Archived: The Corner House

Updated 3 May 2017

The Corner House is a purpose built 12-bedded locked rehabilitation unit in the Moorgate area Rotherham. The service is specifically designed to provide high intensity support and rehabilitation for men with complex needs, including mental health conditions and learning disabilities.The service can accommodate people who are detained under the Mental Health Act as well as those who stay there informally. The Corner House is run by Turning Point and is registered to provide the following regulated activities:

• Accommodation for persons who require nursing or personal care.
• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Diagnostic and screening procedures.
• Treatment of disease, disorder, or injury.

At the time of our inspection, the service had no active registered manager, however, there was a clinical lead in post and a newly recruited interim operations manager. The service had a plan for the clinical lead to apply to become the registered manager. Input from clinical psychology and psychiatry were provided via a service level agreement with a local trust.

We have inspected The Corner House three times before. At the last comprehensive inspection in December 2015, we rated the service as requires improvement overall. We rated safe as requires improvement, effective as requires improvement, caring as good, responsive as requires improvement and well-led as requires improvement.

Following that inspection the provider was informed that it must take the following actions to improve long stay rehabilitation services;

• The service recruits to permanent staff vacancies in a timely manner
• The service introduces positive behavioural support in line with guidance from the Institute of Clinical Excellence.
• Nurses manage medication in line with medications management procedures and incident reporting procedures
• Staff are trained in appropriate physical intervention and de-escalation techniques for working with people with challenging behaviours. Agency staff must also have undergone the same training.
• There is a strong and clear leadership that leads to cohesive team working
• The service adheres to the Data Protection Act and provides secure storage and transfer of records in relation to both staff and patients.

We also told the provider that it should take the following actions to improve long stay rehabilitation services;

• The provider should consider simplifying patients’ care plans so that patients are able to understand them.

• Discharge planning should be in place for all patients and should clearly identify what goals the patient needs to achieve to progress towards independence and discharge from the service.

We issued the provider with requirement notices. These related to:

• Regulations 9 HSCA (RA) Regulations 2014 Person centred care
• Regulations 12 HSCA (RA) Regulations 2014 Safe care and treatment
• Regulations 17 HSCA (RA) Regulations 2014 Good governance
• Regulations 18 HSCA (RA) Regulations 2014 Staffing

The Corner House has been subject to three Mental Health Act review-monitoring visits most recently in December 2015. There were no issues raised at this review.

The current inspection was announced.

Updated 3 May 2017

We rated The Corner House as good because:

• Each patient record contained a comprehensive personal behaviour support plan, which enabled staff to provide care tailored to their specific needs. A multidisciplinary team reviewed behaviour support plans regularly and there was evidence of patient input into them.
• The service had robust risk assessment and monitoring arrangements in place for all patients. When risks changed, staff reviewed and updated these.
• Patients had access to a range of activities and therapies aimed at promoting their independence and recovery
• Patients had access to on-site psychiatric treatment and psychological therapies through a contract the provider held with a local trust.
• Staff provided patients with on-going monitoring of their physical health needs and screened patients for conditions such as obesity and diabetes.
• Staff interacted with patients in a caring compassionate manner. They used verbal de-escalation appropriately to deal with patient anxiety.
• Patients had access to information about their care and treatment in an easy read format. Information about the service including a guide to meetings, events, and activities was displayed clearly in the reception area where patients tended to congregate.
• Managers and staff worked together to reduce restrictive practices and provided patients with access to the internet via their own mobile phones.
• Staff reported a supportive and open culture with colleagues and line managers. Managers were visible and available when staff needed guidance and support.
• The provider had made changes to the management and meeting structures leading to improved learning from incidents. Managers encouraged staff at all levels to report incidents.
• The service had recruited a large number of permanent staff including staff with a variety of part-time hours. This meant they had less reliance on agency staff so patients were familiar with the staff supporting them.
• The service was clean and well maintained. Staff had access to handwashing facilities and to anti-bacterial hand gel. They supported patients to keep their rooms clean and tidy.
• Patient rooms were well equipped and furnishings in communal areas were suitable, attractive and in good order.

However:

• When we asked the provider for information concerning whether patient leave had been cancelled or re-arranged due to staff shortages, they were unable to provide the specific dates on which two episodes of leave had been re-arranged.
• The provider gave us conflicting information about whether two courses were included in their staff mandatory training programme. These were positive behaviour support and moving and handling objects.
• When we looked at staff records, we found that some support staff had only recently started participating in regular line management supervision and some had not had an appraisal in line with Turning Point policy.
• When we visited the service, we observed two patients queueing at the door to the medication room so that one patient could see another patient accepting medication. This could have compromised the privacy and dignity of those patients.
• Not all staff had completed training in the Mental health Act,1983.
• The provider told us about two complaints they had received, one from a patient and one from a member of the public. However, when we visited, we could not find the records relating to those two complaints in the complaints log.

Updated 26 April 2016

Updated 3 May 2017