Archived: ExtraCare Charitable Trust Princethorpe Court

We visited Princethorpe Court on 15 and 17 December 2015. We told the provider before the inspection visit we were coming so they could arrange for staff to be available to talk with us about the service.

The service has a manager who is in the process of registering with us. The manager had been in post since June 2015. 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.

People who lived at Princethorpe Court told us they felt safe. Care workers who supported them understood their responsibilities to protect people from abuse and had carried out training on safeguarding people. There were processes to minimise risks to people’s safety which included comprehensive assessments of their needs to identify what they could do independently and what they needed support with. People’s medicines were managed by care workers if risks had been identified with people doing this independently.

There were enough suitably trained care workers to deliver safe and effective care to people. No new care workers had been employed at the service since our last inspection. Recruitment procedures ensured appropriate checks were carried out before new care workers were employed. This was to ensure they were suitable to work with people who used the service.

People told us care workers had the right skills and experience to provide the care and support they required and did not rush their care when they supported them. Care plans contained relevant information to help care workers provide the personalised care people required. Care workers helped people to prepare meals of their choice or to attend the restaurant at Princethorpe Court where a choice of nutritious meals was available.

The manager understood the principles of the Mental Capacity Act (MCA). Care workers respected people’s rights to make their own decisions and gained people’s consent before they provided personal care.

People were supported by a consistent group of care workers who were kind, caring and respectful towards them. People told us care workers supported them to maintain their independence and were always mindful of protecting their privacy and dignity.

Most of the care workers had worked at the service for many years and knew people’s needs and preferences well. People told us care workers met their needs in accordance with their wishes most of the time. A varied programme of activities and entertainment was organised and regularly provided by the service which people were able to participate in if they wished. People had an opportunity to say what social activities and entertainment they would like by attending ‘Street’ meetings which were held on a monthly basis in the communal areas of the building.

There had been one formal complaint received about the service which had been acted upon in a timely manner by the manager. People felt confident to raise any concerns or issues with the manager or staff if they needed to.

The management team were knowledgeable about people and their care needs and were open to people’s views. There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. The provider carried out quality checks to ensure people received care and support in accordance with their needs and preferences. Results from quality satisfaction surveys showed a high level of satisfaction with the service.

At the time of our visit the service provided care and support to 29 of the 47 people who lived at Princethorpe Court.

We looked at five outcomes to answer the following questions. Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you would like to see the evidence supporting our summary please read the full report.

Is the service safe?

People's needs and abilities were assessed before they received care and support to make sure the support given was appropriate to their needs. Care staff we spoke with told us they had read people's care plans. This was so they understood how to deliver care in a safe way to minimise risks to people's health and wellbeing.

People received their prescribed medicines when they needed them. Staff made the necessary arrangements to make sure medicines were obtained, managed and administered where this was appropriate.

All people we spoke with told us they felt safe living at Princethorpe Court. We saw people wore 'pendants' so they could alert staff if they should need emergency assistance. Staff carried out daily checks on people to make sure they were alright.

We saw records that showed all care staff were required to sign a 'code of practice for the Mental Capacity Act (MCA) 2005' to show they had read and agreed to follow the guidelines. The manager was aware of her responsibilities under the MCA and how this may impact on people who lacked capacity to make their own decisions. The manager told us all staff had completed training on the MCA so they also understood how those people who lacked capacity would need to be supported.

We found the provider made appropriate checks on staff before they began work to make sure they were safe to work with vulnerable adults.

Is the service effective?

People told us the care and support they received met their needs and was delivered in accordance with what had been agreed.

It was clear from discussions with staff and our observations of them, they had a good understanding of people's care and support needs and they knew them well.

Staff attended mandatory training and specialist training linked to people's needs so they could support people safely and effectively.

People were able to participate in a range of social activities organised by Princethorpe Court to meet their social care needs.

Is the service caring?

People we spoke with told us they were involved in planning their care. They also told us they were regularly asked about their care to check it was being provided in accordance with their wishes.

People were positive about the staff who supported them. They told us, 'I think I have had all the care and attention I could have. I am more than grateful.' 'All very nice.' 'They are ever so good, I have not had a problem with any of them.'

Care files contained 'ability profiles' to help staff understand what people could do independently and how they needed to be supported.

Is the service responsive?

We saw the care plans were regularly reviewed to make sure the care and support people received continued to be appropriate.

Records of concerns and issues raised by people showed that prompt action had been taken by the service to address them. For example, a complaint raised about the environment resulted in new carpets being organised for the stairs. On the day of our inspection, these were being fitted.

Is the service well led?

We found the service had an effective system in place to obtain the views of people who used the service. We saw notes of meetings identified actions carried out in response to comments raised. For example putting white lines in the car park and displaying information on a notice board.

People who used the service and staff told us they were able to speak with the manager about concerns. Staff told us they felt well supported and were all positive about working at Princethorpe Court.

We saw the service was subject to extensive audit processes by management staff. This was to ensure the quality of care and services provided met with the expectations of the provider.

We visited Princethorpe Court in May 2013 and found that care records were not always sufficiently detailed or accurate. This meant care staff were at risk of providing inconsistent care and support to people. We received an action plan from the provider with supporting evidence to show the necessary improvements had been carried out.

We saw that appropriate systems were in place to gain consent from people to provide treatment and care. Staff had a good knowledge of people and were able to tell us how they helped people to maintain their independence.

We saw that each person had a care plan file containing information on how they needed to be supported. Some of these records were not sufficiently detailed to make sure staff supported people appropriately.

We saw action had been taken since our last inspection to address the staffing concern where some people had been receiving delayed support. During this inspection we found that people were receiving visits in accordance with the times they had agreed. People were positive about the staff. They told us: 'No grumbles with them at all, they are very helpful.' 'The staff are very sociable and helpful.'

People we spoke with did not raise any concerns about the service but knew who to speak with if they needed to. We saw that complaints received by the service had been recorded, investigated and responded to.

People were positive about the support they received. One person told us: 'I had a stroke and needed help when I came back and they were very good.'

People told us that sometimes they had their meals in the communal dining room. Some people told us they were not happy how the meat was cooked but felt the meals were generally to their liking.

We saw that regular resident meetings took place where people had opportunities to give their views about the service. These meetings also gave people opportunities to raise anything they were not happy with.

We saw that staff were kind and respectful towards people. People told us they were happy with the staff that supported them. We were told: 'There are some very pleasant staff here and they are very friendly.' 'I like it, the girls are very nice'

We identified from records in place that staff did not always make their calls to people within the agreed timeframes. This was acknowledged by the service and we were told about plans for this to be improved.