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Inspection carried out on 13 August 2019

During a routine inspection

Shinewater Court accommodates up to 36 people in a purpose built service. Providing care and support for people with a range of disabilities including multiple sclerosis, cerebral palsy, muscular dystrophy, spina bifida and other disabilities resulting from accidents or stroke. Accommodation consists of large individual rooms in the main building and 13 adjoining ground floor flats. All areas are wheelchair accessible.

People’s experience of using this service and what we found

People were at the heart of the service. Staff promoted people's right to make choices in every aspect of their lives and actively supported them to maintain their independence.

The staff and the management team provided people with support that was based on their individual needs, goals and aspirations. Therefore, care was tailored to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with dignity and respect in a way that supported and valued them as individuals. The registered manager and all staff, whatever their role worked hard to ensure people received the care they needed and lived full and meaningful lives. People's individuality was respected and embraced. Ensuring people received person centred care that met their needs and preferences was embedded into practice.

There was a high level of satisfaction with the service and the ethos at Shinewater Court was one of empowering people to maintain their independence and ensuring every person had a voice.

Risks to people’s health and safety had been identified and actions were in place to ensure risk was minimised. Staff were aware of the actions to take if they thought anyone was at risk of harm or discrimination. Any concerns identified had been reported to appropriate external professionals. A complaints procedure was in place and people were aware of the process. People told us they would speak to staff if they had any concerns at all.

Medicine procedures and systems were robust with staff competencies assessed to ensure high standards were maintained. Suitable systems were in place to prevent and control infection. Accidents and incidents were documented and reported appropriately. Any actions or lessons learned were taken forward to continually improve the service provided.

Recruitment processes were robust and people living at Shinewater had opportunity to be involved in the interview process and give feedback on prospective employees. Staffing numbers were assessed dependant on people’s needs. Regular care reviews were completed, and the service worked closely with people, relatives and other health professionals to ensure consistent, person centred care was provided.

Staff had access to a full range of training and support to ensure they could meet people’s complex needs. A consistent staffing group meant staff knew people well and understood their needs and preferences. Staff were supported to develop, and achievements were recognised.

People were encouraged to continue hobbies and interests that were important to them and supported to maintain relationships with friends and family.

People’s needs, and choices were well documented and understood by staff. It was evident that there was a close relationship between people and staff. People were involved in the planning of care and any changes to the way care and support was delivered. People’s communication needs were identified and recorded in care plans with specific methods and communication tools used to facilitate communication with people.

People were supported to have a varied and nutritious diet with healthy options provided and encouraged. People’s health and weight was monitored, and referrals made to other agencies if any issues were noted.

The registered manager and staff placed emphasis on per

Inspection carried out on 8 November 2016

During a routine inspection

Shinewater Court is part of the Disabilities Trust and provides accommodation and support with personal care for up to 36 people with physical disabilities. There were 33 people living in the home during the inspection, some people needed assistance with all aspects of their daily living, including personal care, eating and drinking and moving around the home. Other people needed assistance with personal care and were able to move around the home independently.

The home is owned by The Disabilities Trust, a charity set up to support people with disabilities. It was purpose built, with wide corridors and automatic doors, and a lift for access to some of the flats. There was access for people to all parts of the home, the gardens and local community areas.

The inspection took place on 8 November 2016 and was unannounced.

A registered manager was present during the inspection. 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.

At our inspection on 16 June 2015 we found the provider was not meeting the regulations with regard to staffing levels, accurate and up to date records and quality assessment and monitoring of the services provided. At this inspection we found improvements had been made and the provider met the regulations. However, some risk assessments were not clear and did not have enough information and guidance for staff to ensure people were supported safely.

The quality assurance and monitoring system had been reviewed and audits had been carried out to identify areas where improvements were needed. Questionnaires had been given to people and their relatives, staff and health and social care professionals to obtain feedback about the services provided and, action had been taken to address any issues raised.

There were enough staff working in the home to provide the support people wanted and people said they were encouraged to join in activities of their choice. People were positive about the food, choices were available and staff supported people as required.

Care plans were personalised and up to date, there was information about people’s individual needs and people were involved in writing and reviewing them. Assessments had been completed with regard to people taking responsibility for their own medicines and, there were systems in place to manage medicines safely.

Staff had an understanding of their responsibilities with regard to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff had attended safeguarding training and safeguarding and whistleblowing policies were in place and staff said they had read and understood these.

Complaints procedures were in place. People said they knew about the complaints procedure and were confident that they could raise concerns if they had any. The registered manager encouraged people, relatives and staff to be involved in decisions about how they service improved and, people and staff were very positive about the management of the home.

Inspection carried out on 16 June 2015

During a routine inspection

Shinewater Court is part of the Disabilities Trust, a charity set up to support people with disabilities, and provides accommodation and support with personal care for up to 36 people with physical disabilities. There were 34 people living in the home during the inspection, some people needed assistance with all aspects of their daily living, including personal care, eating and drinking and moving around the home. Other people needed assistance with personal care and were able to move around the home independently.

The home was purpose built, with wide corridors and automatic doors, and a lift for access to some of the flats. There was easy access for people to all parts of the home, the gardens and local community areas.

The inspection took place on 16 June 2015 and was unannounced.

The home was run by a registered manager who was present during the inspection. 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.

There were not always enough staff to meet people’s needs and a system to determine appropriate staffing levels was not in place. People said they had to wait for assistance and some people were unable to participate in activities of their choice.

The care plans, including risk assessments, did not record people’s needs accurately. Daily records did not reflect how people spent their time or how staff supported them to be independent.

The provider had quality assurance systems in place to audit the services provided at the home, but these did not address areas for improvement identified by the management.

People’s opinions of the food varied. Some people were very complementary, while others wanted changes made to the meal times and the choices available.

There were systems in place to manage medicines, including risk assessments for people to manage their own medicines. Medicines were administered safely and administration records were up to date.

Staff had attended safeguarding training and a safeguarding policy was in place. They had an understanding of abuse and how to raise concerns if they had any. Staff showed an understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Activities were available, in the activity day room or other parts of the home, for people to participate in and some people preferred to remain in their rooms.

Complaints procedures were in place. People said they knew about the complaints procedure and when they raised concerns these had been addressed. The registered manager told us the home operated an open door policy and encouraged people to be involved in discussions about the support provided. People agreed with this and said they could talk to the registered manager and staff at any time.

Monthly residents meetings, quarterly staff meetings and joint meetings enabled people and staff to raise any concerns or make suggestions for improvements to the support provided. People and staff felt confident their views would be listened to although any improvements or changes seemed to take a long time to introduce. Communication between people and staff was open and relaxed, and areas of concern were discussed openly. Including the staffing levels and areas where savings could be made.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 25 July 2013

During a routine inspection

We spoke to seven people who used the service during our inspection visit, six staff members and two visitors. People we were able to speak with who lived in the service told us they liked living at Shinewater Court. We were told "Really good, sometimes I grumble but the staff listen to me," "I like it here, I have friends,� and "I know I'm safe, staff look after us very well." One staff member said, "I love working here, it is so rewarding." Another staff member said, "I consider myself lucky to be working here, the people are great and the staff team is very supportive." One visitor told us, "Excellent all round, dedicated staff and a beautiful place to visit."

During our inspection we found that people who used the service and/or their representatives were involved in decisions about their care and treatment. Care plans were personalised and documented the needs of people. The provider responded appropriately to any allegation of abuse and all staff had received training in safeguarding vulnerable people. Appropriate arrangements were in place in relation to managing people�s medication safely. Shinewater Court had a complaints policy and procedure in place. Evidence was seen that comments and complaints were listened to, and resolved in a timely and appropriate manner.

Inspection carried out on 7, 8 March 2013

During a routine inspection

We visited Shinewater Court and spoke with 10 of the people who lived there. We looked at a range of documents, spoke with the deputy manager, the assistant manager and three care workers.

People told us that they were happy living in the home. They said that the staff treated them with respect and provided the support and care they needed and wanted. One person said, �They look after me very well.� Another person said, �They are our friends, they always ask us what we want to do.�

We observed staff speaking with people in a respectful and appropriate manner at all times. We saw staff provided support that enabled people to make choices about how they spent their time.

We looked at four care plans and talked to the people concerned. People said they wrote the care plans with their link worker and there was evidence in the care plans to support this.

We found that the system for the management of medicines in Shinewater Court did not protect all of the people who lived in the home.

We spoke with staff and looked at the staffing rota. We were told that staffing levels were not based on people�s assessed needs and the number of staff who worked in the home varied from day to day. Following the inspection further information was provided and we were told �that staffing levels within the service is planned according to the needs of the residents.'

Inspection carried out on 29 March 2012

During a routine inspection

People told us that they were happy with the care and support they received and that their needs were being met. They said that the staff treated them with respect, listened to them and supported them to raise any concerns they had about their care. People told us that the service responded to their health needs quickly and that staff talked to them regularly about their plan of care and any changes that may be needed.

Some people who use the service were unable to communicate fully and tell us what they thought of the quality of the care due to their communication difficulties. However through observation during the site visit we were able to observe staff supporting people who use the service in a respectful way.

Reports under our old system of regulation (including those from before CQC was created)