Care Home: Cornerways

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• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well The staff know the residents well and they treat people with dignity and respect. The residents said they liked the staff, comments included `The staff are kind and caring` `They are all very nice and they smile`. The care plans give the staff the information they need to meet all of the residents needs. The staff seek medical advice and they follow this advice when caring for the residents. Complaints are managed appropriately and the staff are aware of how to manage concerns from the residents or their families. The residents benefit from a range of activities that they can participate in. These range from an in house knitting group to potting up plants as well as trips outside the home. These trips will increase as the weather improves and several are planned to local attractions. One relative said ` It was lovely to see my family member smiling while potting the plants as they used to love gardening`. The new manager has ensured that the staff are working as a team and they were praised by the staff, the visitors and the residents for their open and supportive attitude. What has improved since the last inspection? The care plans have improved and they now contain useful information that includes the preferred routines of the residents. The plans continue to be changed and the manager knows what further improvements are needed. The procedure for storing, administering and recording medication has changed and the staff are following the action plan to ensure the administration of medication is safe. The heating in the home has been repaired and one resident said they had noticed the difference and the home was warmer. The manager and the staff have asked the residents their opinions about renaming the wings with flower names. They have then accessorised the dining areas to brighten these up and make them more pleasant areas to eat in. The staff files are now completed and for the safety of the residents criminal bureau checks are available for all staff. Staff training has increased and relevant courses are being offered to the staff to increase their knowledge and skills. What the care home could do better: No new requirements have been made. The manager is working towards further improvements in the care planning information, the environment and the laundry services. Key inspection report Care homes for older people Name: Address: Cornerways Church Lane Kings Worthy Winchester Hampshire SO23 7QS     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kima Sutherland-Dee     Date: 0 9 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Cornerways Church Lane Kings Worthy Winchester Hampshire SO23 7QS 01962882060 01962884340 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hampshire County Council Name of registered manager (if applicable) Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Date of last inspection Brief description of the care home Cornerways is a registered care home providing personal support and accommodation for up to forty older people. The home is owned by Hampshire County Council. The home is divided into four units, with ten single bedrooms, a communal lounge, Care Homes for Older People Page 4 of 26 Over 65 0 40 40 0 1 9 1 2 2 0 0 9 Brief description of the care home dining room and kitchenette in each unit. Both units on the ground floor accommodate residents who require dementia care. The two remaining units on the first floor accommodate older people. The home is surrounded by landscaped gardens. The home is situated in the quiet village of Kingsworthy, three miles away from Winchester. A small local shop is within walking distance from the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We prepared for this inspection by reviewing the requirements that were made following the last key inspection on the 19th December 2009. We also looked at the action plan the home had sent us which told us how the service planned to improve the outcomes for the residents. We looked at the surveys that had been returned from a sample of the residents and the staff and any other information we had received about this home. The new manager at the home is in the process of registering with the commission and they are referred to as the manager throughout out this report. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 7 of 26 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does give people or their relatives the written information they need to make an informed decision before they choose this home. Evidence: The service has not admitted any new service users since they voluntarily suspended admissions following the previous poor rating. A sample of the terms and conditions were seen and these had been given to service users along with the statement of purpose. Five surveys were returned and of these three people said they had been given enough information about the home before they had moved in. Two said they had not had written information. This result should be viewed in the context of the home accommodating service users with varying levels of dementia, therefore people may not recall the written information that had been provided to them. Prospective service users are given opportunities to visit the home before they move in. This was confirmed by two visiting relatives. This is also the homes policy as stated Care Homes for Older People Page 10 of 26 Evidence: in the service users guide. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are having their personal and healthcare needs met and these are being recorded. The residents are treated with dignity and respect. The systems for the administration of medication have improved. Evidence: A sample of four care plans were seen. These have improved since the last inspection, they contained more information about the residents needs and how these should be met. A member of staff is working to improve the personal details in the plans and to increase the ways in which the residents can be involved in their care plans. The residents preferred routines such as when they like to get up are recorded. The care plans have been regularly reviewed and updated and the staff are told about any changes when they start each day at the home. This information was given to staff in a way which respected the dignity and privacy of the residents. The residents said they really like the staff and that they are wonderful and kind and They always help me and they smile. Two staff said how much they enjoyed working with the residents. They said We communicate really well with the residents, they like Care Homes for Older People Page 12 of 26 Evidence: to hear about what we have been doing and they tell us about their families. We think about how we would like things done, and that is how we do the care for the residents. The care plans recorded peoples health needs as well as any visits from doctors or other health professionals. One visiting district nurse said that the care had improved recently and the staff were aware of the residents needs. They said that sometimes the communication could be improved but the staff always sought advice about the care of the residents. They gave an example of one resident who developed a sore area and the staff contacted the nurses straight away and then arranged for the person to be cared for in a way that suited their needs. The nurse also stated that the home arranged to get the equipment people needed and the home had a low incidence of pressure sores. The staff were able to describe the residents needs and how they met these needs. An example is that the staff noticed that a resident had lost weight, they recorded this and then started to use a food chart to monitor the amount of food that was being eaten. They then weighed the resident again. The care plans included useful daily notes that the staff wrote to record the care that the residents had needed that day. Out of five surveys from the residents ,two said they always got the care they needed, two said they usually did and one person said that they sometimes did. The results from the survey should be viewed in the context that the majority of the residents have some level of dementia. During the inspection all the residents spoken with praised the staff and said that they always helped them. The staff survey said that We all care for the residents wellbeing The staff are caring and they spend time with the residents. Two visitors said that the staff had always called a G.P as needed and they had kept the family informed about their relatives condition. The commission received a letter from a relative who said that they had always found the care at the home very good and the staff met the needs of their relative. We saw the staff administer medication. This was being done correctly and new measures have been put in place to prevent a repeat of three recent medication errors. The staff have attended training, staff are not being distracted while giving medicines and new medication trolleys are in use. The senior staff are making sure the medication records are completed daily and these were seen to be complete. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents benefit from a range of activities that suit their needs. The residents are offered food that meets their needs and this is served in pleasant surroundings. Evidence: The activities co ordinator had continued to improve the range and variety of activities that the residents could choose to participate in. Two visitors commented that since the activities co ordinator started they had tried hard to increase the activities. The recent staff meeting instructed staff to always carry out the planned daily activities and to record when residents take part in daily living tasks. The manager recognises that there should be more resident involvement in daily living such as asking residents if they would like to lay the table or tidy their own rooms. The activities co ordinator also recognised that this would be beneficial for some residents. The residents said they enjoyed the activities. During easter the home had hatched eggs and had live chicks. The residents had shown great interest in the progress of the chicks and the staff had taken different residents to the garden room to see them. The home was in the process of consulting the residents about whether to keep some of the chickens or return them to the farm. The residents had started a knitting club which was enjoyed by six or seven people. A relative commented that the knitting club had been good as it provided company as well as something to do. The activities co ordinator had made Care Homes for Older People Page 14 of 26 Evidence: arrangements for trips to a steam railway for D day celebrations and a local attraction who were putting on a special reminiscence day for people with dementia. The residents said they could choose what they do. The manager recognised that it is important to encourage the residents to participate in activities whilst recognising their right to choice. Families are welcome to visit the home at any reasonable time. Visitors to the home are made welcome. Three visiting relatives said that the staff were welcoming and friendly. One relative said that they and their family attend the events at the home which they enjoyed. Five relatives had attended an easter event and they had stayed for lunch. One relative had sent a thank you letter praising the staff. The residents said they liked the food at the home. The residents survey said that one person always liked the food, one said they usually did and three said they sometimes liked the food. The food is discussed at residents meetings and the cooks offer the residents choices. Any food dislikes are recorded in the residents care plans. The dining rooms have improved and they are now colour themed to match the new flower names of the wings. The table cloths, napkins and decorations have made the rooms brighter and more pleasant places for the residents to take their meals. The residents had personalised place mats. They said that the food was good and they could choose what to eat. The manager has spent time eating meals with the residents and encouraged the staff to do the same. The staff had noticed the positive effect of this, as the residents had eaten more of their food. The staff have been instructed during a staff meeting to make sure that all the residents who need fortified drinks get these and that this is recorded. The food charts did have these recorded for the previous week. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents and their relatives are confident that any complaints will be managed appropriately. The residents are protected form abuse by staff training and clear procedures. Evidence: The home has a comprehensive complaints procedure. This procedure is displayed around the home for residents and relatives use. The information is also included in the statement of purpose. One relative said that they would be confident that any concerns would be dealt with. Two other relatives said that they have knocked on the door of the office and the staff have always been friendly and helpful and answered any questions. One new complaint had been received in January 2010. This had been dealt with appropriately. The residents are asked if there are any complaints or comments in the regular meetings. The minutes for a meeting in March recorded no new complaints. The home had received compliments letters from relatives, these praised the care at the home and the attitude of the staff. The survey said that all five residents who responded had someone they could talk to if they were not happy. Four people said they knew how to make a formal complaint and one person said they did not know how to complain. The staff have attended or are booked to attend training in protecting the residents from abuse. All five staff who returned a survey said they knew how to respond to any concerns. Two staff spoken with were clear that they would report any concerns to Care Homes for Older People Page 16 of 26 Evidence: more senior staff. The home has a clear procedure for dealing with any issues of safeguarding the residents. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home environment meets the needs of the current residents. Action is being taken to continue to imrpove the laundry systems. Evidence: The homes heating was fixed in January 2010 and the home was much warmer during this inspection. The resident who had complained about their room being cold said this had improved. Each room now contains a thermometer and the staff are checking these regularly. The staff are asking the residents if they want their windows open and if this is the case the staff are checking that they are closed by the afternoon to prevent the rooms getting very cold. The manager has worked with the staff to improve the laundry systems. The staff meeting minutes in April 2010 recorded that there were still some issues to resolve. The staff have been instructed to take more care with peoples clothes and to ensure that clothes were returned to the right residents and kept in good repair. One relative said that their family members clothes were washed properly and returned to them and they were wearing their own clothes whenever they visited. The manager and the staff have improved the environment by theming the dining rooms and adding colourful accessories such as tablecloths. The residents were asked their opinions about the names for each wing and the colours. One visitor said their Care Homes for Older People Page 18 of 26 Evidence: relative had been asked before they moved in what they wanted in their room. The home then had a new carpet fitted and a special bed supplied. They added that the home is always fresh and clean. Out of the five surveys returned from the residents, three said the home was always fresh and clean and two said it usually was. The home employs domestic staff, and there were no unpleasant odours in any of the wings. The homes AQAA ( self assessment) identifies areas for improvement and how this will be achieved. The manager discussed the need for a shower as one bath was too low to safely use. During the inspection workmen were in the process of fitting new fire doors throughout the home. This was causing some disruption and the staff were ensuring that this was kept to a minimum for the residents. People were offered quieter lounges to sit in in different areas of the home while work was being done. The staff have had training in infection control. The service took appropriate action regarding a recent infection control incident in a limited number of rooms. This had been contained and managed appropriately. The cause had been identified as a resident bringing in an item from their own home. Staff are supplied with the information and the equipment they need to control infection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are cared for by a safely recruited and trained team of carers. Evidence: The staff spoken with said there were enough staff on duty to meet the residents needs. The staff rota showed that there were always at least one member of staff on each wing as well as the assistant unit managers who help as needed and often one other carer. The manager said they often helped as needed. Two members of staff said they had time to chat to the residents. The staff said that the carers motivation had improved along with team work and communication between the staff team. Four staff files were seen and these contained all of the required information for the safe recruitment of staff. These included criminal bureau records checks, Protection of vulnerable adults checks and two references. All five staff who returned a survey confirmed that they had had these checks before they started work at the home. Two staff said that they had had induction training when they started work and they had worked with senior staff for three weeks to get to know the residents and understand their roles. The staff have taken part in training recently and the courses have included, fire safety, manual handling, medication and safeguarding. On the day of the inspection a senior member of staff was running an in house course on nutrition. The staff meeting minutes from early April 2010 discussed the need for all Care Homes for Older People Page 20 of 26 Evidence: staff to attend the arranged training sessions. Two members of staff said the training had been really useful and they had learned many new skills. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of the residents. Evidence: The new manager is in the process of applying to register with the commission. Throughout this inspection both the staff, a health professional and three relatives commented on the open and supportive approach of the manager and that the home had improved. The manager has implemented the improvement action plan and all the requirements have been met by the compliance dates that we set at the last inspection. This has improved the service for the residents. The manager has ensured that the care plans have improved and this has given the staff a better understanding of the needs of each resident and how to meet those needs. The environment has improved as well as the the communication with the residents relatives. The manager has increased the staff training and they have worked with the activities co ordinator to increase the activities for the residents. The manager knows what improvements are still needed and how these will be Care Homes for Older People Page 22 of 26 Evidence: achieved. They are leading and guiding the staff team and supervising the work at the home closely to monitor the improvements and to make sure they are sustained. The home has had two poor ratings in the last twelve months and although many improvements have taken place and no new requirements have been made, the rating is adequate rather than good. This is because the manager is not yet registered and because we need to see that the home can sustain the improvements over a period of time for the benefit of the residents. Five staff responded to the survey and two said that they were regularly supervised and had an opportunity to discuss their roles, two said they were often supervised and one said sometimes. Since the survey had been returned the manager is ensuring that staff are regularly supervised. Three staff said they were supported well and that team work had improved at the home for the benefit of the residents. Hampshire fire and rescue service recently inspected the home and the home passed with one requirement to fit two new signs. An internal health and safety audit also made recommendations and these are being actioned. These related to how the home risk assesses the environment and the residents and the staff knowledge about where to access this information. The care plans contained risk assessments for all aspects of the residents care and the staff knew what they needed to do to minimise the risks to the residents. These included the risks of falls, mobility and manual handling and nutrition and skin condition. The AQAA stated that all of the fire equipement and appliances had been serviced and the dates were recorded. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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