Cornerstone At The Park

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. This is the first assessment for this service which was registered in February 2023. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 81 (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 always learnt to continually identify and embed good practice.

Incidents were immediately reported and appropriately investigated. Staff were alert to any potential risks and took immediate action to mitigate these and prevent harm. Staff were confident to raise any concerns and all staff were updated quickly using an electronic system. A staff member explained, “If I noticed any risk with anybody I will document it and report it to the manager. I put it into our app, how it happened and management review.” This meant staff were notified of any immediate concerns before starting work.

Any learning from investigated incidents was fully shared across the service. Staff received advice in supervisions and team meetings, and additional training or competency checks, where necessary. The provider had a robust culture of learning from all relevant safety events, including those from outside of the service. For example, a recent external check on a sister service had resulted in discussions and changes to practices within this home.

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.

Managers and staff made sure continuity of care was a priority to ensure people had a smooth transition into the service. There were thorough processes to enable this. Managers undertook detailed assessments and worked with all interested parties throughout. People were involved at the earliest stages of potential transition to the service. This supported people to have a safe transition between services.

A professional explained, “Cornerstone have been effective in communication from the beginning of the process, including the assessment period and initial transition. Cornerstone have been able to create in-depth care and support plans, which have greatly benefitted this transition to the community. Staff have been present in all meetings and regular reviews. They have provided regular updates regarding the transition and the activities. The staff have also advocated, strongly, on their behalf.” Where appropriate, people spent regular short periods of time in the service before moving to the service. This helped them to adapt to the service and changes to their lives.

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.

People and staff knew how to report concerns and were confident these would be acted upon. Concerns were shared quickly with relevant authorities. People were supported to understand their rights. Where people’s freedom was restricted, the service worked within the Deprivation of Liberty Safeguards (DoLS) to ensure this was done lawfully and with minimal restrictions to people’s liberty. DoLS is a legal framework in England and Wales designed to protect individuals who lack the mental capacity to consent to their care or treatment in a care home or hospital. DoLS ensures that any deprivation of liberty is in the person's best interests and is the least restrictive option available.Staff understood the requirements of the Mental Capacity Act and protected people’s human rights. A professional said about staff, “Their working knowledge of the Act is really good.” Conditions relating to DoLS were monitored to ensure people were not restricted unnecessarily.

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 were informed about risks and how to keep themselves safe. The service worked creatively to support positive risk taking. The service had individualised strategies in place to ensure people were safely supported in the least restrictive way. Following crisis episodes people were asked whether there was anything else they would have wished staff to do. This meant people were thoroughly involved in managing their own risks and had autonomy where possible.

The service had developed agreements with people about when people needed to return to the home, where they were able to access the community. People knew and understood these ‘house rules’ were to keep them safe. For example, people were expected to return to the home by 11pm but staff were happy to be flexible with prior arrangement or further contact by the person. Staff talked to people about options, the level of risk and gave them guidance to support their decision-making when, for example, accessing the community alone. People with capacity were given support and advice, and the space to consider and discuss freely without judgement from staff any potentially unwise choices they wished to make.

Care notes contained information to ensure risks to people when they accessed the community independently were minimised. For example, when someone went out staff made a note of what they were wearing, where they were going and what time they were due back.

The service had identified that 1 person who spent lots of time playing online games, had a risk of radicalisation. This person’s care plans directed staff how to identify the signs of this. Staff had spent time making this person aware of these risks.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

The service considered the needs of people and their level of independence when placing people in rooms. For example, people who were able to live with a degree of independence had their own front doors and immediate access to the outside and the community should they wish. Each person had a key to their own rooms, which were kept locked. Electronic key fobs were used and were personalised so that people who could safely access outside spaces without supervision were able to do so.

Access to higher risk areas such as the kitchen and laundry was assessed and allocated after individual risk assessments had been undertaken. The service had identified that some people with historical trauma were likely to be distressed by hearing the fire alarm. The service had taken an incremental approach to undertaking effective fire drills whilst minimising the anxiety this caused people. This approach had supported people to become less sensitive to fire drills and hearing the fire alarm. Staff also had access to coloured ‘zone’ cards which assisted them to identify where potential fires could be.

People could choose whether to spend time in their rooms, which were highly personalised, or with others in large communal areas, including the garden. The environment was homely and focused on the people living at the service. One person’s pet had been acknowledged and celebrated by being included in a mural on the wall in one of the communal areas. This was a reminder that they had achieved their goal of having a pet, reinforcing their pride and confidence in doing so.

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 and staff told us there were enough staff to meet people’s needs safely. The service planned staffing in advance with consideration given to people’s activities and appointments. When asked whether there was enough staff a staff member said, “Yes, they [managers] will allocate this. They make sure there is enough staff to support people with their appointments.” The service used a dynamic staffing model to ensure people were adequately supported during times of crisis. A staff member explained, “If we need additional support then we can call the deputy and they will come and help us. We always call on them and they are always here.” Another said, “I feel safe to be honest. I know I can always call the manager.”

All staff received the same thorough training. A staff member confirmed, “We all have the same training so we can support to de-escalate if required.” This meant all staff were able to support people when needed. The service was committed to staff development. A staff member told us, “If I say can I have this training then they will do this.” Staff confirmed they felt well supported. One staff member said, “We are well-supported. I have had a couple of personal issues in the past. I feel listened to. It’s a good place to work, we are lucky.”

Observations, supervision and appraisals were undertaken regularly and records showed how staff were able to discuss their development and action plans were produced to support people to achieve this. Staff told us there was a strong team ethos across the service. One said, “We have teamwork. I have my support system at work. I am motivated to come to work.” This meant staff were committed to providing high-quality care.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was well-maintained and clean. Housekeeping staff were knowledgeable about cleaning products and always followed cleaning schedules. The service had sought and followed guidance from infection prevention and control professionals and ensure all advice was followed.

The provider always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened.

The service demonstrated exemplary practices in medicines optimisation. Staff were thoroughly trained and regularly assessed for their competency in administering medications. One staff member advanced to the role of an associate practitioner, enabling closer collaboration with mental health professionals to tailor the most appropriate medicinal regimens for individuals.

Medicines were meticulously reviewed, especially those prescribed for mental health support. People were actively involved in these reviews, fostering a collaborative approach to their care. The service excelled in enabling people to self-medicate, with comprehensive risk assessments ensuring safety. Medicines were often kept in people's rooms to promote confidence and independence in a secure environment.

Staff creatively balanced autonomy with positive risk-taking. Initially, individuals were given one day's medicine, allowing them to integrate it into their daily routines without disruption. This meant, for example, they could go out for the day without needing to return for their medicines. Successful management led to extended periods where people could handle their medication independently. A professional told us, “[Staff] are very responsive, they listen. Medicines are managed well, in terms of the importance of monitoring. They are very responsive, the second someone misses their medication then they are on the phone.”

This commitment to safe and independent medicine management not only supported individual autonomy but also reinforced the service's dedication to high-quality care.