Cornerstone North Aberdeenshire Housing Support Housing Support Service
Cornerstone Area Office 1 Skelton Street Peterhead AB42 1HR
Telephone: 01779 401630
Type of inspection: Unannounced Inspection completed on: 12 October 2017
Service provided by: Service provider number: Cornerstone Community Care SP2003000013
Care service number: CS2004072999 Inspection report
About the service
Cornerstone North Aberdeenshire registered with the Care Inspectorate in 2004. Cornerstone North Aberdeenshire provided combined housing support and care at home services for people who had learning disabilities, physical disabilities or mental health problems. The service consisted of 13 teams.
The people supported by the service either lived in separate flats/houses, shared houses or purpose-built developments, across the north of Aberdeenshire, encompassing Ellon, Peterhead, Maud, New Deer and Banff.
At the time of the inspection the service was supporting 31 people. Cornerstone's aim is 'to enable the people we support to enjoy a valued life'.
What people told us
For this inspection, we received views from 14 of the 40 people using the service and eight of their guardians/ relatives.
The majority of people this service supported had small staff groups supporting them. When this was the case, people were very happy and favourable about the organisation in comparison to other providers. However, the people who lived in a flatted complex in eterheadP had continued to have larger numbers of staff supporting them until recently. People and guardians told us they had found it difficult to know who to speak with if they had any issues.
Several people told us that despite being happy overall, they had some concerns. We found there were common factors. One was about staff not managing people's homes well enough (laundry, bills and such like). We discussed this with the manager. We suggested the service teach staff how to provide housing support, as well as the more care-focussed training they deliver. Housing support would encompass:
- Maintaining people's homes (repairs, cleaning, security for example).
- Household budgeting, including helping people to get the best value utilities service for example (Cornerstone has good support plan formats that staff should use more widely. Some people had good plans and others did not).
Another common theme was communication. Guardians and relatives felt the organisation did not keep them informed of any changes to the senior staff or management. The service must consider how they can improve how they communicate changes to relatives and guardians.
Self assessment
We have not asked any adult services to provide a self assessment this year.
From this inspection we graded this service as:
Quality of care and support 4 - Good Quality of staffing not assessed Quality of management and leadership 3 - Adequate
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What the service does well
People using this service received good quality support from staff that recognised their strengths and individuality.
In most cases, staff supported people to live active and meaningful lives. Staff supported people in employment, to attend organised day activities or to plan their own daily schedule. A common discussion amongst staff was how to find new and interesting opportunities for people. These discussions could have played more of a part in the formal reviews of support that we discuss under areas for improvement.
Staff strived to support people in keeping with their preferences as detailed in support plans. We found some plans had parts that staff could improve. However, in general these were informative documents. In particular, we were impressed at the detailed guidance staff had completed on how each person communicated.
Staff supported people's health very well by being observant and responsive. This worked better when smaller, consistent staff teams supported people. Having good relationships with the people they supported enabled staff to encourage people to attend appointments where previously they would have refused. This meant people's health was improved. At times, we felt the service could use a step-by-step planned approach more often, to continue improving people's skills and reduce anxieties.
Staff usually provided good, clear accounts of the help they gave people in managing their finances. The service checked and audited these accounts. This means the organisation was safeguarding people's finances.
We saw some good examples where staff identified improvements they could make to their support following their analysis of incident/accident reports. One example was where staff surmised that boredom had led to one person's unrest and they went on to improve their contentedness by increasing their activity levels.
The provider was introducing a new computer based record system. This could be a very positive development. Senior staff told us the current system took up a lot of their time that they could use supporting and developing staff.
Some of the supported people were very happy with recent improvements at the Peterhead, flatted complex. One person told us, "Love my new team!" Another person's guardian described them as being "As happy as can be" with their support.
What the service could do better
We have awarded a grade of adequate for the Quality of management and leadership. This means the service's strengths have a positive impact. However, their weaknesses were limiting the experience of the supported people.
For the third inspection running, the service needed to be better at showing that people/their guardian had been involved in the six-monthly reviews of the support they received. Reviews are an important part of involving people in planning their support. On occasions, we could not find that the service had held reviews six- monthly. (See requirement 1).
We have repeatedly reminded the service of their responsibility to notify us of any incident/ accident that could be detrimental to the wellbeing of the people they support. Despite this, we found examples of occurrences that the service should have notified us of, but did not. Guidance on what notifications need to be made can be
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found in the document 'Records all Services (excluding CM) Must Keep and Notification Reporting Guidance' on www.careinspectorate.com. (See requirement 2).
We again found that staff should improve how they completed the provider's written Housing Support and Living agreements. Everyone who uses the service should have a clear agreement about any additional costs to them, for example shared house keeping costs. Everyone involved, including guardians/representatives should sign and date it. (See recommendation 1).
In two parts of the service, groups of people shared a car. The service had developed agreements for each party. These agreements should include how the service will fairly manage any assets owned by a group should someone leave the arrangement. Everyone involved in these, including guardians/representatives, should sign, and date them. (See recommendation 1).
The service must not use supported people's homes as an office base. We saw a full office set up in a shared house in Ellon. In Peterhead, we saw laptops and printers belonging to the organisation set up in people's guest bedrooms. One of these had additional desk paraphernalia, such as in and out trays. The organisation's own quality assurance visits were imminent and the format included addressing this issue. We look forward to the organisation eliminating the practice of staff setting up offices in people's own homes.
Requirements Number of requirements: 2
1. The provider must ensure they carry out six-monthly reviews of the support they provide to each person. Review records must show how the review was carried out, who was involved, and what progress has been made in addressing previous reviews recommendations.
This is in order to comply with:
The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) - Regulation 4(1)(a) -Relating to health and welfare and Regulation 5 - Relating to personal plans.
Timescale for meeting this requirement: 28 November 2017.
2. The provider must ensure that all appropriate staff in the service comply with the Care Inspectorate's notification equirr ements. The Care Inspectorate must be notified of all incidents as detailed within "Records all Services (excluding CM) Must Keep and Notification Reporting Guidance".
This is in order to comply with:
The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) - Regulation 4(1)(a) - A requirement concerning records, notifications and eturns.r
Timescale: Upon receipt of this report
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Recommendations Number of recommendations: 1
1. The service safeguards the people they support by ensuring they, or their guardian/representative fully understand any financial agreements they enter into.
National Care Standards for Care at Home - Standard 2: Your Legal Rights
Complaints
There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com.
Inspection and grading history
Date Type Gradings 27 Oct 2016 Unannounced Care and support 4 - Good Environment Not assessed Staffing 5 - Very good Management and leadership Not assessed
15 Oct 2015 Announced (short notice) Care and support 4 - Good Environment Not assessed Staffing 4 - Good Management and leadership 4 - Good
23 May 2014 Announced (short notice) Care and support 4 - Good Environment Not assessed Staffing 4 - Good Management and leadership 5 - Very good
31 May 2013 Announced (short notice) Care and support 4 - Good Environment Not assessed Staffing 4 - Good Management and leadership 5 - Very good
31 May 2012 Announced (short notice) Care and support 5 - Very good Environment Not assessed
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Date Type Gradings Staffing 4 - Good Management and leadership 4 - Good
19 Aug 2011 Announced (short notice) Care and support 3 - Adequate Environment Not assessed Staffing Not assessed Management and leadership 4 - Good
25 Aug 2010 Announced Care and support 4 - Good Environment Not assessed Staffing 4 - Good Management and leadership Not assessed
28 Apr 2010 Unannounced Care and support 3 - Adequate Environment Not assessed Staffing Not assessed Management and leadership Not assessed
19 Feb 2010 Announced Care and support 2 - Weak Environment Not assessed Staffing 4 - Good Management and leadership 5 - Very good
19 Dec 2008 Announced Care and support 4 - Good Environment Not assessed Staffing 4 - Good Management and leadership 3 - Adequate
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To find out more
This inspection report is published by the Care Inspectorate. You can download this report and others from our website.
Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough.
Please get in touch with us if you would like more information or have any concerns about a care service.
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