Background to this inspection
Updated
20 June 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection carried out by one adult social care 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. We gave the service 24 hours’ notice of the inspection visit to make sure the manager would be in.
Inspection site activity started on 1 May and ended on 11 May. The inspection was informed by feedback from questionnaires completed by a number of people using the service prior to the inspection taking place. The Care Quality Commission sent surveys to 15 people and their relatives and we received 11 replies.
We visited the office location on 2 and 9 May 2018 to see the registered manager and office staff; and to review care records and policies and procedures. We met and spoke with the area services manager, registered manager, scheme service manager, two team leaders, the administrator and six care staff. We also received further written feedback from three care staff. We visited and spoke with four people in their own homes and two visiting relatives. We spoke by telephone to a further three people and four relatives.
We reviewed information about people's care and how the service was managed. These included: four people's care files and medicine records; three staff files which included recruitment records of the last staff to be appointed; staff rotas; staff induction, training and supervision records; quality monitoring systems such as audits, spot checks and competency checks; complaints and compliments; incident and accident reporting; minutes of meetings and the most recent quality questionnaire returned.
We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. This included previous inspection reports, safeguarding alerts and statutory notifications. A notification is information about important events which the service is required to send us by law.
Updated
20 June 2018
This comprehensive inspection took place on 2 and 9 May 2018. The inspection was announced which meant that the staff and provider were aware that we would be visiting.
Sanctuary Home Care Limited – Devon is a domiciliary care agency. It provides care and support to people living in specialist ‘extra care’ housing at Moreton Court Extra Care Scheme, Bideford. Both services belong to the Sanctuary group. Extra care housing is purpose-built or adapted 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. The Care Quality Commission does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
Not everyone using Sanctuary received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
There were 59 flats at the scheme and 29 people were receiving personal care. The care visit times ranged from a minimum of 15 minutes to a maximum of one hour. The frequency of care visits ranged from once a week to 28 times a week.
At our last inspection in November 2015 we rated the service Good. At this inspection we found the evidence continued to support the overall rating of Good but the caring domain had improved to Outstanding. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Good:
The home had a registered manager. 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 registered manager and care workers delivered care and support which took into account people's individual choices and preferences. People were extremely happy and complimentary over the service and the staff that supported them. Care workers treated people with respect, dignity and compassion at all times. Meaningful relationships had been developed with the care workers who supported them. Families, friends and pets were supported as part of people’s ongoing care, support and wellbeing. Two relatives said, “Absolutely marvellous here, the people, the service, the place” and “They (family members) are so happy here …”
People were encouraged to be as independent as possible by care workers they trusted and felt safe with. Care workers supported people to lead an enhanced quality of life. People commented, “Everything is hunky dory … staff are marvellous” and “They are very friendly and very caring”. People said care workers went 'the extra mile' and that they went above and beyond what was expected of them. They gave examples of when this happened. Relatives said, “I can’t say anything bad … I love Moreton Court”, “Outstanding care, I can’t fault it” and “It is the perfect place sent from heaven … we are more than satisfied …it’s the best place we could have found.”
People had a regular team of care workers and liked to see familiar faces. People were kept safe and cared for by care workers who were aware of their safeguarding responsibilities. Care workers were safely recruited, trained and supervised in their work. They enjoyed their jobs, felt included and listened to in the running of the agency. People had confidence in the management of the service and the registered manager acted as a role model for the staff team. People were confident any issues would be dealt with appropriately.
People were supported by adequate staff to meet their needs. Staff had received safeguarding training and were aware how to raise concerns if they felt people were at risk of abuse or poor practice. People were treated with compassion and empathy by staff. They were relaxed and comfortable with staff that supported them. Staff were discreet when supporting people with personal care, respected people’s choices and acted in accordance with the person’s wishes.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Where people lacked capacity, mental capacity assessments were completed and best interest decisions made in line with the MCA.
People’s views and suggestions were taken into account to improve the service. Regular feedback was sought. Health and social care professionals were involved when necessary. People knew how to make a complaint. There had been no complaints received at the service since our last inspection.
People were supported to follow their interests and take part in social activities both inside and outside of the service. People were encouraged to establish community links. People were encouraged to take part in the running of the service if they wished.
People were supported to eat and drink enough and maintain a balanced diet. Medicines were safely managed and procedures were in place, although these could be improved upon.
The provider had a range of robust quality monitoring systems in place which were used to continually review and improve the service.
Further information is in the detailed findings below.