Three Corners is registered to provide accommodation and personal and nursing care for up to 46 older people. Three Corners also provide short term support to people via the Intermediate Care scheme. This scheme enables people who have left hospital to receive support from the home and healthcare professionals before going home. People living at Three Corners had needs relating to living with dementia, mobility and general health.
A registered manager was employed by the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The service was last inspected on 8 and 9 December 2014 when it was rated as ‘requires improvement’. Improvements were needed in relation to risk assessments for the environment, decisions being made on behalf of people who lacked capacity, the care planning system, staff did not always display a caring attitude and staffing levels not being reviewed. The registered manager sent us an action plan stating all matters would be completed by 31 July 2015. This inspection took place on 28 and 29 October 2015 when we found improvements had been made. There were 44 people living at Three Corners during the time of the inspection.
People’s care records were comprehensive but they did not always contain the most up to date information. We have made a recommendation in relation to this.
There were quality assurance systems in place to monitor care and plan on-going improvements. However, these systems had not identified that some records were not being completed consistently.
People told us they felt the registered manager was very open and approachable. All staff said they felt well supported to do a good job. They told us “….the management, if you have any problems you can go to them and they sit there and listen”. People told us they were confident any concerns would be dealt with straight away.
The registered manager and registered provider were keen to provide a good service. They planned to install ‘wet rooms’ to enable people shower more easily. Specialist advice had been sought to ensure the environment was suitable for people living with dementia. Changes had been made to the nurses’ station and an area had been provided where visitors could help themselves to drinks.
People had a choice at mealtimes and hot and cold drinks were available at all times. We saw people provided with an alternative when they did not want what was on the menu.
Staffing levels were sufficient to ensure people’s needs were met safely at all times. Call bells were answered promptly and people told us they didn’t have to wait for the help they needed.
Staff were responsive to people’s needs and ensured people’s needs were met in a kind and caring manner. Positive relationships had been developed between staff and people living at Three Corners. People made many positive comments about staff including “The staff are excellent and friendly – I suppose it is the extra touch, and they’re willing to get you anything extra you ask for, and they don’t forget. They go beyond the call of duty; they’ll do anything for you”. People looked clean and well cared for. Staff respected people’s privacy and dignity and all personal care was provided in private.
People were supported to receive the healthcare they needed. Records showed they received regular visits from healthcare professionals such as GPs and physiotherapists. One GP told us “My overall impression is very positive. The staff and systems are very responsive”. People's medicines were managed safely and people received their medicines as prescribed in order to maintain good health.
People and their relatives were supported to be involved in making decisions about their care if they wished to be. People’s care plans were comprehensive and updated regularly. Visitors were welcomed at any time. People were confident that if they raised concerns they would be dealt with quickly.
People were protected from the risks of abuse as staff were aware of how to report concerns and had received training in how to keep people safe. Any staff employed were subject to robust recruitment procedures. This minimised the risks of unsuitable staff being employed by the home. People who were able to, told us they felt safe at the home, one person said the staff member who had assisted them that morning had been “excellent” and had made them feel safe. One visitor told us they felt their relative was “absolutely” safe.
People were asked for their consent before staff provided personal care. Staff told us they would always respect people’s wishes if they declined personal care. Staff who displayed a good understanding of the principles of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards (DoLS). This ensured people’s human rights were upheld at all times.
We recommend the service explores the NHS guidance ‘Benchmark for record keeping’.