Archived: Cornerstones (UK) Limited - 9 Roseland Avenue

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the last inspection on 29 June and 5 July 2017 we found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014. This was because audits did not always identify shortfalls. Where shortfalls were identified, action was not taken to ensure fundamental standards were met. The provider wrote to us telling us of the actions they were taking to make improvements. At this inspection we found improvements had been made.

People were kept safe from the risk of harm and abuse. Staff were knowledgeable about the types of abuse and how to report it. Risks were identified and assessed and assessments reviewed regularly. There were sufficient numbers of staff deployed to meet people’s needs. Medicines were administered, stored and managed safely.

Staff were appropriately trained. Care plans were person centred and contained personalised information to support people’s needs. Staff worked together with health and social care professionals to deliver timely health care and promote well-being.

Staff and people had developed respectful and caring relationships. The person-centred ethos of care was shared throughout the staff group. There were quality assurance and audit processes in place, including requests for feedback from people and their relatives about the service.

Care was planned to reflect people’s preferences and abilities. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Further information is in the detailed findings below.

Last inspection was carried out 21 January 2016. We identified two breaches of Regulation 12 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 associated with the safe & well led domain. We made two requirement notices regarding financial arrangements and notifications to us. The provider sent us an action plan as requested. The manager registered with us in May 2016.

At this inspection we identified audits were not always identifying shortfalls, which were not actioned. Where shortfalls were identified action was not taken to ensure fundamental standards were met. This is a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 regulation 17. We have made a recommendation about the management of some medicines.

This inspection took place on 29 June and 4 July 2017 and was announced. The provider was given short notice because people living in the home can become unsettled by the presence of an unannounced visitor. This gave the provider an opportunity to plan our visit with the people using the service. The inspection was carried out by one inspector and an expert by experience. We found improvements had been made to people’s financial arrangements and we have received notifications as required.

A registered manager was employed by the service, they were on annual leave during this inspection, however the nominated individual and another manager registered at another location owned by the provider were present throughout the inspection. 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.

People were supported to maintain good health and had access to healthcare services, however one person had delayed access to dental health.

There was a stable management team who took appropriate action to make sure they provided a safe and reliable service for people.

People received care and support from staff they knew well and had built trusting relationships with them.

People were treated with respect and dignity and were encouraged to make choices.

Staff felt supported and received training they required to carry out their jobs.

The service’s robust recruitment procedure and staff training helped to minimise the risks of abuse to people.

You can see what action we told the provider to take at the back of the full version of the report.

One person told us they 'liked" living at the home and that staff treated them well.

We saw staff offered people choices throughout the day, such as a choice of drinks and food, what they would prefer to watch on the television and if they would like to go out for a walk.

Records demonstrated that staff worked in conjunction with other health care professionals with regard to people's care and welfare. Decisions relating to people's care and treatment were made within a multi-disciplinary team.

As part of our inspection we toured the building and found it to be safe and suitable for the needs of the people living there. One person explained they had moved bedrooms due to changes in their physical health. Records showed staff had explained the reasons for the move to the person and they had agreed it would be in their best interests.

The home had systems in place to ensure any concerns or complaints were dealt with in a timely manner and in line with company policy.