31 July 2018
During a routine inspection
Maritime House is an extra care housing scheme in Portsmouth. It is one of four extra care services provided by Sevacare (UK) Limited in the Portsmouth area. Sevacare (UK) Limited provides personal care to people within their own homes accommodated within one building. People live in self contained flats with some shared facilities including, lounge areas, a restaurant and gardens. The building itself is not managed by Sevacare (UK) Limited. The service is provided from an office located within the building. At the time of our inspection, 60 people residing at Maritime House were receiving personal care and support from Sevacare (UK) Limited.
At our last inspection in February 2016, we recommended that the provider review their care planning and review processes in relation to people's expectations for their care and support and continue to take action to address people's dissatisfaction. During this inspection we saw that these matters had been dealt with satisfactorily and were no longer of concern.
The service 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 of the Health and Social Care Act and associated Regulations about how the service is run.
Staff gave good examples of how to recognise potential signs of abuse. Staff were clear about their responsibilities in safeguarding people and knew who to report their concerns to if they needed to. Staff felt that the management team would robustly investigate and effectively resolve any issues regarding safeguarding issues or concerns. Staff were aware of the provider’s whistleblowing policy and knew how to identify and contact external professionals to assist them if required.
Up-to-date risk assessments were available for staff to assist them to care for people safely. The assessments provided all the required information to manage risks to people’s health and wellbeing. There were regular reviews of people’s risk assessments to ensure that people and staff remained safe should their needs change.
The provider followed safe recruitment practices. These included obtaining photographic identification, satisfactory references and a Disclosure and Barring Service (DBS) check to ensure that appropriate staff were employed to care for people. There were enough staff employed to keep people safe and the employer looked at innovative ways to recruit new staff.
Infection control processes were followed and personal protective equipment (PPE) was available for staff to prevent the spread of infection.
The provider had processes in place to ensure that medicines were managed safely. Medicines Administration Records (MARs) were fully completed to ensure that people received the right medication at the right times.
Learning from incidents was discussed with staff at team meetings to ensure that examples of best practice were shared, with a view to preventing reoccurrence.
Staff received an initial induction, training and shadowing opportunities as a new member of the team. The provider offered mandatory, annual refresher training to ensure their staff maintained the appropriate skills and knowledge to carry out their roles effectively. Supervision, spot checks and annual appraisals were provided for staff and staff were offered other training opportunities to develop professionally if they wished. Staff achievements were recognised with an annual awards ceremony.
The service had implemented ‘diversity Thursday’ where staff were encouraged to embrace different cultures represented within their own teams and in relation to the people they supported. This was part of the wider ‘Well-being Framework’ which included tackling loneliness amongst people using services, supporting people who care for a relative, a ‘disability confidence scheme’ the ‘Armed Forces covenant’ and subscription to ‘The Care Workers Charity.’
Documentation relating to people being able to consent to their care was available in care plans. Where people were not able to sign their consent forms due to lack of capacity or dexterity, there was supporting information to validate why a person was unable to sign consent and evidence of best interest decisions or Lasting Power of Attorney (LPoA) orders were available in people’s care plans.
People were supported to meet their nutritional requirements, where people needed support with food and drink it was detailed within their care plans and included information about what a person’s food preferences were.
Where a person required support from external health or social care professionals, staff would assist them with arranging this. The registered manager told us that they had developed good working relationships with the building manager, care managers and the local safeguarding team to ensure that people received the support and assistance they required.
Staff provided kind, compassionate and person centred care to people living at Maritime House. Feedback from people was overwhelmingly positive for the care staff, level of support provided and for the management team as a whole.
During our inspection the service was not supporting anyone at the end of their life, but they had been in the months preceding. The management team looked at the individual needs of the person and their loved ones to provide a holistic package of care and support to ensure people were provided with thoughtful and compassionate care at the end of their life. The provider had a policy in place to direct end of life care provision.
Care plans contained detailed information to enable staff to meet people’s needs in accordance with their preferences. There was evidence of regular reviews having taken place and people were encouraged to contribute to decisions about their care and support. People’s dignity, privacy and independence was respected and promoted.
There was a complaints process in place that the management team adhered to. Any complaints received were dealt with in accordance with the provider’s policy, in an effective and timely manner.
Staff gave very positive feedback about the management and leadership of the service. They felt able to go to the registered manager or scheme manager as and when required and that they would be supported and listened to.
The service had encouraged and facilitated a resident’s committee for people living at Maritime House. The Recruitment and Well-being Officer attended these meetings to ensure that any feedback regarding how the service might improve was fed back to the management team for action to be taken.
The management team promoted a culture of inclusiveness and transparency with people at the forefront of everything they did. Staff were encouraged to be kind and caring to people and to each other. Wellbeing of people and staff was very important to the leadership of the service and this was embedded into everyday practice. This cultivated a warm and open atmosphere where innovation was welcomed and implemented wherever possible.
The management team robustly promoted equality and diversity within the service.
The provider encouraged feedback from people and conducted annual surveys which were distributed corporately. Feedback was analysed upon receipt of the surveys and any areas of improvement required were then forwarded to the registered manager and scheme manager to implement change. The service completed weekly reports and audits to ensure the smooth running of the service and to establish any areas for improvement locally.