St Oswald's Retirement Village

People’s experience of using this service:

• People told us they felt safe at the service and felt happy to speak up.

• People’s risks had been identified and appropriate safety measures were in place. People were supported by a consistent team of staff who were kind and caring.

• People received their medicines as prescribed and medicines were managed safely.

• Staff knowledge in relation to people’s conditions, their needs, and how to support them was thorough.

• Care plans were person centred and included people’s personal preferences. This meant people received a service which was tailored to their individual needs.

• Staff had good relationships with people and knew them well. People told us they were happy with the staff who supported them.

• There was an open culture where staff and people could raise concerns or issues. People told us they felt safe at the service and felt happy to speak up.

• People, relatives and staff told us the service was well-led. The registered manager was a visible presence and knew people and their relatives well.

• People’s feedback was encouraged and used to shape the service.

The service met the characteristics of Good overall. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: At the last inspection the service was rated Good (This report was published on 6 October 2016).

Why we inspected: We inspected this service as part of our ongoing Adult Social Care inspection programme. This was a planned inspection based on the previous Good rating. Previous CQC ratings and the time since the last inspection were also taken into consideration.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

St Oswald's Retirement Village is a residential community for people aged 55 and over. Care and support is provided to people in their own accommodation. At the time of our inspection there were thirty people receiving personal care from the service.

St Oswald’s Retirement Village had 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.

People were happy with their care and the approach and effectiveness of staff. However, people were at risk of receiving care from unsuitable staff because robust recruitment procedures were not always being applied.

Risks to people’s safety were identified, assessed and appropriate action taken. People’s medicines were safely managed. People’s individual needs were known to staff who had achieved positive relationships with them. People were treated with kindness, their privacy and dignity was respected and they were supported to maintain their independence. People were involved in the planning and review of their care and took part in a range of activities.

Staff received support to develop knowledge and skills for their role and were positive about their work with people. The registered manager was accessible to people using the service and staff. Systems were in place to check the quality of the service provided including regular meetings.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

At the time of the inspection there were approximately 200 people living at St Oswald's Village. The Extracare Charitable Trust was providing personal care to 34 people within the village complex. We spoke to nine people who used the service to get their views on the care provided. We also observed staff providing personal care to people on several visits.

Is the service safe?

People we asked told us they felt safe with the staff who visited them. One person told us, 'Staff are brilliant, I loves to see them.'

Safeguarding procedures were robust and staff were knowledgeable about how they would spot the signs of abuse and how they would report them.

We observed staff working with people in a way that respected people's rights and dignity.

Staff knew about people's risk assessments and we observed staff implementing them in order to keep people safe. People were not put at unnecessary risk but had access to choice and remained in control of decisions about their care and lives.

Is the service effective?

People who used the service told us they were happy with the care they received and felt their needs were being met. One person told us, 'I've got a care package, half hour in the mornings for a shower and quarter of an hour in the evenings and I've got no problems at all with it.' People also told us about the range of activities they could do within the village complex which also helped to meet their individual needs. One person told us, 'I go to Otago (muscle strengthening class) twice a week now and it helps.' Another person told us, 'We have quizzes, line dancing, pottery, art and craft and pictures on a Monday night.'

Staff were supported in their roles to care for people through regular professional development reviews and access to relevant training. One person told us, 'Staff do a lot of training.' It was clear from our observations and from speaking with staff that they understood people's care and support needs well.

Is the service caring?

We asked people for their opinions about the staff that supported them. Feedback from people was positive, for example, 'Staff are very good. I've got favourites. We don't have many agency, I have the usual staff.' Other people called staff 'lovely' and 'brilliant'.

People using the service completed satisfaction surveys, had the opportunity to attend residents' meetings and were regularly asked for their views about the care provided. Where shortfalls or concerns were raised these were addressed.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. One person told us, 'Today I decided I want to go back to bed and if I want to go back to bed I can.'

We observed staff working sensitively with people, particularly with those who experienced sensory loss and needed staff to communicate with them in a particular way. One person told us, 'If you want privacy you can go back to your apartment and if you want company you can come down to the communal village areas'.

Is the service responsive?

On the day of the inspection we saw that staff raised a concern about one person's health with the registered manager. This was followed up through the day so that the person was given the chance to access the relevant health professional. This meant that the service worked well with other agencies and services to make sure people received the care they needed at that particular time.

One person told us, 'If you pull the cord they come, if we're unwell they check on us. They speak through the intercom and check what it is.'

We found that people's care plans were reviewed regularly to ensure the care being provided was appropriate when people's needs changed. People were involved in the process of planning their care. One person told us, 'I'm seeing someone about my ability assessment today.'

People knew how to make a complaint if they were unhappy. We found responses to complaints to be timely and appropriate.

Is the service well-led?

Staff told us they were clear about their roles and responsibilities. Where issues arose these were escalated and actioned appropriately.

People's comments about the processes in place to feed back their views to staff and management were mixed. One person told us, 'You get the chance to tell people how you feel, go to meetings, but they don't listen.' Another person told us, 'People have their say' and 'If I have something and I go to (registered manager), she'll do her best to sort it.'

Other people made positive comments about the quality of care provided and the service. One person told us, 'It was the best move I ever made. I've got company now.' Another person told us, 'I love it here. We have meetings once a month and we discuss all sorts of things.'

The service had a quality assurance system in place and records showed that identified problems and opportunities to change things for the better were addressed promptly and followed through. As a result the quality of the service was continuously improving.

This inspection was part of our planned schedule. We also checked areas of non-compliance with regards to the way the provided handled people's medicines from our inspection in January 2013. We observed that consent was obtained from people using the service before any care was undertaken.

We looked at the care files for eight people and spoke to nine people who used the service. The care files contained up to date care plans and risk assessments. These had been reviewed on a regular basis. People who used the service had been involved in developing their own care plans and had signed them accordingly.

We spoke to nine people who used the service and a selection of the positive comments they told us included. 'Its very good here, I have no complaints' 'There is nothing they could do better, they always go the extra mile for me' 'The staff are really great, I could not ask for more'.

We carried out a routine inspection in September 2012 and found the provider to be compliant with the outcomes we looked at. Since that inspection we have had concerns raised with us from the local authority responsible for safeguarding. The concerns were about the number of medication errors that have been made since July 2012.

During our inspection we looked at the incident forms. These showed us that since July 2012, there had been 36 separate errors involving medicines. Some of these errors occurred to the same people who used the service. We also looked at the medicine charts for 26 people who used the service. Out of these 26 charts, we found 17 had no errors. We did however find errors with the remaining nine charts.

We acknowledge that the provider had recognised there had been a problem with the administration of medicines and had put measures in place to reduce these. These actions were not robust enough and errors were still taking place without the staff picking them up in a timely way.

People told us that: "Everything is good, the staff are very helpful and I have plenty of company if I want it, but I have my privacy too which is important to me". People also told us that: "It is excellent here, the staff keep you informed and always look after me well. I can't fault it and its like a five star hotel with care thrown in."