Healthlinc Apartments

About the service

Healthlinc Apartments is a residential care service providing nursing and personal care for up to seven people who live with a learning disability. Some people may also require support with mental health, sensory or physical needs. There were five people living in the service at the time of the inspection. Healthlinc Apartments is one of three registered services on the same site.

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

The provider’s management systems were not robust enough to demonstrate effective oversight of the quality of the service. There was a lack of distinction between two registered services on site. The provider had not fully acknowledged the impact of the high use of agency staff on people and staff. Staff lacked confidence in the provider. Audits had taken place but needed minor improvements regarding action plans.

People were supported by enough staff. However, regular deployment of agency staff meant there was a lack of meaningful interaction between people and those agency staff. Staff understood their responsibilities to keep people safe. People’s medicines were managed safely and reviewed frequently. Measures were in place to reduce the risk of infection to people.

People were supported to take part in activities which were important to them. However, people’s opportunities were impacted when being supported by agency staff who did not know them well. Information was available to people in different methods depending on their needs and preferences. The provider had a policy to effectively manage complaints.

Staff received training relevant to their role. People’s care records reflected their current needs and assessment tools were used to monitor people’s on-going support. People were supported with eating and drinking and staff supported people with different aspects of their daily living. The service and facilities met people’s needs. People had access to on-going healthcare support. People’s mental capacity had been formally assessed and best interests decisions were in place where required.

People were encouraged to express themselves freely using their preferred communication method. Staff treated people with dignity and respect. Staff and people were involved in the running of the service and their views were sought.

Right Culture

There was a lack of visible leadership from the service manager. Agency staff use was high, and this resulted in people not always receiving consistent care from staff who knew them well. People and those important to them were involved in planning their care. Permanent staff placed people’s wishes, needs and rights at the heart of everything they did.

Right Support

Staff supported people to have maximum possible choice and control over their own lives. The service gave people care and support in a safe, clean and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff supported people to make decisions following best practice in decision-making. Staff supported people with their medicines in a way that and achieved the best possible health outcome.

Right Care

Staff promoted equality and diversity in their support for people. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

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 May 2021).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well-led sections of this full report.

Enforcement

We have identified a breach in relation to the provider’s oversight of the quality of the service 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Healthlinc Apartments are a residential care service providing personal and nursing care for up to seven people who live with a learning disability. Some people may also require support with mental health, sensory or physical needs. There were six people living in the service at the time of our inspection.

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

People told us they felt safe with the staff who supported them. Staff understood how to identify and report any concerns for people’s health, safety and welfare.

Risks were assessed and management plans were in place to minimise the impact on people’s health, safety and welfare. Risks were regularly reviewed and any changes in people's needs were quickly responded to.

Measures were in place to prevent the spread of infection in the service. Medicines were managed safely.

There were enough, safely recruited staff to meet people's individual needs and wishes. Staff were provided with training and support to help them deliver good quality care for people.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People, and those who were important to them, were involved in planning their care so that the way they lived their life reflected their choices and wishes.

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.

There was an open and inclusive culture within the service. Everyone’s views were listened to and respected. The manager and staff worked in partnership with other health and social care professionals for the benefit of people who lived in the service.

Systems were in place monitor the quality of the services provided for people. This enabled any gaps or shortfalls to be identified and addressed in a timely way and promoted a culture of continuous improvement.

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 18 December 2017).

Why we inspected

The inspection was prompted in part due to concerns received about staff deployment. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained good. This is based on the findings at this inspection.

Follow up

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.

Healthlinc Apartments are registered to provide accommodation, nursing and personal care for seven people who may be younger adults or older people. The service can provide care for people who have a sensory or physical disability. It can also support people who have special needs for assistance due to a learning disability or mental health issues. There were seven people living in the service at the time of our inspection visit. Most of the people had special communication needs and used a combination of individual words, vocal tones and sign assisted language to express themselves.

The service was run by a company who was the registered provider. There was a registered manager in post. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on 1 December 2015 the service was rated, ‘Good’.

At this inspection we found the service remained, ‘Good’.

In more detail, there were systems, processes and practices to safeguard people from situations in which they may experience abuse. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. In addition, medicines were managed safely.

Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service and background checks had been completed before new nurses and care staff had been appointed. Good standards of hygiene were being maintained and lessons had been learnt when things had gone wrong.

Nurses and care staff had been supported to deliver care in line with current best practice guidance. People enjoyed their meals and were supported to eat and drink enough to maintain a balanced diet. In addition, there was suitable provision to ensure that people received coordinated and person-centred care when they used or moved between different services.

People had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. Furthermore, people had benefited from the accommodation being adapted, designed and decorated in a way that met their needs and expectations.

Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They were also supported to express their views about the care they received and to be actively involved in making decisions about things that affected them. This included having access to lay advocates if necessary. In addition, confidential information was kept private.

People received personalised care that was responsive to their needs. This included being offered a number of opportunities to pursue their hobbies and interests. People’s concerns and complaints were listened and responded to in order to improve the quality of care. In addition, suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a positive culture in the service that was open, inclusive and focused upon achieving good outcomes for people. There was a robust management framework to ensure that nurses and care staff understood their responsibilities so that risks and regulatory requirements were met.

The views of people who lived in the service, relatives and staff had been gathered and acted on to shape any improvements that were made. Quality checks had been completed and people benefited from the service being able to quickly put problems right and to innovate so that people could consistently receive safe care.

Good team work was promoted and nurses and care staff were supported to speak out if they had any concerns about people not being treated in the right way. In addition, the registered persons worked in partnership with other agencies to support the development of joined-up care.