Cornfields

Updated 24 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, looked at the overall quality of the service, and provided a rating for the service under the Care Act 2014. A service provider is the legal organisation responsible for carrying on the adult social care services we regulate.

This unannounced inspection of Cornfields took place on 16 and 20 March, 2018. When planning the inspection visit we took account of the size of the service and that some people at the home could find unfamiliar visitors unsettling. As a result this inspection was carried out by one adult social care inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed information contained within the provider’s website.

During our inspection we spoke with three people living at the home, some of whom had limited verbal communication. We used a range of different methods to help us understand the experiences of people using the service who were not always able to tell us about their experience. These included observations and pathway tracking. Pathway tracking is a process which enables us to look in detail at the care received by an individual in the home. We pathway tracked the care of three people.

Throughout the inspection we observed how staff interacted and cared for people across the course of the day, including mealtimes, during internal and external activities and when medicines were administered. We spoke with the management team including the registered manager, the previous registered manager, who was now a training manager, the deputy manager, the positive support coordinator (PCS) and the provider’s Director of Care. We spoke with two shift leaders, two senior staff and five staff, including three night staff and two agency staff. During the inspection the training manager held a training session at Cornfields about the use of positive behaviour support strategies. We spoke with four staff who had completed this training.

We reviewed each person’s care records, which included their daily notes, care plans and medicine administration records (MARs). We looked at eight staff recruitment, supervision and training files. We examined the provider’s records which demonstrated how people’s care reviews, staff supervisions, appraisals and required training were arranged.

We also looked at the provider’s policies and procedures and other records relating to the management of the service, such as staff rotas covering February and March 2018, health and safety audits, medicine management audits, infection control audits, emergency contingency plans and minutes of staff meetings. We considered how people’s, relatives’ and staff comments were used to drive improvements in the service.

Following the visit we spoke with the four relatives of the three people and two health and social care professionals. These health and social care professionals were involved in the support of people living at the home. We also spoke with the commissioners of people’s care.

Updated 24 April 2018

Cornfields provides accommodation and personal care to a maximum of three people who live with a learning disability, autism and/or associated health needs, who may experience behaviours that challenge staff. At the time of inspection three people were living at the home.

The service is located in a residential home that has been developed and adapted in line with values that underpin the Registering the Right Support and other best guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can lead as ordinary life as any citizen.

The service did not have a registered manager. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The previous registered manager moved to another role within the care group in November 2017 and their vacancy had been filled by another manager, who was completing the process to become the registered manager.

This comprehensive inspection took place on 16 and 20 March 2018. The inspection was unannounced, which meant the staff and provider did not know we would be visiting.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and on-going 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.

People were protected from all types of bullying, harassment, avoidable harm, neglect, abuse and discrimination by staff who understood their responsibilities to safeguard people. Staff and relatives who raised concerns received sympathetic support from the manager and provider. Risks to people were assessed and plans were devised to minimise potential risks, whilst promoting people’s independence. Medicines were administered safely, as prescribed and in a manner individuals preferred. Prospective staff underwent robust pre-employment checks to ensure they were suitable to work with the people who lived with autism or a learning disability. There were always enough staff with the right experience and skills mix, to provide care and support to meet people’s needs.

Staff were enabled to develop and maintain the necessary skills to meet people’s needs. The manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Where people were subject to restrictions to reassure and keep them safe, these were minimised to promote their freedom and the least restrictive option(s) possible.

The manager had developed effective partnerships with relevant professionals and quickly referred people to external services such as GPs, neurologists, dieticians, urologists, opticians and dentists, when required to maintain their health. People supported staff to maintain high standards of cleanliness and hygiene in the home, which reduced the risk of infection. Staff followed required standards of food safety and hygiene, when preparing or handling food. People were supported to have a healthy balanced diet and had access to the food and drink of their choice, when they wanted it. The physical environment was personalised to meet people's individual needs.

People’s needs were assessed regularly, reviewed and updated. People had detailed care plans which were enhanced by positive behaviour and communication support plans, which promoted their independence and opportunities to maximise their potential.

People were supported by regular staff who were kind and caring. There was a warm and positive atmosphere within the service where people were relaxed and reassured by the presence of staff. The manager designed rotas which ensured people’s preferred staff were readily available.

Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. People were encouraged and enabled to be involved as much as possible in making decisions about how their support needs were met.

Staff demonstrated a real empathy for the people they cared for and one another. Staff spoke passionately about people, recognising their talents and achievements, which demonstrated how they valued them as individuals.

The service was responsive and involved people and their relatives in developing their support plans, which were detailed and personalised to ensure their individual preferences were known. Staff consistently demonstrated in their day to day support of people that respect for privacy and dignity was at the heart of the home’s culture and values.

People were supported to take part in activities that they enjoyed. Staff supported people to maintain relationships with their families and those that mattered to them, which protected them from the risk of social isolation.

The manager regularly sought the views of people and their relatives and used these to drive improvement of the home. There had been no complaints since the last inspection. Relatives were confident that the manager and staff would listen to them if required and take the necessary action.

The service was well led. The vision, values and culture of the service were understood by all staff, which they demonstrated when supporting people. The safety and quality of support people received was effectively monitored and identified shortfalls were acted upon to drive continuous improvement of the service.

Further information is in the detailed findings below.