St Edmunds Court

Updated 25 November 2022

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

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 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave a short period notice of 72 hours for the inspection because some of the people using it could not consent to a telephone call from an Expert by Experience. This meant that we had to arrange for a ‘best interests’ decision about this.

Inspection activity started on 30 September 2022 and ended on 14 October 2022. We visited the location’s office on 14 October 2022.

What we did before the inspection

We reviewed information we had received about the service since they registered. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We used telephone calls and our site visit to enable us to engage with people using the service and relatives. We also used electronic file sharing and our site visit to enable us to review some of the documentation requested. This included three people's care records and medication records. We also looked at staff training and staff supervision. A variety of records relating to the management of the service were also reviewed, including incident records, complaints, compliments, and quality assurance processes.

We spoke with 13 people and two relatives of people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager, care staff and a senior care support worker. The senior care support worker and the team leader are responsible for the day-to-day running of the care service. We also spoke to the housing manager who worked for the separate organisation who was responsible for the extra care housing scheme building, facilities and maintenance.

After the inspection

We sought clarity about how the registered manager and management team at the care service worked alongside the extra care housing schemes housing manager. After the inspection the provider told us they were writing a formal induction for agency staff.

Updated 25 November 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance the Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location only provided support with personal care for one person with a learning disability. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

St Edmunds Court is a domiciliary care service and extra care scheme registered to provide personal care to people living in their own homes. The service is registered to support people some of whom may have dementia, mental health needs, people who misuse drugs and alcohol, had a physical disability, or were sensory impaired. The care agency can also support people with a learning disability and autism. At the time of the inspection 34 people were using the domiciliary care agency at the extra care housing scheme. The extra care housing scheme building had 51 rented flats with shared rooms, a restaurant and a shared garden.

People’s experience of using this service and what we found

Right Support:

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 systems in the service supported this practice. Staff encouraged people to be as independent as possible and to remain in their own homes. This enabled people to have as much control over their own lives as practicable. Staff supported people who required assistance with their medicines to promote the best possible health outcomes. Where needed staff supported people with links with the local community.

We have made a recommendation about improving the level of detail within people’s care records and risk assessments to guide staff on people’s health conditions and known risks.

Right Care:

Staff cared for people kindly. They protected and respected people's privacy and dignity. Staff understood and responded to people's individual needs and wishes. Staff knew how to protect people from poor care and harm. The management team and staff worked with other health and social care professionals to maintain people’s well-being wherever possible. Staff were trained to recognise, and report poor care or harm and they knew how to apply it. People told us they could communicate with most staff and understood information given to them because most staff were aware of people's individual communication needs. However, some people told us some agency staffs language skills could be improved.

The service had enough staff to cover people’s care call visits, however this was due to the use of agency staff. Some people and their relatives had mixed opinions on the skills and knowledge of some agency staff used.

We have made a recommendation for the provider to consider a formal induction and training competency spot checks for agency staff working at the service to ensure they had the right skills and knowledge to support people.

Right Culture:

People and those important to them, were involved in planning their and their family members care decisions. People and relatives had mixed opinions about how complaints or concerns were dealt with. Incidents and accidents were reviewed to look for patterns and trends. Action was taken when needed, this included retraining staff on safe medicines administration to try to reduce the risk of recurrence. Audits were undertaken to monitor the service and a survey in 2021 was sent to people to ask for feedback on the service provided. Staff had chosen not to complete the 2021 staff survey, but another survey was about to be sent out to engage staff and ask for their views.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 6 May 2021 and this is the first inspection. The last rating for the service under the previous provider was good, published on 9 October 2019.

Why we inspected

This inspection was based on the service being unrated since the new provider reregistered with the CQC.

Recommendations

We have made some provider recommendations for them to consider.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.