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Archived: Cornerstone Care

Overall: Inadequate read more about inspection ratings

Eckington Business Centre, 62 Market Street, Eckington, Sheffield, South Yorkshire, S21 4JH (01246) 439220

Provided and run by:
Cornerstone Care Management Ltd

All Inspections

24 April 2018

During a routine inspection

The inspection took place on 24 April 2018 and was announced. We gave them one days’ notice to ensure somebody would be available in the office for the inspection visit. It was the provider’s first inspection since registering with us.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It currently provides a service to 12 older people and younger disabled adults.

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 this inspection the overall rating for this service is Inadequate which means it will be placed in special measures. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Safe recruitment procedures were not followed to ensure that staff were suitable to support people in their own homes. When the provider had assessed a risk around staff they did not put any additional checks in place to ensure they were safe. There were not enough staff to meet people’s needs and this resulted in people having late and reduced calls. It also meant that risk was not managed for some people. When people had been assessed as needing two staff to move them safely this was not always provided putting them at increased risk of harm. People and staff were also at risk because staff were sometimes working for excessive hours without break. Medicines were not always managed and administered to ensure that people had them as prescribed. Staff had not received the training and checks to ensure that they could administer medicines safely. There were limited checks in place to learn from previous mistakes or to avoid repetition. When abuse allegations were made these were not always fully investigated or reported to ensure that people were protected.

Staff did not always have the training and support required to ensure they could do their jobs effectively. New staff did not receive an induction to support people in line with national guidelines. Competence checks were not regularly completed to ensure that standards were being met. Other quality improvement systems were either not implemented, not regularly reviewed or not effective in highlighting and addressing concerns.

The provider was not always open and transparent with us when we conducted the inspection. We needed to request additional information from them after the inspection visit.

People’s ability to decide about restrictions was not always assessed which meant that they were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice. They were not always supported in line with their preferences and could always participate in activities and interests as requested.

People told us that they had been involved in planning their care. However, the care plans at the registered address were not current or reviewed. Other management information was not fully completed to take account of all staff. We found that the provider did not always respond to complaints in line with their procedure. They did not always respond to feedback from people about the quality of the service.

People did not always receive compassionate care from staff when they were rushed or needed to leave early to attend to other people. When they had regular relationships they developed caring relationships based on respect and upholding their dignity. When staff were responsible for people’s meals they ensured that they had enough to eat and drink. Relationships were developed with other professionals to ensure that their healthcare needs were met.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

16 October 2018

During a routine inspection

The inspection took place on 16 and 18 October 2018 and was announced. We gave the provider one days’ notice to ensure somebody would be available in the office for the inspection visit. At the last inspection the overall rating for this service was Inadequate which means it was placed in special measures. At this inspection the overall rating for this service is ‘Inadequate’ and the service will remain in 'special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It currently provides a service to three people.

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. The registered manager was also the provider and for ease we have referred to them as the provider throughout this report.

Risk was not adequately managed to protect people from harm. They were not always safeguarded from abuse and harm. The systems in place to manage medicines were not adequate. There was little evidence of learning from when things went wrong. The systems in place to monitor staffing did not provide any assurance that people received the support they had been assessed for. Recruitment procedures were not sufficient to ensure staff were suitable to support people in their own homes.

Staff were not provided with the training and support they required to be competent to support people with complex needs. Care plans did not provide clear concise guidance for staff and were at times not available. There was limited guidance on how to support people with complex nutrition needs and staff did not demonstrate a consistent understanding of this. Other professional’s guidance was not always embedded to ensure people’s health needs were met.

Complaints were not managed in line with the provider’s policy. Some people with complex communication needs were not given the opportunity to give feedback on the quality of their care. The provider did not respect people’s dignity and privacy.

The provider had not improved their oversight of the service provided and had not implemented the changes that they had assured us were in place. This put people at continued risk of harm to their safety and wellbeing.

When people had regular staff they developed caring relationships and those staff supported them to communicate their choices.

We found nine breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.