The inspection was carried out on 11 February 2016 and was unannounced.
Queen Elizabeth Court is a 40 flat housing with care (HWC) scheme situated in the Royal British Legion Village with a dedicated Domiciliary Care team. The care team assisted people to maintain their independence by helping them with things like preparing meals or cleaning. Personalised care was also provided to maintain people’s health and wellbeing, assist with personal care and work with the community team’s delivery of dignified end of life care.
The scheme is designed to enable those of 55 years and over to live independently with the security of 24 hour on-call emergency assistance and day to day good quality and reliable personal care. There is an emphasis on delivering the military covenant. (The armed forces covenant is a promise from the nation that those who serve or have served, and their families, are treated fairly.) Each of the flats has its own lounge, kitchen and wet room and is fitted with emergency call facilities. A lift was available to take people between floors.
There was a registered manager employed at the service. 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 Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (2005) Code of Practice. The registered manager understood when the code of practice needed to be used so that decisions people made about their care or medical treatment were dealt with lawfully.
Having access to dedicated staff on-site made people feel safe. Staff were experienced and understood their responsibilities to protect people from harm. Staff had received training about protecting people from abuse. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.
People told us the service they received often exceeded their expectations with a whole range of support available to them. This included re-enablement back to independence after illness, accompanied activities outside of the service and light touch assistance such as getting shopping or carrying out small tasks when people were unwell.
The registered manager and care staff used their experience and knowledge of people’s needs to assess how they planned people’s care to maintain their safety, health and wellbeing. Risks were assessed and management plans implemented by staff to protect people from harm. Staff were trained to such an extent that they could effectively support people’s decisions about end of life care. Staff were enabling people to stay at home and receive care until they died.
There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.
People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell.
People and their relatives described a service that was exceptionally welcoming and friendly. There was a heavy emphasis put on welfare, community involvement and belonging. This was underpinned by the appointed welfare director. Staff provided friendly compassionate care and support. People were fully getting involved in how their care was planned and delivered. Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected.
The registered manager involved people in planning their care by assessing their needs when they first moved in and then by asking people if they were happy with the care they received. Staff knew people well and people had been asked about who they were and about their life experiences. This helped staff deliver care to people as individuals.
Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. The risk in the service was assessed and the steps to be taken to minimise them were understood by staff.
Managers ensured that they had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. Emergency life line and staff on call systems were in place. The premises and equipment in the service were well maintained.
Recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the service. The registered manager ensured that they employed enough staff to meet people’s assessed needs. Staffing levels were kept under constant review as people’s needs changed.
Staff understood the challenges people faced and supported people to maintain their health by ensuring people had enough to eat and drink.
If people complained they were listened to and the registered manager made changes or suggested solutions that people were happy with. The actions taken were fed back to people.
People told us that the service was well led. They told us that managers were approachable and listened to their views. The registered manager understood the balance they needed to achieve by providing and developing the best care packages for people, whilst recognising people’s autonomy, independence and lifestyle choices. The registered manager of the service and other senior managers provided good leadership. The provider and registered manager developed business plans to improve the service. This was reflected in the positive feedback given about staff by the people who experienced care from them.