Cornford House

Updated 19 October 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Cornford House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Cornford House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Cornford House is also a domiciliary care agency. It provides personal care to people living in their own rooms under a tenancy agreement within Cornford House.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. This included things the provider needs to tell us about, for example, serious injuries or safeguarding concerns. We sought feedback from professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 11 people who use the service and 12 relatives about their experience of the care provided. We spoke with 14 members of staff including the registered manager, compliance manager, deputy manager, clinical lead, nurses, care workers and supporting staff. We spoke with two professionals who worked with the service. We reviewed a range of records including 11 peoples’ care records and multiple medicine administration records. We looked at four staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, such as audits, meetings, monitoring activity and training were reviewed.

After the inspection

We reviewed information relating to peoples’ tenancies, care agreements and local authority assessments.

Updated 19 October 2022

About the service

Cornford House is a residential care home providing accommodation and nursing and personal care for up to 70 people. The service is arranged across four floors with lift access to lower ground and upper floors. There were 20 people using the service at the time of our inspection. Cornford House also provides personal care for people living in their own homes, within the same accommodation. These people have a tenancy agreement and a separate agreement for their care provision. There were 46 people receiving personal care in their ‘own homes’. People receiving personal care can choose to have their care provided by another care provider. However, everyone living in Cornford House had their care provided by staff employed by Cornford House.

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

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests.

People were not always offered choice in the care and support process. Some people had tenancy agreements in place, separate to their care agreement, and were not always aware of their rights to choose between a tenancy agreement or an agreement for accommodation with care. Tenancy agreements placed restrictions on people, for example, they were not able to have cooking facilities in their home.

People had comprehensive risk assessments in place that contained enough information for staff to support people safely. Staff had received training and people were supported by staff who knew them well. Staff had been recruited safely. The provider had systems in place to manage environmental risks, such as fire.

People and their relatives told us they felt safe and happy living in Cornford House and that it was a nice place to live. One person said, “I feel very safe, one hundred and ten percent. Everyone is so lovely.” Another person said, “I like it very much. People are very nice. You’ve only got to ask, and they’ll get it for you.” A relative said, “Yes, it is safe. [Relative] is well cared for; there is a resident nurse on duty; and doors are secured.”

Medicines were managed safely, and people received them as prescribed. People were protected from the risk of infection. People were supported to eat and drink enough and told us the food was good in Cornford House.

People, relatives and staff told us the management team were supportive and approachable and they were confident to raise concerns. Checks and audits had been completed on the service and actions had been taken to address any shortfalls.

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

Rating at last inspection

The last rating for this service was good (published 23 October 2018). At this inspection the service has been rated requires improvement and there were breaches of regulations in relation to person centred care and consent.

Why we inspected

The inspection was prompted in part by notification of an incident, following which a person using the service died. This incident is subject to further investigation by the Care Quality Commission (CQC) as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of health and safety in the service. This inspection examined those risks. We found people were no longer at risk from these concerns. We had also received some concerns about the service in respect of physical abuse and poor care practices. We found no evidence during this inspection that people remained at risk of harm from these concerns.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cornford House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person centred care and need for consent at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.