Inspection on 07/04/05 for Cornerstones

This inspection was carried out on 7th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Cornerstones 04/10/06

Cornerstones 16/11/05

Cornerstones 20/10/04

Cornerstones 08/07/04

Cornerstones 23/03/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Cornerstones 43-45 St Johns Road Exmouth Devon EX8 4DD Lead Inspector Bel Heginworth Announced 7 April 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. Cornerstones Version 1.00 Page 3 SERVICE INFORMATION Name of service Cornerstones Address 43-45 St Johns Road, Exmouth EX8 4DD 01395 275892 01395 275892 Jacqueline.watson@devonptnrs.nhs.uk Devon Partnership NHS Trust 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) Mrs Jacqueline Watson CRH Care Home; PC Personal Care Only 5 Category(ies) of LD Learning Disability [5]; registration, with number PD Physical Disabilty [5] of places Conditions of registration Date of last inspection Yes 20/10/04 Brief Description of the Service: Cornerstones provides support and personal care for five residents with a learning disability. The home consists of two semi detached bungalows which are linked internally. One bungalow provides care for one resident and the other for four. Each house has a lounge, dining room, kitchen, bathroom and bedrooms. The home also has an additional toilet and an office. There are gardens to the front and rear of the property. Cornerstones Version 1.00 Page 4 SUMMARY This is an overview of what the inspector found during the inspection. A number of the residents living at Cornerstones have limited verbal communication skills therefore were unable to contribute fully to the inspection process. Five residents were spoken with or spent time with. Six staff were spoken with including the deputy manager. This announced inspection took place over 6 hours. The provider’s representative, Mr Richard Platt attended for a short period and the manager Jacqueline Watson was present throughout the day. The inspector looked around parts of the building and a number of records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Cornerstones Version 1.00 Page 5 Information relating to what residents pay for and what they don’t should be made clearer Restrictions on choice or freedom should be discussed, agreed and recorded with other professionals. For example a Good Practice Committee. Medication should be stored in a cabinet secured to a fixed point. Some areas around the home are in need of decoration, replacement or repairs. For example, showers, bath surround, cooker, walls. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cornerstones Version 1.00 Page 6 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 Cornerstones Version 1.00 Page 7 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 The home’s Statement of Purpose and Service User Guide are very good. They provide residents and prospective residents with details of the services the home provides. This enables an informed decision to be made about admission to the home. Information relating to fees needs to be improved. EVIDENCE: A recommendation was made during the last inspection relating to information about what is included in the fees and what residents would be expected to pay for. The Statement of Purpose, Contracts or Terms and Conditions of occupancy do not provide sufficient detail. For example who pays for furniture, bedding and holidays. Cornerstones Version 1.00 Page 8 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 Care planning and risk assessments provide staff with the information they require to satisfactorily meet residents’ needs safely. Some improvements are needed in relation to the decision making process. This is particularly important given that residents have limited capacity to contribute to plans and decisions. EVIDENCE: Residents have limited communication skills and have a limited understanding of care plans and are therefore unable to contribute to their formulation or reviews. Care plans provide accessible information and guidance about assessed needs and set individual goals that encourage independent living skills. Relatives and the staff team advocate on behalf of the residents and work hard to identify any changes in their assessed needs. Staff demonstrated an excellent knowledge and understanding of the plans. Risks are carefully identified and minimised. The home uses a listening device to meet the health needs of one resident. This was discussed with relatives but not with other professionals. The use of devices which might impact upon a resident’s privacy should always be discussed and agreed with families and community professionals. Cornerstones Version 1.00 Page 9 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) 17 The meals in the home are good and offer both choice and variety. Specialist dietary needs are catered for. EVIDENCE: Menus are provided. Records of food eaten confirmed that balanced, nutritious and varied meals are provided at the home. Residents’ likes, dislikes and preferences are recorded in individual files and nutritional needs are assessed at each care plan review. Residents who can and who wish to, can help prepare and cook meals. Cornerstones Version 1.00 Page 10 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) 20 Medicines and administration are managed well. The storage arrangements need to be improved. EVIDENCE: The manager provides in-house training on the safe administration of medicines. Medication policies and procedures give staff additional information and guidelines. Medication is stored in a locked filing cabinet in the staff sleeping–in room. The CSCI pharmacy inspector has advised that the cabinet should be secured to a wall or floor. He has also advised on appropriate training for staff. Cornerstones Version 1.00 Page 11 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) 22 & 23 The home has a good complaints system with some evidence in care plans that residents’ views are listened to and acted upon. The home has good systems in place to protect residents from abuse, neglect and self-harm. EVIDENCE: The home has a clear complaints policy displayed in the hall which ensures residents and visitors are aware of how to complain. Staff demonstrated a good knowledge and understanding of the policy and knew what to do if they suspected abuse. Staff have received Adult Protection training and relevant policies are in place. Residents have bank accounts where benefits are paid. The home keeps good financial records which are clear, accurate and up to date. Policy and practice on the storage and handling of residents’ monies is good. There was evidence of regular audits and two signatures are provided for each transaction. Any significant spending is discussed with care managers and relatives. Residents’ interests are thereby well protected. Cornerstones Version 1.00 Page 12 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) 24 The standard of décor within the home is adequate with evidence of improvement through maintenance or future planning. EVIDENCE: A number of areas in the home were identified as in need of improvement. Two showers and a bath surround need replacing. Some walls around the home have holes in them due to damage caused by residents. A garden bench is broken and could cause harm to anyone who sits on it. A cooker in one of the kitchens needs replacing. A window is boarded up due to broken glass and there was no door on a bathroom due to service users removing it the day before. The provider has arranged for this work to be completed. Once completed the home will be safer and more homely for residents. Cornerstones Version 1.00 Page 13 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) 34 & 35 Residents are supported by an effective, competent and experienced staff team with recruitment practices that protect service users. EVIDENCE: The home’s recruitment procedure and practices ensure that the necessary checks are carried out for the protection of residents. Any new staff joining the team are using the Learning Disability Award Framework (LDAF) for induction and foundation training. This will provide underpinning knowledge for progress towards achieving NVQs. A number of staff have achieved NVQ qualifications. The home has a good record of staff training that meets the needs of residents. The manager uses team meetings and supervision to provide training, guidance and clear direction to staff to protect and meet residents’ needs, safety and welfare. Cornerstones Version 1.00 Page 14 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) 37 & 39 The home is managed effectively, efficiently and safely. The home regularly reviews its performance through a good programme of self-assessment that includes seeking the views of relatives. EVIDENCE: The manager has completed NVQ level 4 and the Registered Manager’s Award. She is also an NVQ assessor and attends a range of relevant training sessions. Staff said that the manager provides a clear sense of direction that helps to ensure that residents’ needs are met. The home has quality assurance standards that has include information about staff training and supervision, and other practices carried out in the home to ensure that good quality care is delivered. The manager intends to develop this further as part of a continuous improvement programme. Residents’ care plan reviews; team meetings and relative meetings, staff supervision and training are all included in the quality review system. Cornerstones Version 1.00 Page 15 The fire logbook was up to-date with records of relevant staff training to ensure that the health and welfare of residents are protected Cornerstones Version 1.00 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x x x 3 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 4 x 3 x x x x Cornerstones Version 1.00 Page 17 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 Regulation None Requirement Timescale for action 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. Refer to Standard YA1 Good Practice Recommendations Details of the items residents will be expected to pay for should be further clarified within the contracts, statement of purpose or terms and conditions of occupancy to ensure that staff, residents and/or their representatives know exactly what services are covered within the fees, and what items are considered to be ‘extras’ that the residents will be expected to pay for. Restrictions on freedom of choice or privacy should be discussed within a multi-disciplinary setting with records of reasons why. Medication should be kept in a cabinet that is secured to a fixed point. Training on the Safe Handling and Administration of Medicines should be obtained for all staff who adminster medicine. All repairs and replacements should be carried out in the home as soon as possible. 2. 3. YA7 YA20 4. YA24 Cornerstones Version 1.00 Page 18 Commission for Social Care Inspection Suite 1 Renslade House Bonhay Road Exeter EX4 3AY 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 Cornerstones Version 1.00 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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