Background to this inspection
Updated
15 October 2021
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
This inspection was carried out by one inspector.
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 service.
The registered manager had recently left the service and the provider was in the process of recruiting a replacement. This means the provider is 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 people are often out and we wanted to be sure there would be people at home to speak with us. We also needed to be sure that a manager would be in the office to support the inspection.
Inspection activity started on 13 September 2021 and ended on 21 September 2021. We visited the office location on 14 and 15 September 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and one relative about their experience of the care provided. We spoke with the regional manager, the team leader and another manager who was supporting the service whilst a new manager was recruited. We also spoke with two carers who worked at the service.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
15 October 2021
About the service
Human Support Group Limited - The Windings is an extra care housing setting providing personal care to 26 people who lived in their own apartments at the time of the inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Medicines were not always managed safely. Staffing pressures and a lack of registered manager in post had impacted on the capacity for the remaining management team to undertake quality audits which would have identified issues much sooner. Plans were in place to address this. New staff had been recruited and a new manager had come into post during our inspection. This person had yet to register with the Care Quality Commission.
Other areas of people’s care were safe. Risk assessments and appropriate care plans had been developed to meet people’s needs. Staff were also recruited safely.
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. People were involved in developing their care plans which were person-centred and changes were made as people’s needs changed.
People received a caring service. People told us they were treated with respect and staff upheld their dignity during care visits. People were supported by staff who knew them well.
The provider worked with other professionals and organisations to ensure positive health outcomes were achieved for people.
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 (published 21 October 2020).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the safe management of medicines and effective oversight at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.