Miners Court Extra Care provides accommodation and support to up to 64 people on a purpose built site. People live in their own self-contained flats. Numerous communal facilities are provided including a café, hair salon and lounge areas. 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 experience of the personal care provided by the service. At the time of our inspection 50 people living at the Miners Court were receiving personal care.
This unannounced comprehensive inspection was completed on the 5 April 2018 by one inspector and one expert by experience.
The service did not have a registered manager at the time of our inspection. However, an acting manager had been appointed and was in the process of applying for registration. 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.
The acting manager had been appointed prior to the registered managers departure and there had been an effective handover of responsibilities. The acting manager was supernumerary and supported by two deputy managers who were also not routinely allocated care shifts This meant staff had access to management support every day and we saw there was open and effective communication between staff and managers. Staff said they felt well supported and commented, “The new manager is brilliant. She has a really caring nature” and “I have never had a manager that has been so approachable. They sort things out straight away.”
The acting manager received regular supervision and support from the providers theme Leadwho visited the service regularly. There were effective systems in place to support the manager and staff outside of office hours and the acting manager told us, “The support is fantastic” and “[Senior management] are always on the end of the phone if I need them, even at weekends.”
People were relaxed and comfortable in the service and consistently complementary of the care and support they received. People’s comments included, "The staff give me all the care I need", "The best thing I did was come here" and "I love it here." Staff enjoyed the company of the people they supported and actively sought additional opportunities to interact with people. Staff told us, “I adore it here, we have lovely clients. All different with different needs” and “I get a lot of enjoyment out of working here.” We saw staff dancing and laughing with people in communal areas and it was clear staff knew people well and understood their individual likes and preferences.
Staff had received safeguarding training and understood their responsibilities in relation to protecting people from abuse, harm and all forms of discrimination. Staff told us they would report any concerns to their managers who they were confident would take any action necessary to ensure people’s safety.
Staff had the skills necessary to meet people’s needs and their training had been regularly updated and refreshed. Staff told us, “You have a lot of training and it is constantly updated” and “You do shadowing for a while, then someone shadows you, then you are released.” All new staff completed training in accordance with the care certificate and shadowed more experienced staff before providing support independently. Staff records showed all necessary pre-employment checks had been completed.
Staff were well motivated and worked effectively with their managers to ensure people’s needs were met. Staff spoke positively of the acting manager's approach and commented, “The new manager is brilliant. She has a really caring nature” and “I really like our manager actually. I have never had a manager that has been so approachable. They sort things out straight away.”
The provider actively encouraged staff development and operated a variety of schemes designed to support staff and ensure good practice was shared. There was an employee assistance programme where staff could anonymously access support during periods of difficulty. The provider had been recognised nationally as one of the top 100 not for profit employers.
People understood how to report any concerns or complaints and where issues or suggestions were made they were acted upon. Residents meetings were held regularly and records showed people’s suggestions had led to changes in how activities were arranged within the service.
People’s care plans included risk assessments and guidance for staff on how to protect individuals from all identified risks. Where areas of increased risk had been identified appropriate measures were introduced to mitigate these risks.
The service was well staffed and people told us, "There's always somebody around to help." Records showed planned staffing levels had been routinely achieved and staff reported, “There are enough staff” and “The deputy manager is always spare and can pick up a list if someone is ill.” There were no records of any planned visits having been missed and staff consistently told us this did not happen.
Staff responded promptly when additional help was needed and records showed additional visits had been arranged where staff were concerned about an individual’s welfare. Staff told us they did not feel rushed and used radios to reschedule visits if they were delayed. One staff member told us, “I don’t want to be too late, 10 or 15 minutes maximum. I will ask for help if this happens so the person can be warned I am running late.”
Assessments of people’s needs were completed before they moved into the service to ensure their needs could be met without impacting on people already using the service. Information gathered during the assessment process was combined with details supplied by commissioners and relatives to form the basis of people’s care plans.
Care plans were sufficiently detailed and staff had a good understanding of individual care and support needs. They provided staff with specific guidance on the support people normally required and were designed to encourage people to remain as independent as possible. Care records also included information about people’s life history and background to help new staff to see each person as an individual.
People were able to choose how to spend their time and access the community independently when they wished. Facilities were provided for the storage and charging of mobility aids and everyone was invited to weekly coffee mornings held in the service’s café to help reduce the risks of people becoming socially isolated. In addition, there was a day centre and hair salon on site which people enjoyed. There was an active gardening club and raised plant beds and a poly tunnel had been provided to enable people to continue to enjoy gardening. People told us, “We have great entertainment, I love to listen to the singers and music players." Games and entertainments were regularly arranged in communal areas.
The management team strived to continually improve the quality of service they provided. There were robust processes in place to seek people's views and monitor the quality of care provided at the service. These included unannounced spot checks of the quality of support provided by individual staff, management audits, regular residents meetings and an annual survey of people’s feedback. Where any concerns or issues were raised action was taken to address and resolve them. For example, people had raised issues in relation to the availability of parking at the service. As a result of these concerns parking enforcement had been introduced which had successfully resolved this issue.
Information was stored securely and there were systems in place to monitor the service’s performance, gather feedback from people and their relatives and identify where improvements could be made.