Corner Lodge Limited

People’s experience of using this service and what we found

Staff and people felt there were enough staff working in the service and people said staff were available to support them when they needed assistance.

Medication was administered by staff who had received training to do so and medicines were managed safely. Risk assessments were in place, which identified possible risks and how to manage them.

The service had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required. Relatives felt able to speak to the staff team at any time if they needed to know about their loved one.

Staff recruitment processes were in place however, some personnel files had documents missing.

We recommend the provider seeks guidance to ensure staff personnel files have completed work history.

Rating at last inspection

The last rating for this service was good (published 30 January 2018).

Why we inspected

We received concerns in relation to notifications and safeguarding. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Corner Lodge website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Corner Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Corner Lodge provides personal care for up to 48 people. At the time of our inspection there were 42 people living at the service, some of whom were living with dementia.

The management team had worked hard to improve the culture since the last inspection and had a clear set of values, which they had embedded within the service, and these were reflected throughout the staff team. Staff, people and relatives spoke highly of the management team and the improvements that had been made.

The service maintained good links with the local community and there was a varied programme of activities. People were valued and treated as individuals and were supported to follow their interests and hobbies. Special trips and events were arranged for people to promote their well-being and enjoyment of life and to help them realise their dreams.

There were a range of audits in place to check the quality and safety of the service and action plans and lessons learnt were part of the management team’s on-going quality review. There was an emphasis on continually striving to improve.

Medicines were stored safely and administered at the correct times by staff who were trained and competent. Risk assessments were in place for people and for the environment. The service was clean and tidy, infection control processes were in place and staff had access to personal protective equipment. Staff and the management team understood their responsibilities with regard to safeguarding and had been trained in safeguarding vulnerable adults. There were sufficient numbers of staff and the service followed safe recruitment and selection processes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people lacked the mental capacity to make decisions about aspects of their care, staff were guided by the principles of the Mental Capacity Act 2005 (MCA) to make decisions in the person's best interest. Records of best interest decisions showed involvement from people's family and staff.

Staff were supported to maintain and develop their skills through training and development opportunities and regular supervision. Staff told us they felt well supported by the management team and were comfortable raising any concerns.

Care records showed people's needs were assessed before using the service and they were supported well to make their move to the service as smooth as possible. People's likes, dislikes and preferences were reflected in their care plans and people were supported to make choices which were respected. People were supported to have a varied, balanced diet which met their needs and wishes. People, staff and professionals were regularly consulted about the quality of the service and their views were used to make improvements.

We received good feedback about the caring and dedicated nature of the staff. People felt very comfortable with staff members, were treated with dignity and respect and there was a warm and positive atmosphere in the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

There were some procedures and processes in place to ensure the safety of the people who used the service. However, not all environmental risks had been identified and managed and improvements were required around cleanliness and infection control.

The provider had not ensured that people were receiving safe and effective care provided by sufficient numbers of skilled and knowledgeable staff. Staffing levels were not always adequate to ensure that people were kept safe at all times and to ensure that records were completed. People did not always receive the time and attention they needed to fully meet their needs.

There were systems in place to safeguard people from abuse and the recruitment of staff was safely completed to make sure that they were suitable to work in the service.

Appropriate arrangements were in place to ensure people's medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being. However, improvements were needed in the recording and monitoring of people’s food and fluid intake and record keeping in general.

The dining experience was not conducive to an enjoyable mealtime. It was very loud and chaotic and staff were not always attentive to people’s needs. Improvements were required around the engagement of those cared for in their rooms and ensuring that activities were suitable for people.

Staff were trained and supported to meet the needs of the people who used the service. Staff were trained in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff had good relationships with people who used the service and people and their relatives were complimentary about the care people received.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received.

There had been a lack of oversight of the service by the provider to ensure the service delivered was safe. Although the provider had some quality assurance systems in place, these had not been effective in allowing the management team to identify concerns and take the required action.

We spent some time observing the usual routines in the service. We found that the staff were attentive to people's needs and they interacted with people in a caring, respectful and professional manner.

We spoke with a person's relative who told us, "My (person) is always clean and well looked after. When I visit or phone they (staff) always have time to tell me how (person) is."

We looked at the care records of four people who used the service. We found that people experienced care, treatment and support that met their needs and protected their rights. People's dietary needs were met. People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. We found that people's complaints were listened to and acted upon.

Staff personnel records that were seen showed that staff were trained to meet the needs of the people who used the service.

We looked around the service and found that people were provided with a clean and hygienic environment to live in.

We saw that Corner Lodge provided a relaxed and homely environment for people. Staff were friendly and respectful in their approach and interacted with people using the service in a confident and considerate manner.

During the course of our inspection we saw that people were supported to express their views and choices by whatever means they were able to and staff clearly understood each person's behaviours and their way of communicating their needs. Staff looked after people's healthcare needs in a proactive way.

The staff team were well trained and supported to carry out their role.

The provider had effective systems in place to monitor the quality and safety of service that people received.