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Inspection Summary


Overall summary & rating

Requires improvement

Updated 21 September 2018

This announced inspection took place on the 20 and 21 August 2018. During our previous inspection in February 2017 we found evidence of a breach of Regulation 17 of the Health and Social Care Act 2014. This was because the provider did not have a robust quality assurance system in place to effectively monitor the safety and quality of people's care.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; is the service Safe and is the service Well-led, to at least good. During the current inspection we found improvements had been made to the safety of the service, however, we found the service was still in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had not checked the information recorded in the quality assurance audits was accurate. Audits that had been completed did not identify the concerns we found.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Swan Court has 12 apartments and can accommodate up to 24 people. At the time of our inspection there were 12 people living in the service. The service is registered to accommodate older people, those living with dementia, and people with sensory of physical disabilities. Each person had their own apartment which comprised of an open plan kitchen/ lounge area, bathroom and bedroom. The apartments were all on one site with a communal lounge/ dining and kitchen area, bathrooms and garden.

The service was mostly safe, although the provider had systems in place to ensure the safe recruitment of staff these had not always been followed. We have made a recommendation about this.

Staff were trained to identify signs of abuse and how to report concerns. Medicines were administered by trained staff. Records showed people received their medicines in a safe and appropriate way. Where people required additional support with maintaining their health, they were referred to health professionals such as psychologists and GPs.

People spoke positively of their experience of living in the service, they told us “The best thing about living here is the atmosphere and the other people living here.” “I do everything I want to do.”

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.

People were supported with their nutritional and hydration needs. This included providing food and drinks that was safe for them to consume and in line with their preferences.

Care plans documented people's preferred method of communication. People had access to the information they needed in a way they could understand it. People's relatives were encouraged, where appropriate, to be involved in the planning and monitoring of the care provided.

Families and friends were encouraged and supported to maintain contact with people. This protected people from the risk of social isolation. People were treated equally, regardless of their disability, gender, sexuality, religion, race or age in line with the requirements of the Equality Act 2010. People's chosen lifestyles were respected and where staff could offer support to people they did.

People, staff and others had positive opinions about the management and leadership of the service. There was a good workplace culture and we saw the staff worked well together to ensure effective care for people. Staff comments included ““S

Inspection areas

Safe

Requires improvement

Updated 21 September 2018

The service was not always safe.

Thorough checks had not always been carried out prior to the employment of staff. This meant the provider could not be assured of their safety to work with people.

Care plans were detailed and risks associated with the provision of care and the environment had been assessed. This reduced the risk of people receiving inappropriate and unsafe care.

Information and training in the administration of medicines was available for staff, this meant the registered manager could be assured people were receiving their medicines safely.

Effective

Good

Updated 21 September 2018

The service was effective.

People were encouraged to make decisions about their care and day to day lives. People were supported to be as independent as possible.

People’s consent was obtained and the service complied with the requirements of the Mental Capacity Act 2005.

People’s health was monitored and when necessary external professionals were contacted to provide support to people on maintaining good health.

Caring

Good

Updated 21 September 2018

The service was caring.

People were supported by staff who demonstrated a caring nature and who were knowledgeable about people’s needs and the care required.

People’s dignity and privacy was respected and promoted.

Responsive

Good

Updated 21 September 2018

The service was responsive.

People participated in activities both in the service and in the wider community. This encouraged inclusion and protected people from social isolation.

Systems were in place for the registered manager to obtain feedback on the quality of the service. This helped drive forward improvements.

Well-led

Requires improvement

Updated 21 September 2018

The service was not always well-led.

Records related to completed audits of the service were not representative of the findings we made during our inspection. This meant areas requiring improvements had not been identified.

Staff told us the management were supportive and they worked well as a team. There was an open and honest culture which enabled effective communication and a positive working environment.