4 January 2018
During a routine inspection
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
People using the service lived in one of 36 self-contained flats in a single four-storey building. At the time of our inspection 36 people were receiving personal care. Each flat consisted of a living room, bedroom, kitchen and bathroom. People also had access to shared facilities including bathrooms equipped with lifting baths, dining rooms on each floor and a guest room for overnight guests. The service adjoined Elgin Close resource centre, which provides activities and a catering service for residents.
The service had a registered manager who has been in post since January 2016, and had been registered since August 2016. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.
We found that the provider had systems to safeguard people from abuse and manage risks to people who used the service. Staffing levels were suitable to meet people’s needs and people’s care visits were organised through a rounds system which meant it was clear who needed to be seen and when. This was planned in line with people’s care plans and checked at handover to ensure people had received the right care. Care plans clearly documented people’s needs but weren’t always easy to follow; however we saw examples of accessible communications and the service had developed documents in order to improve this further.
Care workers were recruited in line with safer recruitment measures and practical exercises carried out to ensure that staff had the right values to deliver good care. Staff received the right training and supervision to carry out their roles.
People received the right support to eat and drink well, including assessing people’s needs and making sure that people had the right food delivered by the onsite catering service. People’s health needs were assessed and people received support to stay healthy, including diabetes plans and support to attend appointments. Health and safety checks were carried out in order to ensure a safe environment, and people were able to call for help using intercoms and pendant alarm systems.
People were protected from medicines errors by correct management and audit of medicines. Where errors had occurred the service had procedures to ensure that lessons were learned and that these were not repeated. Managers had systems in place to make sure people received the right care.
At our previous inspection we made a recommendation about how the provider assessed people’s decision-making abilities in line with the Mental Capacity Act. We found the provider had acted on this recommendation and had robust procedures for assessing people’s capacity and to demonstrate that they were working in line with people’s best interests. This included working with other health professionals to consider advance decisions such as hospital admission in the event of ill health.
There were good systems of communication in place, such as handovers, team meetings and newsletters. People were engaged with the service through tenants meetings and their views were recorded in tenant profiles. The service was in the process of implementing key-working in order to support people to express their views about their care. People knew how to make complaints and who the manager was, and complaints were investigated and suitably resolved.
The provider told us they intended to merge with another provider later in the year. This means that this location will be archived at this time and registered under the new, merged provider. We will aim to return to this service within 12 months of registration.