Archived: North Hertfordshire Homes

Flexicare housing is a version of extra care scheme where people rent their own flat, but have access to care and support as and when they need it over 24 hours a day. Because it meets a wide range of needs, flexicare is a positive choice for people with a range of needs, from those starting to need a little help with physical or memory problems, to those who were seeking an alternative to residential care. People lived in their rented flat with the privacy of their own front door, but had care available if they needed it.

There was a registered manager in post who was responsible for all the five schemes operated by the provider. 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. In addition, all the schemes had an allocated Care Team Manager who was responsible for the day to day management of the schemes.

Staff received training in how to protect people from harm and they were aware of how to report any concerns internally and externally. People and their relatives told us that the care and support people received from staff was safe and had a positive impact on people`s life.

People told us staff were respectful and offered care and support in a caring way which promoted their independence. The care and support offered to people met their needs and made people feel safe. People were involved in developing their own care plan based on their needs and wishes.

Staff had comprehensive induction training when they started working for the provider and they attended regular refresher training sessions. The registered manager identified and offered specialist training for staff to develop and progress in their career.

The provider successfully supported people to overcome the risk of social isolation. They organised regular events to encourage social interaction. People were given opportunities to pursue their hobbies and interests.

People and their relatives told us they had good communication with staff and the managers who were running the service. They felt their voice was listened to and any suggestions they had, the staff were able to action and resolve issues to their satisfaction. People confirmed that staff sought consent before assisting them and the service worked in accordance with the principles of the Mental Capacity Act 2005.

People and their relatives told us they felt the service was well managed and well led. People we spoke with told us how they enjoyed living and being supported by staff at the service. Regular audits were carried out by the registered manager and areas identified as in need of improvement were actioned and the quality of the service provided was improved.

We reviewed information about staff recruitment and training. We also confirmed how the provider monitored the quality of the service provided together with record keeping. Below is a summary of what we found.

If you wish to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe and were involved in decisions about their care. One person said, 'I am safe and well looked after.' A relative confirmed, 'Mum is safe here. The environment is safe.'

We saw that staff were provided with regular mandatory training in topics such as medicines management and safeguarding vulnerable adults from abuse. This meant that staff had the knowledge that they needed to ensure that people were kept safe.

Training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) was planned for later in the year to ensure that all staff were able to support people unable to make decisions for themselves.

Is the service effective?

We observed a good rapport between staff and people who used the service. Staff we spoke with demonstrated a good understanding of people's individual needs. Care plans were up to date and a range of health care professionals were accessed when required. One person told us, 'I see a doctor when I need to.'

People's care records showed that support was planned and delivered in a way that was intended to ensure their safety and welfare. Care records were regularly reviewed which meant that staff were provided with up to date information about how to support people.

Is the service caring?

We saw that people were supported by staff who were kind and respectful. One person commented, 'The staff are all very helpful. They are kind.' A relative told us, 'The staff are very caring and respectful and ask for Mum's views.'

We observed that staff treated people with dignity and respect, for example they knocked on people's doors before entering their flats and addressed people by their preferred name. People and their relatives told us they could approach the staff with any issues or concerns.

Is the service responsive?

People received an assessment before they used the service and care records included detailed information about people's support needs. We saw that people's needs were reviewed regularly and that care was provided in a way that was intended to ensure their safety and welfare.

People told us that they were involved in decisions about their care. One person told us, 'I have a key worker and we go through my file together.' Another person confirmed, 'I am involved and informed. I know what is going on.'

Is the service well led?

People told us they had no complaints and were well looked after. One person said, 'I like it here. The company is good. I have no complaints at all.'

We found that the provider had a number of systems in place to ensure that the quality of the service was regularly assessed. For example, a survey of people who used the service took place annually. There was evidence that the provider took action to improve the service when this was required.

During this inspection on 05 November 2013, we found that the provider had taken action to ensure that people were protected from the risk of abuse. Records we checked showed that staff were following the operational procedures for the management of people's money. Staff told us that they had received training on protecting vulnerable adults from abuse.

Prior to our inspection on 05 November 2013, we had received some information of concern in relation to the management of people's medication. People we spoke with during our inspection told us they were happy with the way staff administered their medicines. One person said: "They are very good at doing it". However records we checked showed that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

We found that care records were current and reflected the needs of people who lived in the home. Staff demonstrated a good understanding and knowledge of the care and support people required.

People living in the scheme said that they felt safe. The provider had systems in place to notify the local safeguarding authority of any incidents or allegations of abuse. However, the provider was not familiar with the requirement to notify the commission of such incidents. Some staff we spoke with were not sure which agencies were involved in protecting vulnerable adults.

Staff we spoke with said that they felt well supported to do their job and were encouraged to promote their professional development. The provider had systems in place to ensure that their learning and development needs were identified based on the needs of people who used the service. Staff received a wide range of training to equip them for their role.

The provider had systems in place to check that people were satisfied with the service.

People said, 'I am happy living here, it is a very nice place.' And, 'You don't have to ask for things to be done, they are done.'