provides accommodation and personal care for up to eight people who have learning and physical disabilities. At the time of our inspection there were eight people living in the home. Accommodation is all on one floor, suited to people who require a wheelchair to mobilise.

Cordwainers has a registered manager in post. 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.

There were not enough staff deployed to meet people’s assessed dependency. The registered manager had assessed everyone’s dependency and determined that people’s dependency did not match funded staffing levels. Although this had been identified prior to the inspection, it had not been remedied because funding authorities had not been responsive to the requests made for reassessment.

Staff had received safeguarding training. They told us they understood how to recognise the signs of abuse and knew how to report their concerns if they had any. There was a safeguarding policy in place and staff knew where to find relevant telephone numbers. Relatives told us their family member felt safe and people behaved in a way which indicated they felt safe.

Risks had been appropriately identified and addressed in relation to people’s specific needs. Staff were aware of people’s individual risk assessments and knew how to mitigate the risks.

Medicines were stored safely and administered by staff who had been trained to do so. There were procedures in place to ensure the safe handling and administration of medicines.

People were asked for their consent before care or support was provided and where people did not have the capacity to consent, the provider acted in accordance with the Mental Capacity Act 2005. This meant that people’s mental capacity was assessed and decisions were made in their best interest involving relevant people. The registered manager was aware of her responsibilities under the Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications for people living in the home.

Relatives told us they were very happy with the care provided. Staff understood people’s preferences and knew how to interact and communicate with them. People behaved in a way which showed they felt supported and content. Staff were kind and caring and respected people’s dignity.

Support plans were detailed and included a range of documents covering every aspect of a person’s care and support. The support plans were used in conjunction with person centred planning ensuring that people’s wishes were recorded as equally important to their support needs. We saw this reflected in the support observed during the visit.

There was evidence in support plans that the home had responded to behavioural and health needs and this had led to positive outcomes for people.

The registered manager was liked and respected by people, staff and relatives. There was good morale amongst staff who worked as a team in an open and transparent culture. Staff felt respected and listened to by the registered manager. Regular staff meetings meant that staff were involved in the development of future plans. There was a positive and caring atmosphere in the home and effective and responsive planning and delivery of care and support.

We found a breach 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.