Cera - Plymouth - Extra Care Scheme

Cera – Plymouth – Extra Care Scheme provides care and support to people living in specialist 'extra care' housing schemes. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building.

This extra care scheme was provided over seven different blocks of flats within Plymouth and the surrounding areas. The accommodation is rented and is the occupant's own home. Peoples’ housing was provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for extra care housing; this inspection looked at peoples’ personal care and support service.

Not everyone who used the service received personal care. The CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where this type of support is provided, we also consider any wider social care provided. At the time of our inspection there were 190 people using the service who received personal care.

Peoples’ experience of using this service and what we found

People, their relatives and staff raised concerns around staffing levels and people gave examples of where this did not always meet peoples’ needs. Improvements were needed to ensure people were fully protected against some of the risks associated with medicines.

Although staff received a training and induction package, people, their relatives and more experienced staff did not feel that all new staff were always competently trained to support people effectively. Staff told us they would like a mixed approach in relation to training which was primarily provided via an online platform. Staff responses about support through supervision and appraisal was varied.

Whilst people spoke positively about being treated with dignity and respect by staff, some people told us of significant communication issues with some staff whose first language was not English. Some people raised concerns around not being given choice relating to staff and appointments.

We received mixed feedback from people and their relatives about the level of involvement they had in their care. We have judged improvements were needed to ensure a consistent approach. There was a system to receive and act on complaints, however it was evident that some complaints made at individual schemes were not communicated to the service management.

Staff spoke positively of the registered manager and other managers at this service, but were less positive at times about the new provider of the extra care scheme. They gave examples of how they felt this had impacted on morale.

The current governance systems in operation had not identified the areas of concern we found during the inspection which meant people were at risk of not receiving care in line with their assessed needs and preferences.

Risks of abuse to people were minimised. Staff had received safeguarding training and the service had appropriate safeguarding systems and processes. Staff understood safeguarding reporting processes. Care plans identified risks and highlighted risk management strategies.

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 were systems in place that ensured people who were deprived of their liberty were done so with the appropriate legal authority.

Most people and their relatives commented positively about the registered manager and the quality of care their family member received. No significant concerns were raised about the quality of care provided. There were systems for people to feedback to the service management about care experiences and peoples’ views were sought through questionnaires.

The service worked well with other professionals and we received positive feedback from a healthcare professional we contacted about both the care provided and the standard of care delivery and leadership at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 19 February 2021 and this was their first inspection.

Why we inspected

This was a planned inspection.

Enforcement and Recommendations

We have identified breaches in relation to staffing and governance. We have also made a recommendation around the current systems in place for supporting people with their medicines and a recommendation about training provision.

You can see what action we have asked the provider to take at the end of this full 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.