Brendoncare Mary Rose Mews

Brendoncare Mary Rose Mews provides extra care housing or 'Close Care' as the provider terms the service. The service is available to people who live in one of the 46 leasehold apartments located in the grounds of Brendoncare Care in Alton; if people wish to purchase a personal care service from the provider. People can also arrange personal care with external providers if preferred. At the time of our inspection 15 people were receiving personal care provided by the service.

At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At our last inspection we rated the service requires improvement in one area, safe, where we found one breach of the regulations. At this inspection we found requirements relating to care workers had now been met. The provider was able to demonstrate they operated thorough recruitment processes.

People were safeguarded from the risk of abuse. Potential risks to people had been identified, assessed and managed so they could stay safe whilst maintaining their freedom. There were sufficient staff to provide people with their care safely. People received their medicines where required, from trained and competent staff. Staff ensured people were protected from the risk of acquiring an infection during the provision of their personal care. Processes were in place to ensure any incidents were reflected upon and relevant changes made for people’s future safety.

People’s care needs were assessed prior to the provision of their care and reviewed regularly. Staff had the appropriate skills and knowledge to provide people with effective care. Staff supported people as required to ensure they ate and drank sufficient for their needs. Staff worked both within the service and across organisations to ensure people received effective care. People were supported by staff to ensure their healthcare needs were met and healthcare professionals' guidance was followed. 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 consistently reported they were treated in a kind and caring manner by staff. People were supported by staff to express their views and to be involved in decisions about their care. Staff ensured people’s privacy and dignity were upheld during the provision of their personal care.

People received personalised care which was responsive to their needs. People’s concerns and complaints were sought, listened to and relevant action taken. People’s views about their end of life care had been sought and staff had undertaken relevant training.

There was a clear vision for the delivery of high quality care to people and a positive culture. There were robust arrangements in place for the management and governance of the service, with a dedicated domiciliary care supervisor who managed the service day to day. The general manager’s application to become the registered manager of the service was being processed by the Care Quality Commission. People and staff were engaged and involved with the service. There were good processes in place to monitor and assess the quality of the service provided. The service worked with other agencies in the provision of people’s care.

Further information is in the detailed findings below

The service did not 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 provider has provided regular updates on their progress in recruiting a manager. They last wrote to us on 20 April 2016 to inform us that a peripatetic manager was overseeing the service and that a permanent manager had recently been appointed who was due to commence their role with the provider and register with CQC. Suitable arrangements had been put in place in the interim to ensure the smooth running of the service. The domiciliary care supervisor who had been in post since 22 June 2015, had responsibility for the day to day running of the service. They were unavailable during the inspection so we were supported throughout by a senior member of care staff.

The provider had carried out recruitment checks in relation to staff. However, they had not always ensured that applicants had provided a full employment history. They had not obtained photographic proof of identity for two care staff. Therefore, people might have been placed at risk from the recruitment of staff unsuitable for their role.

People were safe from the risk of abuse as staff had undergone relevant training and understood what action they should take to protect people from the risk of abuse.

There were processes in place to identify and manage risks to people. Staff were provided with relevant guidance and understood how to minimise the risks to people to ensure their safety.

People received their medicines safely from trained staff, although staff competency in relation to medicines management was not assessed following their medicines training. There was no evidence to demonstrate people had been placed at risk of harm as a result. The domiciliary care supervisor has since assured us that they will be introducing a competency assessment for staff and we have made a recommendation in relation to this. There were processes in place to ensure people received their medicines safely and relevant action was being taken to assess staff competence.

Staff received an appropriate induction to their role and were offered on-going training and supervision, to ensure they had the opportunity to update their skills and were supported in their role. People were cared for by appropriately trained and supported staff.

People told us staff always sought their consent before providing their care. Although people were able to make decisions about their daily care, staff had undergone relevant training to ensure they could identify if a person lacked the capacity to make a particular decision when required.

Staff supported people to ensure they received sufficient food and drink. Risks to people associated with eating and drinking had been identified and managed effectively.

Staff ensured people had their healthcare needs met. Where people required supported to make or attend healthcare appointments this was provided.

People were consistently positive about the caring attitude of staff who were heard to speak with people in a warm and friendly manner. Staff understood people’s likes and preferences about their care. People were proactively supported to express their views and staff supported people to make decisions about their care. People told us staff upheld their privacy and dignity when providing their care. Staff were aware that they were providing care to people in their own homes and were respectful of people’s homes and privacy.

People told us the service was responsive to their needs. People’s care calls and the duration of their calls were agreed with them. People could use the service if and when they required it. Staff supported people’s independence and ensured they did not experience social isolation. People received care that was personalised to them and their care needs.

Processes were in place to enable people to make a complaint if they wished. People were provided with relevant information about how to make a complaint. When people had made a complaint their concerns had been investigated.

Staff were encouraged to speak out if they needed to about issues which could impact upon people’s care. Staff told us there was a good team. Staff were observed to apply the provider’s aims and values in their work with people.

People’s views on the service were sought through regular questionnaires and coffee mornings. People also had the opportunity to meet with the provider’s representatives at the annual general meeting and to give their views. Various aspects of the service were audited to identify areas which could be improved for people and action was taken as a result.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

We had visited Mary Rose Mews in March 2013 and had found people were happy with the service provided. We however identified areas where improvements were needed. These related to record keeping and to how the the quality of the service was assessed and monitored.

During this visit we spoke with two staff, and looked at four people's records. We also spoke with three people who used the service and with one relative.

People remained very positive about the service. Staff told us that records had been audited to ensure that they were accurate and up to date and paperwork we saw supported this. There were appropriate systems for gathering, recording and evaluating information about the quality and safety of care.

At this visit we also checked staff recruitment processes. There were effective recruitment and selection procedures in place. This helped to ensure that people were supported by staff who were fit, appropriately qualified and physically and mentally able to do their job.

We found that records relating to people's care and welfare were not always clear and accurate. This had not been addressed as part of the services own quality monitoring systems. Although we found no evidence that this had adversely affected people's care it increased the risk of inappropriate care being given.