We carried out a review of the data available to us about Housing 21 - Anvil Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Housing 21 - Anvil Court, you can give feedback on this service.
Housing 21 – Anvil Court is an extra care housing setting where staff provide personal care and support to people living in their own flats within one large adapted building. People living here are supported with a range of needs such as dementia and Parkinson’s disease. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, 29 people who were using the service received a regulated activity.
People’s experience of using this service and what we found
People told us they felt safe with the support they received. Relatives reflected this view and told us they felt comfortable and more relaxed knowing their family member was safe and well cared for.
There were enough staff to meet people’s needs. People received their care from staff who knew people’s health needs well and had the training they needed to provide safe care.
People’s individual health needs were fully risk assessed and there was detailed guidance in place to support staff to manage known risk. Lessons were learned from adverse events. Accident and incident records were analysed, and measures put in place to reduce the risk of a similar incident happening again.
The provider’s recruitment procedures helped ensure only suitable staff were employed. Staff understood their responsibilities in protecting people from abuse and knew how to report any concerns they had. Staff were well supported by their managers and worked well as team to meet people’s needs.
Medicines were managed safely. For example, there was detailed guidance and body maps in place to ensure people received the correct creams safely.
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 received support with their meals to maintain a healthy diet.
The provider worked closely with healthcare professionals to ensure referrals were made in a timely manner. Staff followed guidance provided to them to maintain and improve people’s health.
The provider’s quality monitoring systems helped ensure people received safe care. The management team and staff communicated important information about people’s needs effectively. People’s care records were accurate and up to date.
People and their relatives told us their views about the service were listened to. Relatives were encouraged to be involved as partners in their family members’ care. People and relatives provided positive feedback about the management team.
The provider ensured relatives were kept informed about their family members’ wellbeing during the COVID-19 pandemic. The provider had also considered the effect on staff of the pandemic and put support mechanisms in place.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was requires improvement (published 07 May 2020.)
Why we inspected
A decision was made for us to inspect, examine and follow up what improvements had been made since the last inspection. Due to the COVID-19 pandemic, we undertook a focused inspection to only review the key
questions of Safe, Effective and Well-led. Our report is only based on the findings in those areas reviewed at this inspection. The rating from the previous comprehensive inspection for the Caring and Responsive key questions were not looked at on this occasion.
Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Housing 21 – Anvil Court is a domiciliary care agency providing personal care to people with a range of needs such as dementia and Parkinson’s disease. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection, 32 people who were using the service received a regulated activity.
People’s experience of using this service and what we found
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Although risks to people were appropriately managed, they were not always recorded. Medicine administration practices were not always safe, which left people at risk of not receiving their medicines correctly. We have made recommendations in these areas. Records were not always robust or completed in full, which meant the registered manager could not always demonstrate full management oversight in areas such as accident and incident mitigation and complaints received. Audits did not always identify the issues we found during our inspection, but action had been taken where other audits had identified areas for improvement.
Staff were passionate about caring for people, and this was evident in our observations of care and feedback from people and their relatives. People told us they were treated with dignity and respect and were encouraged to make choices around their day to day care. The registered manager had created a positive ethos within the service, with people’s quality of life at the forefront of staff’s objectives. People, relatives and staff all felt the registered manager was approachable and open.
People felt safe with the support they received from the service, and staff were aware of their responsibility to protect people from abuse. There were a sufficient number of safely recruited staff to meet people needs, and people told us staff arrived on time and stayed the full length of the care call. Staff were up to date with training and received regular supervision meetings. Staff adhered to infection control practices, which made people feel safe and comforted in light of the current COVID-19 pandemic.
Referrals were made to a range of healthcare professionals to maintain people’s health and allow them to keep living in their homes as long as possible. There was effective communication in the service, with relatives informing us they were kept up to date with their loved one’s health and wellbeing. Staff were kept up to date with best practice and changes in national guidelines through communication boards and meetings. People, relatives and staff were all asked for feedback regularly, and action was taken to address any concerns found.
People were encouraged to maintain their wellbeing and hobbies through support from staff to attend activities that were important to them, as well as complete tasks such as shopping for essentials. Staff held a range of activities within the building for people and promoted a social gathering for breakfast once a week. People were able to make suggestions for activities they would like to see within the building, and these were taken on board and arranged by the registered manager.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 9 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to keeping thorough and contemporaneous records at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Anvil Court is an extra care scheme for older people. Extra Care Housing is housing designed to support older people within their own flat. They support people who need varying levels of care and support available on site. People who live in extra care housing have their own self-contained homes, their own front doors and a legal right to occupy the property. On the day of inspection there were 33 people living at the service.
During the inspection we met the 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.
People felt safe at were safe at Anvil Court. People did not always receive their care and support at times that suited them. This was particularly evident during the mornings. We recommended that the provider reviews the way in which staff are deployed to address this.
Risks of harm to people were identified at the initial assessment of care and staff understood what actions they needed to take to minimise risks. Staff understood people's needs and abilities.
People were supported by staff who understood the signs of abuse and their responsibilities to keep people safe. Recruitment practices were followed that helped ensure only suitable staff were employed at the service.
People were supported with the medicines safely. Staff were confident and had the knowledge to administer medicines safely. They knew how to support people to take their medicines safely and to keep accurate records.
Staff felt they received the training and support they needed to meet people's needs effectively. Staff felt supported by the management team.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of MCA and DoLS. When people lacked capacity the best interest process was followed.
People were supported to eat meals of their choice and staff understood the importance of people having sufficient nutrition and hydration. Staff referred people to healthcare professionals for advice and support when their health needs changed.
People praised staff for their caring nature. Staff were kind and respected people’s privacy, dignity and independence. Care staff were thoughtful and recognised and respected people's wishes and preferences.
People received person centred care and people were supported with activities which were meaningful to them and were in line with their interests and preferences.
People knew how to complain and were confident any complaints would be listened to and action taken to resolve them.
The provider audited the care and support delivered and sort feedback from people and relatives regarding the support received. Despite having audits in place at times people’s care plans and risk assessments did not reflect their needs. The impact of this was low because from our observations people were receiving the care and support they needed. Since the inspection improvements have been made in this area.
The provider understood their responsibilities in terms of notifying CQC of significant events at the service. Staff support people in line with the organisational values as support was centred around increasing people’s independence.