Miners Court Extra Care

Miners Court Extra Care provides accommodation and support for up to 64 people on a purpose-built site. People live independently in their own self-contained homes with access to full-time on-site care and support.

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. At the time of the inspection 52 people were receiving personal care.

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

People told us they were happy living at Miners Court and felt they were safe and able to access care when they needed it. They received scheduled visits during the day to help with personal care. Everyone had a lifeline so they were able to call for additional support when required.

The service had several staff vacancies and some staff had been working longer than their contracted hours. Staff told us they were sometimes rushed and, on occasion, had to work later than planned. We have made a recommendation about staffing in the report.

People received their medicines as prescribed. When it was important for people to take their medicine at a specific time, staff prioritised their visits to make sure this happened.

Risk assessments were developed so staff were aware of any circumstances when people might need additional support. There was guidance for staff on how to support people safely and with a view to people maintaining their independence where possible.

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 had been a restructuring of the management team shortly before the inspection. The registered manager was supported by a deputy manager and three assistant managers. All had clearly defined roles and responsibilities.

Some staff told us they did not always feel confident approaching managers with any concerns or questions. Following the inspection, the Nominated Individual told us the actions they would be taking to improve staff experience in this area.

Staff were very supportive of each other and frequently spoke of the importance of working together and communicating well to make sure people got the care and support they needed and in line with their routines and preferences.

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 June 2018).

Why we inspected

We received concerns in relation to staff retention and staff confidence in management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Miners Court Extra Care on our website at www.cqc.org.uk.

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.

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.

Miners Court Extra Care is a supported living service that provides personal care to people living in the service’s 62 flats. A supported living service is one where people live in their own home and receive care and support to enable their independent living. People have tenancy agreements with a landlord and receive their care and support from a domiciliary care agency.

On the day of our inspection the service was supporting 47 people with personal care. People received short care visits at key times of the day to help them get up in the morning, go to bed at night and to give support with meal preparation or medicines.

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. However, the registered manager had been on leave for an extended period before our inspection. The provider had made arrangements to ensure the service was appropriately lead during the registered manager’s absence. Staff told us they had been well supported during this period and commented; “We have had three temporary managers but they have all been great and had minimal disruption to the service. I think it was well handled and we were never without someone here” and “The manager had made lots of very subtle positive changes.”

People were comfortable and relaxed at Miners Court Extra Care. We saw people enjoyed the company of their staff who they approached for support and conversation without hesitation. People enjoyed spending time in the service’s reception area and communal lounges chatting to staff and other people.

Everyone told us they felt safe and well looked after at Miners Court Extra Care. People's comments included, “The staff are all nice people, I feel safe with them”, “They are absolutely wonderful” and, “It’s heavenly here.”

While staff told us, “Morale is generally pretty good, it’s a good team to be part of”, “I don’t think I could find somewhere better to work, the mix of residents and staff is great.”

People’s visits were provided on time and there were sufficient staff available to provide all planned care visits. Staff told us, “we have not had any agency staff recently, we have four bank staff who come in when we need them.” We found the service’s senior carers were not routinely scheduled to provide care visits but instead provide cover during periods of staff leave or illness. People told us, “They come at the same time each day” and, “They are normally on time. Sometimes they are a bit late when [other] people need more help but I don’t mind that.” Daily care records showed staff normally arrived on time and provided care visits of the planned length.

A wireless life line system was available throughout the service to enable people to summon help from staff when required. Everyone told us staff responded promptly to request for support and one person said, “When you press your button it is amazing how quickly someone comes.”

Training records showed staff had been provided with all the necessary training which had been refreshed regularly. Staff told us; “All my training is up to date” and, “The training is pretty good.” In addition staff told us they were well supported, and records showed regular supervision and spot checks on staff performance had been completed. People told us they were regularly asked by managers for feedback on the performance of individual members of staff.

The service’s systems for the induction of new members of staff were effective and fully complied with the requirements of the Care Certificate. Recently recruited staff told us they had felt well supported during their induction training and commented, “The first couple of weeks were training and shadowing one of the team leaders” and, “Once I felt confident I was allowed to progress, the managers asked for feedback on my initial performance from people.”

People received care and support from staff who they knew well and who understood their care and support needs. People told us, “The carers have gotten to know me and know what I like” and, “I like the way I get the same staff most of the time.” While staff said, “what makes the difference here is that the staff all do the little extra things for people” and, “it’s nice that all the staff go the extra mile for people.”

Staff respected people's privacy and supported their independence. Everyone was able to lock their own front doors and staff always knocked and waited for a response before entering people’s rooms. Each person’s care plan included an access agreement which set out the circumstances in which people were happy for staff to enter their rooms, if they failed to respond when staff knocked on their door.

People’s care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people’s care needs. All of the care plans we reviewed were up to date and accurately reflected people’s individual needs and wishes.

People’s feedback was valued by the manager. Surveys were used to monitor the service’s performance and residents meetings were held regularly. The minutes of these meetings showed people’s suggestions and concerns had been acted upon and resolved. The small number of minor complaints received had been resolved to the complainant’s satisfaction. People told us, “I’ve got nothing to complain about” and “I have never regretted moving in here.”