Background to this inspection
Updated
9 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
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 bought or 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.
This inspection took place on 5 and 22 December 2017 and both days were unannounced.
The inspection team included one inspector and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Prior to the inspection, the experts by experience and inspector carried out telephone interviews to gain people’s views in relation to the quality of the service provided.
Before the inspection we looked at all of the key information we held about the service, this included whether any statutory notifications had been submitted. Notifications are changes, events or incidents that providers must tell us about. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We also contacted the local commissioning teams. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority or by a health clinical commissioning group. We also checked what information Healthwatch Nottingham had received on the service. Healthwatch Nottingham is an independent organisation that represents people using health and social care services.
Prior to the inspection we attempted to speak with 34 people. We successfully spoke with 13 people who used the service and two relatives.
During the inspection we spoke with the locksmith, wellbeing advisor, an administrator, care coordinator, two team leaders, two personal support assistants, a nurse, head of care and the manager. We looked at the relevant parts of the care records of nine people who used the service, three staff files and other records relating to the management of the service.
Updated
9 March 2018
This inspection took place on 5 and 22 December 2017 and was unannounced.
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 bought or 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.
Not everyone using ExtraCare Charitable Trust Lark Hill Village 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. Where they do, we also take into account any wider social care provided. 58 people were receiving regulated activity at the time of our inspection.
The service is required to have 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The manager had started at the service in September 2017. At the time of our inspection visit the manager was not registered but was going through the process to become registered. Since the inspection visit the manager has completed their registration with the CQC.
At the last inspection in August 2015, the service was rated Good. At this inspection we found the service remained Good.
Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Risks were managed so that people were protected from avoidable harm and were not unnecessarily restricted. Sufficient staff were on duty to meet people’s needs and staff were recruited through safe recruitment practices.
Medicines were safely managed and people were protected against the risk of infection. Themes and trends in relation to accidents and incidents were reviewed and investigations of specific incidents were carried out.
People’s needs and choices were assessed and care was delivered in a way that helped to prevent discrimination. This was in line with evidence based guidance however positional charts were not always fully completed. Staff received appropriate induction, training, supervision and appraisal. People received sufficient to eat and drink, but food and fluid charts were not always fully completed.
People’s healthcare needs were monitored and responded to appropriately. External professionals were involved where appropriate. 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 cared for by staff who were kind. People were involved in decisions about their care and support and information had been made available in accessible formats. Advocacy information was not easily available to people. Staff respected people’s privacy and dignity and promoted their independence.
People were involved in planning their care and support. People were treated equally, without discrimination. The manager had limited knowledge of the Accessible Information Standard, however efforts had been made to ensure people with communication needs and/or sensory impairment received appropriate support.
Staff were aware of people’s interests, hobbies and preferences; staff took steps to ensure people enjoyed meaningful activities and stayed connected to their local community. Complaints were handled appropriately. Processes were in place for supporting people with end of life care where appropriate.
A clear vision and values for the service were in place. Staff felt well supported by the manager. The provider was meeting their regulatory responsibilities.
People and their relatives were involved or had opportunities to be involved in the development of the service. Systems in place to monitor and improve the quality of the service provided were effective.