CQC report explained · a care home with nursing
What the CQC found at Cornford House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found that some environmental risks for people who had expressed suicidal thoughts had not been properly assessed. Staff shortages also meant some people were still waiting for help with washing and dressing at 11.30am.
- Effective?
- Requires improvement
- Care plans, staff training, food support and healthcare arrangements were generally good. However, some decisions about tenancy and care agreements were not shown to have been made in people's best interests, and the correct legal authorisations were unclear.
- Caring?
- Good
- People and relatives spoke highly of staff. Inspectors saw staff protecting privacy and dignity, offering choices and encouraging people to remain as independent as possible.
- Responsive?
- Good
- Care plans were detailed, personalised and regularly reviewed. Activities were generally praised, but an activity was cancelled during the inspection because of a lack of staff, and there had not yet been activities outside the home.
- Well-led?
- Requires improvement
- Managers were described as approachable and staff felt supported. However, the home's monitoring systems had not identified important problems with risk assessments, staffing time, tenancy choices and legal applications.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found kind, responsive care but concerns about staffing, choice, consent and oversight.
This was an unannounced inspection on 26 July 2022. Inspectors spoke with people, relatives, staff and other professionals. They reviewed care records, medicines records, recruitment files and the home's audits and monitoring.
People generally said they felt safe and were treated kindly. Inspectors found good care planning, safe medicines, infection control, staff training and support with food and healthcare. However, some people had to wait too long for help in the morning because staffing was not always enough.
Inspectors also found that some people did not have a real choice about tenancy and care agreements. The home did not always show that decisions were made in people's best interests or that the correct legal applications had been made. The overall rating fell from Good in 2018 to Requires Improvement, with breaches of Regulations 9, 11 and 17.
Kind and respectful staff
People and relatives consistently described staff as kind, caring and respectful. Inspectors saw staff communicate patiently and protect people's privacy during personal care.
“People were cared for by staff who knew them well.” from the report
Personalised care
Care plans recorded people's preferences, interests, communication needs and end of life wishes. They were reviewed regularly, with people and relatives involved.
“Peoples' care plans were detailed and extensive and reflected peoples' preferences in all areas.” from the report
Medicines managed safely
Medicines were stored, administered and recorded safely. Staff giving medicines were trained and checked as competent.
“Medicines were managed safely in accordance with national guidance.” from the report
Good support with food and healthcare
People could choose meals and received support with eating and drinking. Staff worked with healthcare professionals and responded when people became unwell.
“People were supported to eat and drink enough.” from the report
Risk assessments did not always protect people
seriousSome people who had expressed suicidal thoughts did not have effective environmental risk assessments. Inspectors found items in one person's room that increased risk, although extra measures were put in place during the inspection.
“Some people had expressed suicidal ideation; these people did not have effective environmental risk assessments in place and there was insufficient information for staff to manage the risks.” from the report
Staffing delays
needs fixingStaff said there were not enough staff on one floor in the mornings. Inspectors saw six people still waiting for help with washing and dressing by 11.30am.
“During our inspection we saw six people on this floor had not been supported to have their wash or get dressed for the day by 11.30am.” from the report
Limited choice over agreements
seriousSome people did not know they had tenancy agreements or did not have a choice about them. These agreements also restricted access to cooking facilities and the choice of care provider.
“People with tenancy agreements did not have access to cooking facilities, so could not choose to cook their own meals if they wanted to.” from the report
Consent and best-interest records
seriousNot all decisions were supported by evidence that they had been made in people's best interests. Inspectors were also unclear whether some deprivation of liberty applications had gone to the correct authorities.
“Not all decisions had been made in peoples' best interests.” from the report
Activities were not always available
minorAn afternoon activity was cancelled during the inspection because of staff shortages. There had not yet been activities outside the home.
“There were no meaningful activities happening during our inspection; the afternoon activity had been cancelled.” from the report
- 01What changes have been made to morning rotas so people do not wait too long for washing, dressing or other care?
- 02How do you now make sure each person understands whether they have a tenancy agreement or a care and accommodation agreement?
- 03How are best-interest decisions and deprivation of liberty applications recorded and checked?
- 04What changes have been made to environmental risk assessments for people who may be at risk of self-harm?
- 05How often are activities cancelled because of staffing, and what activities outside the home are now available?
This inspection considered all five CQC questions and infection prevention and control, but it did not examine the circumstances of the death that prompted part of the inspection. This explanation was written from the published report of 19 October 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2018
Rated Good in all five areas; inspectors found safe, kind and personalised care, with some people saying more staff would help at weekends.
This was an unannounced inspection on 13 and 14 September 2018. Inspectors spoke with 16 people, seven relatives and staff. They observed care and checked care records, medicines records, staff files, training records, complaints and quality checks.
The home was judged safe, effective, caring, responsive and well-led. Inspectors found suitable risk assessments, safe medicines systems, enough staff to meet people's needs, trained staff and good access to health professionals. People were treated with kindness, dignity and respect, and their care plans reflected their needs and preferences.
The report says the home had improved since the previous inspection in July 2017. The new monitoring systems were now embedded and sustained. A Good rating means inspectors judged the service to be meeting the expected standards in all five areas at this inspection.
Improvement sustained
The report says the changes introduced after the previous inspection were no longer new systems only. They were embedded in daily practice and improvements had continued.
“new systems were embedded and sustained and the service that people received had improved.” from the report
Personalised support
Care plans included personal preferences, life history and communication needs. Relatives could access the electronic care planning system with consent.
“The care plans we saw were well written and person centred documents.” from the report
Strong quality checks
The management team carried out wide-ranging audits and acted when they found problems, including replacing damaged equipment and investigating call bell issues.
“The service had implemented robust quality assurance practices and these were fully embedded in daily practice.” from the report
Activities and social contact
People were supported to join activities or choose not to. Digital life-history activities helped staff engage people and reduce social isolation.
“Technology was used in the service to provide tailored support to meet people's needs, keep them engaged positively and reduce social isolation.” from the report
Weekend staffing
minorA minority of people said more staff would be helpful, particularly at weekends. Inspectors observed staffing that met people's needs, but the home was recruiting more care staff for cover.
“Sometimes no, particularly at the weekends, people's needs have changed but they haven't increased the number of staff.” from the report
- 01How many care staff and nurses will usually be available during weekends and at night?
- 02How will you use my relative's care plan, life story and communication preferences in everyday care?
- 03How will you support my relative to take part in activities, including if they have memory loss or dementia?
- 04How are medicines checked and recorded, and who would administer them?
- 05How would you involve our family in care reviews, complaints and decisions about end-of-life care?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall rating, with visits on 13 and 14 September 2018. This explanation was written from the published report of 31 October 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Cornford House
5 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- October 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 29 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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