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Archived: Exning Court

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Inspection report

Date of Inspection: 13 October 2011
Date of Publication: 2 December 2011
Inspection Report published 2 December 2011 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

Our judgement

The service is non compliant in this outcome area.

The needs of people using the service are not fully considered by the service when deciding upon sufficient staffing levels.

User experience

People who use the service (or their relatives) were very positive about the staff at Exning Court. One person said they couldn't find fault with the staff, saying, “they are exceptionally good” and “they seem happy working here”.

A relative we spoke with said that staff were hard to find but if they needed them they would pull the emergency call cord in the flat to speak with someone.

Other evidence

We visited the service on 27 October 2011 after receiving information which raised concerns about staffing levels. Some of those concerns were being looked into by the local authority and we were unable to comment on them in this review because they were still being investigated. The service is based in Exning Court (sheltered accommodation) and registered to provide “Personal Care” to people living in their own homes.

People can choose to live in sheltered accommodation because it helps maintain independence, with their own flat, but with the added security of care staff being available to provide care and support when it is needed (often called flexible care packages). At Exning Court we found people with various needs including those living with dementia and/or limited mobility.

When we arrived two members of staff were on site. One was in the front hall working on their training with a National Vocational Qualification (NVQ) Assessor. Another was booking in and organising medication. They told us there were no scheduled visits to people’s flats at that time, but if someone pulled their emergency call cord they would visit and find out what they needed. They confirmed staff were available 24 hours a day to respond to emergencies outside of their normal scheduled visits.

The Assistant Housing with Care Manager told us there were no specific times that carers visited people because there had been problems in the past when staff were late because the previous visit or visits had overrun. Staff worked to a “job card” which listed the order of visits. Staff told us that they assisted people flexibly, for example they often went to help with medication, then returned later to help the person to get up when the medication had had time to work.

People living in Exning Court were assessed as needing a minimum of six hours care a week. On this basis rotas showed there were enough staff hours to cover this. However it was not clear how many hours of care were actually being provided. The Assistant Housing with Care Manager told us some people received less than six hours and some had more. No other information was provided about how staffing hours were assessed and monitored against staffing levels.

The local authority told us that during a recent visit, they found records showed some people received less care hours than they had been assessed for. This could have been because they were not needed but may also mean that staff were not spending enough time with people.

Staff told us additional hours were provided for “well being” visits and people could “buy” extra hours for other services. The rota showed that the majority of the time there were two care staff on duty during the day and one at night. The night carer had an ‘on call’ staff member to contact if they needed help. They told us staff lived nearby and it took around ten minutes for someone to arrive. It was not clear how this level of staffing would cope appropriately with the amount of potential variation of the hours of the care packages. For example, if more than one person, at the same time, required help during the night or at peak times of the day when more people needed care in a short period of time. The “job card” for the night carer showed that there were visits that were important to attend to promptly. One entry said ‘As soon as (person) buzzers you must attend as this could be vital”. Some of the tasks required on other visits meant they would be unable to leave for an additional visit, for example if they were assisting with a shower and/or personal care. Staff carried a phone that linked to the call system so they were able to advise people how long they may be.

We saw two carers were needed for a visit but it did not appear on both carers “job cards”. We were told this then affected one carer’s timings for the following scheduled visits.

People living with dementia had flats in one area of Exning Court. We were advised that ther