Lisbon Court

Updated 31 July 2019

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

The inspection was carried out by one inspector.

Service and service type

Extra Care Housing:

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.

Notice of inspection

We gave 24 hours’ notice of our inspection to give the provider opportunity to inform people of our visit and arrange for people to speak with us if they wished.

Inspection activity started on 20 June 2019 and ended on 21 June 2019. We visited the office location on both dates.

What we did before the inspection

We reviewed information already known about the service. This included the previous inspection report, any notifications which are important events the service are required to tell us about. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with seven people using the service, one relative, the registered manager, the deputy manager and two care staff. We spoke with a volunteer visiting the service. We also spoke with the provider’s regional director.

After the inspection

We requested further information which was received in a timely way. We also spoke with two more relatives, a friend of a tenant, and the Norfolk County Council commissioning team. We sent various emails to health, social care and housing professionals and received seven responses back which are reflected in the report.

Updated 31 July 2019

About the service

Lisbon Court is a housing with care scheme. People live on site in their own flats and have secure tenancies with a housing provider. Norse Care provides care and support over a twenty-four-hour period. This was usually up to thirteen hours a week but if the care needed exceeded this the registered manager would negotiate additional hours, but these were provided by an external, regulated care agency. The service can accommodate up to thirty people and had two vacancies at the time of the inspection which were due to be filled.

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

People were supported to live well, and staff encouraged them to remain independent and to achieve what they wanted to in line with their personal goals. There was a strong person-centred

culture which put people at the centre of the care provided which meant people received an outstanding service. Everyone we spoke with had high praise for the care provided and the exceptional ambiance which enhanced people’s well- being. Staff were motivated and worked in innovative ways to best benefit people they supported. They went above and beyond what was expected of them to help ensure people were not isolated and continued to be engaged in the service and wider community and take part in meaningful activity.

People benefited from security of tenancy and a service which was flexible around their assessed and changing care needs. Staff were quick to identify changes and supported people to either continue to live at Lisbon Court or move to a more appropriate setting. Staff gave people and their families time to transition and liaised regularly with multidisciplinary teams to help ensure change was managed effectively putting the person at the centre.

Care plans and assessments were comprehensive and focused on enabling people to live well and to take risks which were both proportionate and appropriate to need. The service facilitated people’s independence and only intervened when people lacked capacity to make informed decisions. Many people continued to take their own medicines and received minimal support from staff. Where extra support was needed this was provided and support was flexible.

The service took into account people’s back ground and interests and were able to adapt the service provided in line with people’s needs. People were given regular opportunity to voice their views and preferences and staff received training around equality and diversity to help ensure they recognised people’s individuality and did not discriminate.

Staff when providing care and support to people considered people emotional and physical health and encouraged people to undertake activities of daily living. Staff supported people to retain their existing skills and learn new ones by participating in their routines and taking part in planned activity or planning activities for others.

The registered manager was a good motivator and supported her staff to be the best they could be. Equally the registered manager told us how staff and the wider organisation had supported her well after a recent illness. The service was inclusive and caring which attributed to people receiving consistent and positive outcomes of care from well trained, considerate and cheerful staff.

Staff continued to be well recruited and well trained which contributed to people feeling safe. Two people told us how staff had saved their lives through quick and decisive actions. Staff said training had equipped them for their role and helped them to act instinctively. There was a strong culture of positive teamwork and accountability which helped ensure the care and support people received was seamless.

There continued to be robust audits which took into account the safety of the service and how effective the service was at meeting people’s needs. This took into account people’s views and experiences. Any known or potential risk was considered in line with people’s individual needs and steps taken to reduce or eliminate risk. There were strong governance processes and evidence of lessons learnt to maximise people’s safety.

Staff received medicines training and were assessed to ensure they were competence before being able to administer medicines. Audits also helped to determine people received their medicines as intended. Staff received support from other health care professionals to ensure people’s needs were met in a holistic way.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Rating at last inspection

The last rating for this service was good, (published 24 August 2016)

Why we inspected

This was a planned inspection based on the previous rating.

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