CARE HOME ADULTS 18-65
THE CORNERSTONE 115 Doncaster Road Rotherham South Yorkshire S65 2BN Lead Inspector
Beryl Horton Unannounced 19 September 2005 12:20 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. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Cornerstone Address 115 Doncaster Road, Rotherham, South Yorkshire, S65 2BN 01709 365387 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) The House of Light Trust Mrs Rachel Devine Care home only 8 Category(ies) of Learning disability (8) registration, with number of places THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: One named resident over the age of 65 shall be allowed to reside at the home. Date of last inspection 14-Mar-2005 Brief Description of the Service: The Cornerstone is a residential care home and provides care and accommodation for eight adults with a learning disability. It is owned by the House of Light Trust, a charitable organisation which has other care homes for people with a learning disability in the area. It is situated in a residential area of Rotherham, opposite the local park and close to other community facilities such as shops and public houses. The building is a large victorian house with a modern extension. Accommodation is provided on three floors. There is a bathroom on each floor and all the residents rooms are of single occupancy. Communal space is provided by the three lounges and there is a large kitchen/dining area where residents like to congregate. To the rear of the house is a garden area for use of the residents and to the front is a driveway and a small off road parking area. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.75 hours. The inspection included reading a selection of residents care plans and other documentation, speaking to 4 residents, staff on duty, discussion with the manager and deputy manager, observation of the lunch time and a tour of the home. Both the manager and deputy manager assisted with the inspection. The deputy manager expressed her intention to apply to the company for the managers’ post over the two small homes, (Canna 54 Doncaster Rd and Arran) and will be contacting the Commission for Social Care Inspection for a managers’ application pack. What the service does well: What has improved since the last inspection?
The home has responded to the requirements and recommendations identified in the report of the last inspection. A summary has now been added at the end of the Statement of Purpose/Service User guide stating that the most recent inspection report and service users views of the home are available.
THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 6 The home now deals with a new pharmacist who assists with completion of the mar sheets. The stained carpet in the main lounge has been replaced with a new one. 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. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.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 THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.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 and3 Any prospective service user would be given a Statement of Purpose/Service User Guide so that they have the information they need to make an informed choice about whether to move into the home or not. To ensure that the home can meet their needs residents are admitted to the home following a full assessment of their needs. EVIDENCE: The Statement of Purpose/Service Users Guide was examined during this inspection. This document contained all the required information including a summary added at the end stating that the most recent inspection report and service users’ views of the home are available. Discussion with the deputy manager highlighted that the above document had been discussed with the residents and explained to them. Some relatives had received this document. The Cornerstone has been the present residents’ home for many years. Records showed that when these service users had been admitted a social workers assessment had been carried out. The House of Light has a policy on assessment of potential service users, and covers the needs and aspirations of the individual. When appropriate this would be used.
THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.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 and 8 Residents’ plans of care contained relevant information. EVIDENCE: Three residents plans of care were looked at. These were of a high standard and contained pictorial illustrations to help the resident understand their plan. They promoted independence and skill enhancement and covered in detail aspects of the individuals’ health, personal and social care needs. Reviews take place regularly and mini goals set. Each resident is involved in discussions about their needs and agree the content of their care plans. Through observation and discussions with the staff and residents it was clear that residents are positively encouraged to make their own choices and decisions. Residents spoke of leisure activities and where they liked to holiday. One Resident had just returned from a shopping trip to Rotherham with a member of staff and was keen to show the items she had purchased.
THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.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 and 14 The home offered opportunities for the residents to develop social, emotional, communication and independent living skills. EVIDENCE: Discussions with the staff and residents identified that the residents have the opportunity to attend the Gateway Club and day centres. During their annual review residents are encouraged to make their own decisions with regard to choice of holiday, leisure activities shopping and decorating their rooms. This information is incorporated into their plans of care. Residents are able to fulfil their spiritual needs by attending their chosen church. Community facilities including the local shops, pubs, library, cinema and public transport are accessed with support. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 11 The House of Light provides a number of communal activities that residents from all three houses could be involved in. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.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 Appropriate guidance and support is offered to residents. Residents’ physical and emotional needs are met. There are no residents who currently administer their own medication The ageing, illness and death of a resident is dealt with by the registered manager and staff in a sensitive and respectful way. EVIDENCE: The home operates a key worker system and through this residents are offered appropriate guidance and support with their personal hygiene and the way they dress. All residents spoken to said they were happy with the care they receive and that the staff were kind and helpful. Residents’ consent for staff to administer their medication is recorded in the individual plans of care. The home now deals with a new pharmacist who assists with completion of the mar sheets. Residents’ personal care plans identified appointments with a range of healthcare professionals, for example the dentist and chiropodist.
THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 13 All residents had been given the opportunity to discuss their wishes in relation to death and dying. The families’ wishes would also be taken into consideration. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 14 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 and 23 Residents’ views are listened to and acted upon. Residents are protected from abuse, neglect and self harm. EVIDENCE: Residents are able to discuss any problems they may have at the weekly residents meetings or at any other time on an individual basis with a staff member. Residents spoken to confirmed that staff are always ready to listen to them. It was noted that residents at the home were assertive and vocal and able to communicate their likes and dislikes. The home had a comprehensive complaints procedure and was in the service users guide. The complaints book was looked at and there were no complaints recorded since the previous inspection. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 15 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) 24,25,26,27,28 and 30 The Cornerstone is a large Victorian house with a modern extension. It is a spacious light and airy comfortable home, suitable for its’ stated purpose. EVIDENCE: On a tour of the home Cornerstone appeared comfortable, clean, well decorated and maintained. Furnishings and fittings were domestic in nature. Several bedrooms were checked. They were furnished to the tastes and choice of the individuals. One resident was proud to show off her room pointing out cherished items. The home had sufficient space for a number of activities to take place. Kitchen and laundry facilities were domestic in scale. It was noted that the laundry door was wedged open, thus allowing access to the machinery and cleaning products to anyone in the building. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 16 The home had sufficient bathrooms and toilets for use of the residents. There were locks on the bathroom and toilet doors. The lower ground floor toilet would benefit from redecoration in a brighter more homely colour. The broken toilet roll holder needs to be replaced and toilet paper provided. At the time of the inspection the home was clean and no adverse odours were detected. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 17 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) 35 and 36 Training is available for all staff. Staff are supervised at the required level. EVIDENCE: The home has a comprehensive induction programme which meets Sector Skills Council targets. This is delivered within six weeks of appointment followed by foundation training within six months. Each staff member had an individual training and development profile. Records showed that recent training courses have included Health & Safety, Abuse, Fire and Food Hygiene. Care staff all have NVQ Level 2 or 3. Staff receive supervision monthly on a 1-1 basis, carried out by a senior member of staff. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 18 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 and 41 Regulation 26 visits are carried out monthly. The homes’ records were stored securely. EVIDENCE: Reports of Regulation 26 visits were accessed. These expressed satisfaction with the provisions of the service. A sample of records the home is required to keep under this legislation was checked and have been commented on throughout the report. These were stored securely. The registered manager is experienced in the care of people with learning disabilities and has the required management experience. She is currently working towards the required NVQ Level 4 in Management and Care. THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 19 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 x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 4 4 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 3 2 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
THE CORNERSTONE Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 x 3 x 3 x x 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 20 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 24 Regulation 13(4)(a) Requirement For the safety of the residents the registered manager must ensure that the laundry door is locked and not wedged open as wedging of the door allows access to machinary and cleaning products to anyone at the home. Timescale for action upon receipt of this report. 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 27 Good Practice Recommendations Consideration should be given to the redecoration of the lower ground floor toilet. a brighter colour would enhance the homely feel. The broken toilet roll holder should be replaced and toilet paper supplied. 2. n/a THE CORNERSTONE 20051909 The Cornerstone X00023 UN Stage 4 S3115 V1854189 J55.doc Version 1.40 Page 21 Commission for Social Care Inspection First Floor Barclay Court Heavens Walk Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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