We carried out a review of the data available to us about Creative Support - Regency Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Creative Support - Regency Court, you can give feedback on this service.
Creative Support - Regency Court is an extra care housing service providing support, including personal care, to people living in a purpose-built housing scheme made up of 60 flats.
Not everyone who used the service received support with 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. Staff were supporting 47 people with personal care 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 support they received from staff. They were protected from the risk of abuse because staff knew to follow the provider’s safeguarding procedures if they suspected abuse had occurred. Risks to people had been assessed and risk management plans had been put in place to help ensure people’s safety.
The provider followed safe recruitment practices and ensured there were enough staff on each shift to safely meet people’s needs. People’s medicines were safely managed. Staff were aware to report any incidents or accidents and acted to reduce the risk of repeat occurrence.
People had been involved in the planning of their care. They received support which reflected their individual needs and preferences. The provider had a complaints procedure in place and acted to address any issues raised with them.
People and staff spoke positively about the working culture of the service and the support they received from the registered manager. The provider sought people’s views and acted on their feedback using surveys and by carrying out spot-checks. Feedback from the most recent survey showed people were experiencing positive outcomes from the support they received. Senior staff carried out a range of checks and audits to help drive service improvements. The provider worked with other agencies to ensure people received good quality support.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 10 July 2019) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 6 and 7 June 2019. A breach of legal requirements was found relating to shortfalls in the safe management of people’s medicines. We also identified minor issues requiring improvement regarding the handling of complaints. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions ‘Is the service safe?’, ‘Is the service responsive?’ and ‘Is the service well-led?’ which contain those requirements.
The ratings from our last comprehensive inspection for the other two key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Creative Support – Regency Court 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.
Creative Support – Regency Court provides personal care and support as assessed by the local authority, to people who live in a specialist 'extra care' purpose-built housing scheme. People live in their own home or flat within the shared building of 60 flats. People at the scheme can choose their own personal care agency and not everyone who lived there received personal care from the service. Some people also purchase additional care and support from other agencies. At the time of the inspection there were 53 people using the service. CQC does not regulate premises used for extra care housing; this inspection therefore looked at the personal care and support service.
Rating at last inspection and update
The last rating for this service was 'Requires Improvement' (published 19 June 2018). At this inspection the rating remains 'Requires Improvement'. This service has been rated 'Requires Improvement' for the last two consecutive inspections.
At the last inspection in May 2018 we found a breach of regulations as medicines were not always managed safely. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found some improvements had been made to the systems to manage medicines, but these were not always consistently sustained, to ensure medicines were always safely managed. The provider was still in breach of this regulation.
People’s experience of using this service and what we found
We found there remained areas for improvement needed with the service. We had mixed feedback about the staffing levels at the service particularly to meet any needs outside of planned care times. There was a high level of agency staff at the inspection. The service had recently recruited new staff, but they had not yet started.
We have made a recommendation that the provider reviews their systems for assessing safe staffing levels to meet people’s needs at all times.
People’s risk assessments and care plans were not always up to date or reflective of their current needs. This had been identified by the provider and the service was being supported to address this issue.
While formal complaints were responded to appropriately; people and their relatives said that sometimes minor concerns were not always addressed. There had been several changes in the management and leadership of the service which had impacted on the provider’s ability to make sustained changes. The provider told us they were confident in the new management team that had been appointed.
There were quality monitoring systems in place but some improvements were still needed to the provider’s quality monitoring to ensure improvements were sustained. For example, checks were carried out on people’s pendant alarms and the response times; however, these did not track the response in the evening or at night.
There had been some improvements made since the last inspection, accidents and incidents were monitored for learning, to improve the quality and safety of the service. Staff received training and support to meet people’s needs. Areas of medicines management had improved. People told us they felt safe and staff understood how to keep people safe. There were robust recruitment practices in place.
People’s nutritional needs were assessed and supported where this was part of their planned support. 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 told us staff were kind and caring and respected their privacy and dignity. They said they were encouraged to be as independent as possible. People’s communication needs and needs with regards to their protected characteristics were considered as part of the assessment process to understand how they could be best supported.
Staff told us the provider and registered manager were working to make improvements, they felt well supported and worked well as a team. People’s views about the service were sought and considered to make improvements. The registered manager worked in partnership with other agencies, local authority and health and social care professionals to meet people’s needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.
People receiving this service live in 60 one or two-bedroom apartments located in a single apartment block within the London Borough of Bromley. Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating.
The service had a registered manager in post although they were not available at the time of our inspection. 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 provider also had a separate manager in post who oversaw the day to day running of the service.
At this inspection we found a breach of regulation 12 of the Health and Social Care Act 2014 because people’s medicines were not always safely managed or recorded. We also found areas requiring improvement because; identified risks to people were not always safely managed; accidents and incidents were not consistently reported, recorded and reviewed to help reduce the risk of repeat occurrence; staff were not always consistently deployed in a way which ensured people’s needs were met; staff did not always receive regular supervision or refresher training to ensure they were up to date with current best practice and; the provider’s systems for monitoring the quality and safety of the service identified issues but action had not always been taken to drive service improvements.
The provider followed safe recruitment practices when employing new staff. Staff worked in ways which reduced the risk of the spread of infection. People were protected from the risk of abuse because staff were aware of the type of abuse which could occur and the provider’s procedures for reporting abuse allegations. Staff were also aware of the provider’s whistleblowing policy and told us they would be confident to report any concerns to external agencies if needed.
People’s needs were assessed to ensure the service was able to support them effectively before they moved in to their apartments. Staff supported people to maintain a balance diet where this was part of their assessed needs. People had access to a range of healthcare services when needed and staff worked to ensure people received joined up care when moving between services. Staff sought people’s consent when offering them support. 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 supported this practice.
Staff treated people with dignity and respected their privacy. People were involved in making decisions about their care and treatment, and in the planning of their care. Staff supported people to maintain their independence where possible. People were treated with care and consideration. People also knew how to make a complaint and expressed confidence that any issues they raised would be addressed.
People and staff spoke positively about the manager and the impact they had had since starting work at the service. Staff told us they worked well as a team. The manager held regular meetings with staff to discuss the running of the service and ensure staff were aware of the responsibilities of their roles. People’s views on the service were sought through spot checks, meetings and surveys, and the most recent survey showed that people were satisfied with the service they were receiving. The provider worked with other agencies to ensure people received good quality care.