Corner House

There was 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.

At our last inspection in August 2015, we found that people received personalised care, which was responsive to their needs, and the service was rated good. At this inspection, we found that people continued to receive good care and found the service was outstanding in the way it was led.

The management team were dynamic and innovative in their approach. They had a clear vision and set of values which they worked towards, and which were reflected throughout the staff team. Staff, people, relatives and healthcare professionals spoke highly of the management, and were confident in their ability.

There was a robust quality assurance system which meant the directors and management team had highly effective oversight of how the service was meeting people’s physical, emotional and social needs. The management team set a high standard for their staff and led by example. There was a strong emphasis on continually striving to improve.

People were at the heart of the service and the atmosphere was warm and welcoming. There was a positive, open and inclusive culture in the service.

People presented as relaxed and at ease in their surroundings and told us that they felt safe. Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. People knew how to raise concerns and were confident that any concerns would be listened and responded to.

There were systems in place to minimise risks to people and to keep them safe. Staff were trained and supported to meet people’s needs effectively. There were sufficient numbers of staff to meet people’s needs. Recruitment processes checked the suitability of staff to work in the service.

People were provided with their medicines in a safe manner. They were prompted, encouraged and reassured as they took their medicines and given the time they needed.

Staff understood the importance of gaining people’s consent and were compassionate, attentive and caring in their interactions with people. They understood people’s preferred routines, likes and dislikes and what mattered to them.

The management team and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff supported people to have maximum choice and control of their lives in the least restrictive way possible; the policies and systems in the service supported this practice.

People were complimentary about the way staff interacted with them. Independence, privacy and dignity was promoted and respected. Staff took account of people’s individual needs and preferences and people were encouraged to be involved in making decisions about their care.

People’s nutritional needs were assessed and professional advice and support was obtained for people when needed. They were supported to maintain good health and had access to appropriate services which ensured they received ongoing healthcare support.

There was an open and transparent culture in the service. A complaints procedure was in place. People’s comments, concerns and complaints were listened to and addressed in a timely manner. People, relatives, visitors and staff were confident that any concerns raised would be taken seriously and dealt with appropriately by the management team.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were asked for our identification and asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The service was aware of new changes in the law with regard to DoLS. Where applications had needed to be submitted, appropriate policies and procedures were in place and had been followed. Relevant staff had been trained to understand when an application should be made and how to submit one.

We saw appropriate processes were in place with regard to medication and its administration. People could be confident they were protected from the unsafe use and management of medicines.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw the service had processes in place which ensured that staff had the skills and knowledge to support people safely.

We saw that people's personal records including care files were accurate and that staff records and other records relevant to the management of the service were accurate and fit for purpose.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs. One person said: "They treat us very well here, I like being here it is a lovely place to be." People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.

Is the service caring?

We saw that the staff interacted with people who used the service in a caring and respectful manner. We saw that staff treated people with respect.

Staff had a good knowledge and understanding of people's care and support needs, including recognising and supporting them as an individual. Where people required assistance, staff provided this in a timely manner and at a relaxed pace. This ensured people received care and support consistently and in ways that they preferred.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised, these were addressed.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to.

People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns, appropriate action had been taken to address them. People could therefore be assured that complaints were investigated and action was taken as necessary.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor, dietician and district nurse.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good service at all times.

The service had a quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. The service had processes in place to collate the information they had gathered, identify the service's strengths and weaknesses, and plan the actions required to improve the experiences of people who used the service. This ensured continued improvement in the areas identified.

We saw that Corner House 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.

A visiting healthcare professional who attended the home on the day of our inspection said: 'They are very good staff here, they are always very helpful and friendly.'

We noted that the environment at Corner House was spacious, with sufficient communal areas to meet the needs of people living there. We saw that people were comfortable in their surroundings.

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.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the storage and recording of medicines. There was insufficient guidance for staff on the use of some medicines.