The Care Quality Commission
  • Residential substance misuse service

Cornerways

Overall: Good read more about inspection ratings

20 Braidley Road, Bournemouth, Dorset, BH2 6JX (01202) 552536

Provided and run by:
Streetscene Addiction Recovery

All Inspections

9 January 2019

During a routine inspection

We rated Cornerways as good because:

  • Managers and staff shared a clear definition and vision of recovery for clients that was embedded throughout the service. Staff understood their roles in supporting clients in their recovery journey and treated them as partners in their care. Staff said they felt respected, supported and valued, and were proud of the work they did.
  • The provider actively worked to reduce barriers to treatment for their clients. For example, the service had admitted clients with their pets, purchased support from domiciliary care agencies for clients requiring personal care and employed a driver who collected clients when public transport was a barrier to treatment.
  • The ethos of the service was to go the extra mile for clients and put people before profits. The provider regularly provided free care to clients who had unmet needs but did not have funding available. The provider offered free aftercare for life to all clients after completion of treatment.
  • Staff were motivated and inspired to offer care that was kind and promoted dignity. Staffing levels were safe and there were plans in place to cover vacancies, sickness and annual leave. There was a positive culture within the house, staff felt respected and valued as members of the team and there was support from the registered manager. Staff received the specialist training needed to carry out their work effectively. Through safeguarding training and information, staff understood how to protect clients. Staff had two-monthly supervision and yearly appraisal.
  • The service was clean, well equipped, well-furnished and had good facilities. The design, layout, and furnishings of the service supported clients’ treatment, privacy and dignity and there were adaptations for people with disabilities.
  • The service manager proactively managed health and safety concerns. The manager completed environment health and safety checks, this included an assessment of ligature points and regular fire safety checks. The service had a de-choking device, ventilated pillows and an automated external defibrillator (AED) for use in emergencies. The provider encouraged clients to be active partners in managing their own safety and trained clients in fire safety and how to use an AED.
  • The service provided a therapeutic program based on National Institute for Health and Care Excellence guidance. Both one to one counselling and group work was provided. Staff monitored and addressed physical health of clients in the house. Staff received mandatory and specialist training and they had a good understanding of the Mental Capacity Act.
  • There was no waiting list for the service. The service admitted urgent referrals, in some instances, in under 48 hours. Referrals were screened and assessed for suitability although there were no documented exclusion criteria as admissions were agreed on an individual basis.

However:

  • Staff did not complete comprehensive risk assessments for clients admitted to the service and there was no evidence of crisis planning. Staff did not complete individualised care plans for clients accessing the service. Staff did not document discharge plans. Staff kept a lot of information in their heads and this was not translated into the documentation. There were blanket restrictions in place.
  • Medicines were not always prescribed safely due to staff not using medicines reconciliation processes as routine. This means that staff did not routinely check that the medicines they were giving were the ones prescribed by the GP.
  • The service did not have sufficient governance systems in place to ensure sufficient oversight and risk management of incidents and safeguarding. Managers therefore did not monitor to look for trends, this meant that if the same incident kept on occurring then there was no oversight to look at the reasons why or for example, if there was a gap in staff training.

23 February 2016

During a routine inspection

We found the following areas of good practice:

  • We saw a robust admission and discharge procedure at Cornerways. Care records were complete, up-to-date; person centred, and contained evidence of client involvement in planning their own care and treatment. Care plans met the national standards and staff used the care-planning tool consistently. There was a range of treatments available including therapies and medicines. Staff identified risks for clients undergoing alcohol and opiate detoxification. Risk management plans demonstrated how staff managed or reduced the risks.
  • We saw feedback and learning following incidents, this included implementing appropriate processes and procedures for the effective management of medicines. The providers demonstrated ‘duty of candour’ when communicating with relatives following incidents. Staff understood the importance of being open and transparent.
  • Staff treated clients with kindness, dignity and respect. The staff we met were conscientious, professional and committed to doing the best they could for the people in their care Morale was good among the staff team. Staff told us they were unaware of any issues with bullying and that managers and peers were supportive. All staff we spoke to said they enjoyed their jobs.
  • Staff knew how to use the organisation’s safeguarding and whistle-blowing processes and felt able to raise concerns without fear of victimisation. Staff received statutory and mandatory training; there was good knowledge of safeguarding procedures. The manager implemented lone working protocols.
  • The leadership team were approachable, they supported staff to carry out their roles effectively, and provide the treatment and help clients needed. We saw positive interaction between with operational staff and the senior management, in particular the chief administration officer.
  • There were robust auditing procedures in place to check and monitor the quality of the service provided and also to identify, assess and manage risks to the health, safety and welfare of clients using the service. There was a community group meeting for clients to make changes and suggestions for the service.

However, we also found the following issues that the service needs to improve on:

  • The service did not have an automated external defibrillator (AED), a portable electronic device that automatically diagnoses life-threatening cardiac issues, available for use in a medical emergency.

22 October 2013

During a routine inspection

We spoke with seven of the 16 people accommodated at Cornerways about their treatment programmes and their experiences of living there. We also spoke with a person who had moved onto more independent living but continued to spend some time at Cornerways.

We spoke with five members of the staff team about working practices and training. We also telephoned two care managers and obtained their views about Cornerways.

People told us they were made aware of limitations and restrictions on their rights and freedom considered essential to help with their recovery. They said they were involved in decisions about the support they wanted in order to complete their treatment programmes. People told us their independence was promoted and their diversity, values and human rights were respected.

There were arrangements in place that ensured people were provided with a choice of suitable and nutritious food to meet their needs.

People told us they thought there were enough qualified, skilled and experienced staff on duty at all times.

The provider had arrangements in place that ensured staff were supported to carry out their roles effectively and provide the treatment and help people needed.

There were arrangements in place to check and monitor the quality of the service provided and also to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

12 March 2013

During a routine inspection

When we visited, 12 people were receiving a service.

We spoke with two people using services and three staff, including the manager, about their experiences of the service. We looked at two people's care records and other records kept by the provider.

People's consent was obtained before they started treatment. People told us they felt they had received sufficient information about Cornerways beforehand.

People's individual needs were assessed and care and treatment was planned and delivered in a way that ensured their safety and welfare. People spoke highly of the support they received. They told us that the provider had clear expectations of them, but noted, 'they make you feel comfortable'.

People told us that the provider kept in regular contact with other services supporting them. Records showed that Cornerways worked in co-operation with other providers.

Medicines were kept safely and recorded properly.

People using the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. People told us about keeping the house clean as part of their therapeutic duties: 'we run a tight ship here'.

People were protected from unsafe or unsuitable equipment because the provider ensured it was properly maintained and suitable for its purpose.

People were supported by suitably qualified, skilled and experienced staff.

There was an effective complaints system. People did not raise any concerns with us during our visit.

29 December 2011

During a routine inspection

We carried out an inspection of Cornerways between 9:30am and 2:30pm on 29 Dec 2011. One of the managers for the organisation, as well as the staff on duty, assisted us throughout the inspection.

Streetscene offers a complete treatment programme, from 'tail-end' detoxification from drugs and/or alcohol to re-integration into the community and aftercare. The programme uses evidence based interventions such as; abstinence based treatment, relapse prevention, anger management, motivational interviewing, cognitive behavioural therapy and the twelve step approach. The treatment programme is based on 3 phases. The first phase focuses on containment and information, giving people time to stop and reassess their lives. The second phase gives people more responsibility to use and put into practise the life skills, coping skills and relapse prevention skills they have learned. The third phase of treatment prepares people for their return back into the community and includes benefit advice, career training and support with securing and maintaining a home. The organisation also has some move on accommodation and provides an aftercare service.

At the time of this inspection there were 18 people staying at the home. We spoke with five of these people about their experience of the treatment they were receiving and how they were involved in this. We received only positive comments about the service. People told us that the programme was effective and provided a safe environment for them to make changes to their lives. They told us that they were very much involved in their treatment through setting their own goals with support from the staff team. People said that the staff team were very supportive, non-judgemental and knowledgeable.