Background to this inspection
Updated
18 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Two inspectors carried out this inspection.
Service and service type
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 bought or 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or the registered manager would be in the office to support the inspection.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed all the information we held about the service, which included information shared by local commissioners, feedback from members of the public and notifications from the service. These included information about events and accidents and incidents which involved people who used the service. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who received support with their personal care needs, including two relatives. We reviewed three people’s care records which included a range of risk assessments and care plans. We reviewed records relating to these people’s medicines. We inspected two staff recruitment files and records relating to staff support and training. We spoke with four members of staff and the registered manager.
We reviewed a variety of records relating to the management of the service which included complaints records, accident and incident records, staff training record and monitoring audits. We reviewed the services continuous improvement plan.
Updated
18 February 2020
About the service
Sanctuary Home Care Ltd - Gloucester provides extra care housing where people live in ordinary flats in one building called Middleton House. A range of communal facilities are also available for people’s use, lounges, a restaurant, outside space and car parking. People can receive support with their daily living activities, cleaning and shopping, where needed. Some people receive support with their personal care needs, personal hygiene and eating. CQC only inspects the care service provided to these people. In these cases, we also consider any wider social care being provided. At the time of the inspection 19 people received personal care support.
People’s experience of using this service and what we found
People were complimentary about the service they received. Comments included "The staff are very nice”, “I am really honestly very happy, I haven't got one thing I am concerned about”, "Carers are considerate of my needs", "Best move of my life, staff are very helpful and caring”, 'It’s not like living at your own home but it is the next best thing. I am quite content” and “It’s very nice here. Lovely and warm.”
There had been an improvement in how the service was managed and monitored. The registered manager had introduced additional monitoring processes. These enabled them to ensure actions were taken so the service met with the required standards and regulations and, so the provider’s actions for improvement were fully met and could be sustained. There had been a change in approach which people told us felt more inclusive of their views and feedback.
People told us they found the registered manager to be “Very approachable” and “A very nice person.” One relative confirmed there had been an improvement in their relative’s health since they had moved into Middleton House. Staff told us the service was more organised since the registered manager had been in post. They told us they felt well supported, communication had improved, and senior staff were there to support them when needed.
People told us they felt safe. People felt reassured that they would receive their care as planned. People confirmed that staff responded quickly if they pulled their call bell for support, in between their planned care visits. People had control over who they let in to visit them. Arrangements were in place to reduce the risk of ‘unknown visitors’ entering the building and accessing areas where people lived.
People told us staff were caring and knew how they liked their care to be delivered. People told us the registered manager had acted when staff had not performed to the standard expected and they felt reassured by this. People told us there had been an improvement in the quality of care staff and in the quality of the care provided, since the registered manager had arrived.
There were arrangements in place to ensure staff received the training and support they required to deliver people’s care safely and in line with best practice and current legislation. People’s care was provided in line with their protected characteristics and people’s specific cultural and religious preferences.
People who required support with managing their medicines received the level of support they required. This included, for some people, ordering their medicines, getting them delivered, storing them safely and administering them.
People were supported with their healthcare needs by staff liaising with GPs and community nurses where appropriate, about people’s health requirements. Staff used the emergency services where needed.
Support was provided to people with their eating and drinking, where this was required. This support could be provided wherever people chose to eat, in their flats or the service’s main restaurant.
People’s care was planned with them and people had access to their individual plans of care. Information about people’s care was kept secure. People’s privacy and dignity was maintained, and staff were expected to maintain professional boundaries and confidentiality. Action had been taken where this had not been the case in the past.
The provider had a complaints process which some people had used, and we saw evidence that these complaints had been investigated and addressed. People we spoke with had either not needed to raise a complaint or where they had raised an area of dissatisfaction, this had been addressed and resolved to their satisfaction. The registered manager told us they took a proactive approach when communicating with people and seeking their feedback, so that any areas of dissatisfaction or “niggles” could be addressed immediately.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (last report published 5 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.