Archived: Cornish Close

Updated 2 May 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Cornish Close is a service providing both accommodation and nursing or personal care for people living in the respite unit. This is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Thirteen people living in five bungalows on the same site had their own tenancies. Staff provide personal care so they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; for people living in this setting we only looked at personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with ten members of staff including the registered manager, area manager, support workers and a member of agency staff.

We reviewed a range of records on the unit and in the bungalows. This included five people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, supervision matrix and quality assurance records.

Updated 2 May 2020

Cornish Close is a service registered to provide accommodation, care and support for up to six people accessing care and support on a respite basis, sometimes in the event of an emergency. There are also five bungalows on the same site and people with their own tenancies receive personal care and support from staff at the service. People receiving a service have a learning disability; some people have other additional complex needs.

At the time of this inspection there were three people accessing the respite unit, some on a longer-term basis until a more suitable placement could be sourced. Thirteen people were being supported in five bungalows. A bungalow empty at the last inspection was now refurbished. Two people previously living in the respite unit had moved into this bungalow as planned.

The service has been designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. The service did not always consistently apply these principles and values. Staffing levels meant people could not always participate in activities they enjoyed doing on occasions.

People’s experience of using this service and what we found

Premises checks were in place to ensure that all the accommodation was safely maintained, although not all aspects of electrical installation had been completed to ensure compliance. All necessary work was completed shortly after this inspection. There were sufficient numbers of staff providing support to people. In times of emergency staff from the respite unit had supported people living in the bungalows. This had impacted on people’s support. Recruitment processes helped ensure staff employed were suitable for their job role. People were offered and received their medicines as prescribed; staff had been trained and had their competency checked to administer medicines safely. The service had learned lessons following the outcome from a safeguarding investigation and delivered additional medicines training to night staff. Systems were in place to help ensure people were protected from the risks of abuse and avoidable harm.

Staff had received training in aspects of care relevant to people's needs and now received regular supervision. People received sufficient nutrition and fluids, including any modified or specific diets. People accessed appropriate healthcare services when required and were able to live healthier lives. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Where the provider deemed the service no longer best met people’s increased needs, referrals for reassessments were sent to the local authority.

Steps had been taken to ensure people's rights were understood and respected. People were assured they would receive care that was not discriminatory. Staff respected people's privacy and dignity and encouraged people to be as independent as possible. People’s views and preferences were reflected in their support plans. People were cared for by friendly staff.

People received personalised and responsive care. People were supported to achieve their goals and pursue activities that supported their independence. The registered manager was aiming to encourage people to try new things and use local public transport more. Communication needs were assessed, although specific communication needs were not always fully supported. We have made a recommendation about addressing this. Processes were in place and followed to ensure any complaints received were investigated and resolved.

The systems the provider had introduced since our last inspection had helped to shape and improve the service, but these were not fully effective and needed to be properly embedded by the registered manager. The registered manager was supported by a wider management team. Staff felt supported and considered the service had improved. The service worked in partnership with numerous external stakeholders, and shared information appropriately where required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The provider completed an action plan after the last inspection to show what they would do and by when to improve and we identified one breach in regulation. At this inspection we found the service had improved and the provider was no longer in breach of regulations.

The last rating for this service was requires improvement (published 20 February 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections whilst managed by this provider.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.