Cordwainers

Updated 2 March 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 Cordwainers took place on 10 and 11 January 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 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 four 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 activities and when medicines were administered. We spoke with the staff including the new manager, two visiting registered managers from the provider’s care group, the area manager, one team leader, two senior staff, and ten staff.

We reviewed each person’s care records, which included their daily notes, care plans and medicine administration records (MARs). We looked at 10 staff recruitment, supervision and training files. We examined the provider’s schedules 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 December 2017 and January 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 relatives of five 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 five commissioners of the service.

Updated 2 March 2018

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

This comprehensive inspection took place on 10 and 11 January 2018. The inspection was unannounced, which meant the staff and provider did not know we would be visiting.

At our comprehensive inspection of Cordwainers on 11 and 12 November 2015, we judged the service required improvement in the key question area of safe. We found there were insufficient staff deployed to meet people’s needs. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At our focused inspection on the 25 July 2017, we found that the provider had followed their action plan and had taken action to improve the safety of the service to meet the regulation. The provider had ensured there were sufficient staff deployed at all times to meet people’s assessed needs.

At the conclusion of the focused inspection we undertook to review our rating for safe at the next comprehensive inspection. At this comprehensive inspection we found the improvements to safety through increased staffing levels had been sustained and embedded. We found the service was safe. At the inspection in November 2015 the service was rated 'Good'. At this inspection we found the service remained 'Good'.

The service did not have a manager who was registered with the Care Quality Commission (CQC). 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 registered manager had recently left the home and had cancelled their registration with the CQC. The new home manager had commenced the process to become the registered manager of the service and was being effectively supported by a mentor who was an experienced registered manager from the care group.

People were kept safe from harm and staff knew what to do in order to maintain their safety. Risks to people were assessed and action was taken to minimise potential risks. Medicines were managed safely and administered as prescribed.

The provider operated thorough recruitment procedures to ensure staff were safe to work with the people. There were always enough staff to provide care and support to meet people’s needs.

Staff understood the importance of food safety and prepared and handled food in accordance with required standards. Staff maintained high standards of cleanliness and hygiene within the home.

People were supported by staff who had the skills and training to meet their needs. The home manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were involved in making every day decisions and choices about how they wanted to live their lives and were supported by staff in the least restrictive way possible.

Arrangements were made for people to see their GP, specialist nurses and other healthcare professionals when they needed to do so. 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 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.

People's independence was promoted and support workers encouraged them to do as much for themselves as possible. 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 to meet their needs.

The service was responsive and involved people in developing their support plans which were detailed and personalised to ensure their individual preferences were known. People were supported to take part in activities that they enjoyed. Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.

The service was well led. Staff consistently said they had received good support from the management team who were always available to give advice and guidance, especially whilst awaiting the appointment of a new registered manager. The safety and quality of support people received was effectively monitored and identified shortfalls were acted upon to drive continuous improvement of the service.