Inspection on 09/08/06 for Cornerstone

This inspection was carried out on 9th August 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cornerstone 06/09/07

Cornerstone 19/01/06

Cornerstone 18/08/05

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 Durham DL1 4EX Lead Inspector Mr Leonard Hird Unannounced Inspection 9th August 2006 10:00 Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 1 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 Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 2 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 Stationery 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 DS0000061043.V304767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornerstone Address 51 Pease Street Darlington Durham DL1 4EX 01325 261658 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) rich@wecare.org.uk Cornerstone Care (Durham) Ltd Richard McManners Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Cornerstone is a residential care home providing residential care services for up to 12 adults in the Category of Learning Disability (LD). Cornerstone is owned and managed by Cornerstone Care (Durham) Ltd. Cornerstone is located in a residential part of Darlington and 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 residents. The accommodation comprises 10 single and one double bedroom along with a range of communal spaces and garden areas. Cornerstone has its own separate day centre called the Ruby Centre within its grounds. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection of Cornerstone took place on the 9th August between 1430 and 1800 hrs, the 14th August between 1330 and 1800 hrs and 21st August between 1000 and 1300hrs. The inspection process considered all of the Key standard areas as identified by the Commission for Social Care Inspection within the Care Homes for Younger Adults National Minimum Standards. These Key standards are: Choice of Home (NMS2), Individual Needs and Choices (NMS 6,7 and 9), Lifestyle (NMS 12, 13, 15,16 and 17) Personal and Healthcare Support (NMS 18,19 and 20), Concerns Complaints and Protection (NMS 22 and 23), Environment (NMS24 and 30) Staffing (NMS 32, 34, 35) Conduct and Management of the Home (NMS 37,39 and 42). Comments were received from residents, the registered manager and members of the care staff team. What the service does well: What has improved since the last inspection? Remedial repairs and decoration to the water and plaster damage found in the dining room at the last inspection had been satisfactorily completed. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 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 DS0000061043.V304767.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 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 the following standard(s): NMS2 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home had ensured that prior to the admission of a resident to the home both the local authorities social care and health team as well as the home’s registered manager had carried out an assessment of need. EVIDENCE: From a review of individual residents care plans it was noted that assessments of need had been carried out prior to admission. The local authorities social care and health team and the home had undertaken these assessments of need separately. Resident’s representatives had signed the assessment documentation on behalf of their relative and the information was being maintained on individual residents files. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 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 the following standard(s): NMS 6 NMS 7 and NMS 9 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service The system for care planning in the home is adequate and provides staff with the information required to assist them in meeting the needs of the individual resident. Residents were being encouraged and supported to participate in the decisionmaking and risk taking process that affected their lives. EVIDENCE: Residents care plans were generally being reviewed on a monthly basis at the home by the care staff and records were maintained of these reviews. The local authorities social care and health team also reviewed the individuals care plan, annually. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 10 When there had been an involvement or intervention of specialist staff in the care of a resident this had been recorded. Where changes had been identified to an individual’s care plan by the specialist staff this had been recorded and carried out by the care staff. Records were being maintained of the daily life of the individual resident within the home and included information on the activities the resident had taken part in. Contained within the care plans was information regarding any restrictions on individual residents choice and freedom and how this was to be managed e.g. the introduction of a new specialist diet for a resident. Not all of the information contained in some individual care plans had been maintained in an up-to-date manner. This lack of up-to-date information within some care plans had also been commented on in the last two Regulation 26 Visits of the 14/07/06 and the 19/06/06 made by the companys representative to the home. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 11 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 the following standard(s): NMS 12 NMS 13 NMS 15 NMS 16 and NMS 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities available at Cornerstone were varied and flexible and met the current needs of the residents. The independence and personal choices of residents at Cornerstone were being actively promoted by the home. The dietary needs of residents were catered for with a balanced and varied selection of food being provided. EVIDENCE: Residents had individually planned programs of weekly activities that had been developed to take account of the residents’ own likes and dislikes. Activities ranged from walks, a meal or drink at local public houses, swimming sessions, pamper sessions and listening to music. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 12 Activities were arranged either for the individual resident or the group as a whole by the home. Cornerstone had recently appointed a member of staff to develop and improve the current activities programme. During the inspection, it was observed some of the residents were getting ready to go swimming or visit their favourite local public house. Residents communicated that they were looking forward to going to their swimming session at Northallerton Leisure Centre, as well as going to the local public house. Cornerstone had its own people carrier for transporting residents to different activities or used public transport where appropriate. In discussions with staff it was confirmed that if residents didnt wish to partake in an activity they didnt need to. Menus were being displayed in the home of the choices of food available and special diets were catered for as and when required. The Registered Manager confirmed that the home along with a residents family had been involved in the introduction of a specialist diet for one of the residents. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 13 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 the following standard(s): NMS18 NMS 19 and NMS 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The health needs of residents were being met with evidence of good multidisciplinary working taking place. No resident currently can self-administer medication. EVIDENCE: A review of residents care plans confirmed that residents were receiving support and advice from health professionals as and when required. Individual residents care plans contained information about the involvement of doctors, dentists, dieticians and other healthcare professionals who were contributing to the well being of the resident. The home had appropriate policies and procedures in how to administer medication to residents for care staff to refer to. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 14 Staff involved in the administration of medication had undergone training in the Safe Handling and Administration of Medication. Records of this training and first aid training were been maintained. Staff were observed during the inspection process to be providing friendly and sensitive support to the residents. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 15 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 the following standard(s): NMS 22 and NMS 23 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The complaints and adult protection policies and procedures currently being used in Cornerstone provide for a safe environment for residents to live in. EVIDENCE: Cornerstone had appropriate policies and procedures in place for the Protection of Vulnerable Adults. Staff had received training on how to deal with the Protection of Vulnerable Adults. In discussions with staff they confirmed that they were aware of the importance of acting quickly in cases of suspected abuse and that they would follow the homes policy and procedures if the situation arose. There had been no recent adult protection issues in the home Cornerstone had a simple and effective complaints procedure available within the home for residents and their families. There had been no recent complaints made. It was observed during the inspection that the residents could communicate with staff in various ways, and if necessary, they could express themselves well enough to be listened to and be able to put forward their point of view. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 16 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 the following standard(s): NMS 24 and NMS 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Cornerstone provides a safe, and comfortable environment for residents to live in. EVIDENCE: Cornerstone was on the whole clean and tidy but not completely free from unpleasant odours on the days of inspection. Individual residents rooms that were viewed by invitation of the resident had been decorated and furnished in a style that suited the resident, though some rooms were not free from unpleasant odours. Residents communicated that they were pleased with their room when they were showing the Inspector around. During the inspection, it was noted that work was being undertaken to upgrade the resident’s bathrooms. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 17 The communal living and dining areas were decorated and furnished adequately. Maintenance work undertaken on the homes equipment and facilities had been recorded appropriately. There were appropriate systems in place for infection control. The homes infection control policies and procedures were written in accordance with relevant legislation and professional guidance. It was confirmed by staff that they had or were about to receive training in infection control and a record of this, where applicable had been kept. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): MMS 32 NMS 34 and NMS 35 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service Cornerstone through its recruitment, employment and training procedures were ensuring that only suitably qualified care staff had been employed at the home. Staffing levels at the home were sufficient to meet the current assessed needs of the residents. EVIDENCE: From a review of the staff rota provided it was noted that staff were being deployed in sufficient numbers as to ensure the current needs of the residents were being met. There was a commitment to training for staff at the home and 25 of the care staff were qualified at NVQ level 2 or above with the rest of the staff in the process of completing the qualification. Discussions with the visiting external NVQ assessor for the home, confirmed that the home, offered them every assistance in completing their assessments of the staff. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 19 The Registered Manager had not yet completed the appropriate qualification at NVQ level 4 in management and care. Staff recently employed at the home had received induction training. There was a training programme operating in the home providing training for staff in moving and handling, first aid and the Protection of Vulnerable Adults. Records of training undertaken and completed by staff were being maintained. All staff employed at the home had being recruited in accordance with the homes recruitment policies procedures. All of the appropriate employment checks prior to starting to work at the home had been undertaken and recorded. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 37 NMS 39 and NMS 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Cornerstone has an established management structure ensuring that the home promotes the health, safety, welfare, and rights of residents. EVIDENCE: Records of individual staff supervision sessions were being maintained securely and staff confirmed that they had received copies. Staff meetings were held regularly and records of these meetings were being kept. From discussions with staff it was confirmed that they were aware of the management structure within the home. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 21 Records were being maintained of when equipment had been serviced and who had undertaken and completed the work. There were policies and procedures available in the home regarding health and safety for staff and residents. Cornerstone does not currently carry out in-depth surveys of residents, visitors or visiting professionals to find out their views of the home and the care provided Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 X 3 3 X 3 X 3 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 23 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 YA6 Regulation 15(2)(b) Requirement Timescale for action 31/10/06 2. YA30 16 (2) (k) The registered manager must ensure that service users plans are kept up to date and reviewed regularly. The registered manager must 31/10/06 ensure that the home is kept free from offensive odours 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. Refer to Standard YA37 YA39 Good Practice Recommendations The manager should achieve the Registered Managers Award by May 2006 It is recommended that the home undertake surveys of residents, visitors of visiting professionals to find out their views of the home and the care provided. Cornerstone DS0000061043.V304767.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office 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 DS0000061043.V304767.R01.S.doc Version 5.2 Page 25 - 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. 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