Inspection on 18/08/05 for Cornerstone

This inspection was carried out on 18th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cornerstone 06/09/07

Cornerstone 09/08/06

Cornerstone 19/01/06

Cornerstone 07/02/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Cornerstone 51 Pease Street Darlington Co Durham DL1 4EX Lead Inspector Belinda Parker Unannounced 10:00am 18 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cornerstone Address 51 Pease Street Darlington Co Durham DL1 4EX 01325 261658 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cornerston Care (Durham) Limited Richard McManners CRH Care Home only 12 Category(ies) of LD Learning Disability registration, with number of places Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7 February 2005 Brief Description of the Service: Cornerstone is a residential care home and providing residential care services for up to 12 adults in the category of learning disability. The home is located in a residential part of Darlington within walking distance of the town centre and all of its amenities. Cornerstone is a large end terrace house, that has been extended to provide suitable living accommodation for the client group. The accommodation comprises 10 single and one double bedroom a range of communal spaces, garden areas and a separate educational building. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 18/8/05 over a period of 3.5 hours. During the inspection a discussion took place with staff and management. Two service users were present in the home during the inspection but were unable to communicate verbally with the inspector. The inspector toured the home and a number of records were examined. What the service does well: What has improved since the last inspection? Since the last inspection the registered manager has commenced NVQ4 in Care and will commence the Registered Managers Award in September 2005, which will enhance the manager’s skills and abilities to ensure an effective and efficient management of the home and service delivery to service users. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 The system in place for admission to the home is clear, providing prospective service users and their relatives with good information to enable them to make an informed decision as to whether the service user wishes to move in. EVIDENCE: A comprehensive up to date Statement of Purpose and Service User Guide was in place. These documents were in an appropriate format to provide service users and their relatives with information about the service the home provides. A care plan examined contained information to show that a service user recently admitted to the home had a full pre-admission assessment carried out by persons trained to do so prior to admission. The manager said any admission to the home is gradual to allow the service user and their family to make an informed decision as to whether the service user wishes to come and live there. The service user and their family are welcome to spend time in the home getting to know other service users and get to know the staff. The manager said the home does not admit service users if following assessment they do not have the capacity to meet the individual needs of the service user. Evidence was available to show that each service user is issued with a copy of the Terms and Conditions of Residency, which was seen to be signed by the manager and the service user or their representative as to their agreement. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9 and 10 The system for care planning in the home is adequate in providing staff with the information required to meet the individual needs of service users’. EVIDENCE: Care plans examined had been compiled from assessments carried out prior to admission and re-assessment of service users who had lived in the home for many years. Care plans contained adequate information to enable staff to meet the needs of the service users. The care plans did not contain evidence of agreement by service user or their relatives for the plan of care agreed. The care plan did not contain evidence of an audit being carried out by the manager to monitor quality of information to ensure the needs of service users was being met. Care plans contained evidence to show that risk management strategies where in place to ensure service users had the opportunity to lead an independent life in the home and the community. Staff during discussion said they had received training during induction to the home on confidentiality regarding personal information relating to service users. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14,15, 16 and 17 Links with the community are good and support and enrich service users’ social and educational opportunities. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The manager said one service user living in the home chose to commence a catering course at the local college as he has an interest in cooking. Evidence was available to show that service users take part in a wide range of leisure, social and cultural activities , supported by staff in the home and the community. The home has transport available to enable service users to visit facilities in the wider community. A record of activities attended by idividual service users was available for inspection. The manager said due to service users lacking capacity staff support them to maintain contact with their friends and relatives. Two service users visit their relatives on a regular basis. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 11 Two service users where observed to be assisted appropriately by staff to eat their mid-day meal. Dining arrangements where comfortable and spacious. The manager was able to demonstrate that the needs of service users who require special diets are met. The manager provided evidence to show that service users have a varied range of foods made available including a weekly take away meal of their choice. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 and 21 The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. The medication at this home is well managed promoting good health. EVIDENCE: Staff during discussion were able to demonstrate that they assisted service users with personal care in an appropriate manner respecting the dignity and privacy of the individual service user. Evidence was available to show that the physical and emotional needs of service users are being met. Visits from other health care professionals is documented in the plan of care. Due to lacking capacity staff administer medication to service users, an assessment with regard to the ability to self-administer medication was in the care plan. A policy and procedure was in place for the safe handling of medication. A policy and procedure was in place for serious illness or death occuring. Staff demonstrated during discussion that they would respect the wishes of the service user and their family during this time. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: This standard section was not assessed at this inspection. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: This standard section was not assessed at this inspection. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: This standard section was not assessed at this inspection. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The quality monitoring system in the home requires further development by the manager to ensure information included in care plans is adequate to enable staff to deliver a good service to the people who live in the home. EVIDENCE: Care plans did not contain information to show that a quality audit of the plan of care by the registered manager had been carried out. This is important in ensuring that staff have up to date quality information to adequately meet the changing needs of individual service users. Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cornerstone Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x x x B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 18 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA 37 Regulation 9 (i) Requirement The manager must achieve the Registered Managers Award by May 2006 Timescale for action May 06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard none none none Good Practice Recommendations Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cornerstone B54 S61043 Cornerstone V232452 180805 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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