Background to this inspection
Updated
6 March 2018
We undertook an unannounced focused inspection of Hazelmere Extra Care Scheme on 24 January 2018 and 1 February 2018. The team inspected the service against three of the five questions we ask about services: is the service safe, is the service effective and is the service well led.
No risks or concerns were identified in the remaining Key Questions through our on-going monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.
This inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. The information shared with CQC about the incident indicated potential concerns about the management of risk of falls from moving and handling equipment, risk assessments and an understanding of capacity and consent to care and treatment.
Concerns had also been raised following the last inspection in regards to staffing levels, and the safe management of medicines. Therefore, this inspection also explored these aspects of current care and treatment..
Inspection site visit activity started on 24 January 2018 and ended on 1 February 2018. We visited the office location on the 24 January 2018 and 1 February 2018 to see the manager and office staff; and to review care records and policies and procedures.
The inspection was carried out by two adult social care inspectors.
Prior to the inspection, we reviewed information that we held about the service such as whistle blowing concerns, complaints, and compliments and safeguarding investigations. We also took note of notifications received from the service such as serious injuries and deaths.
During the inspection we looked at the records relating to the care and support of nine people who used the service: this included care plans, risk assessments and medication administration records. We also spoke to four people who used the service.
We also reviewed records in regards to staffing and the management of the service. This included three staff files, training records, and audits, meeting minutes, policies and procedures.
We spoke to the commissioners of the service who told us that they had no concerns about the service. We also spoke to the safeguarding unit to discuss the incident that prompted this inspection.
Updated
6 March 2018
We undertook a focused in inspection on the 24 January 2018 and 1 February 2018
Our last comprehensive inspection of Hazelmere Extra Care Scheme took place on the 13 and 14 March 2017 and the service was rated as Good.
Following that inspection we received concerns in relation to safe care and treatment and consent. As a result we undertook a focused inspection to look into those concerns.
This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hazelmere Extra Care Scheme on our website at www.cqc.org.uk.
The service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation here is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
Planned, day-to-day personal care can be provided by staff based at the site or from elsewhere, including ordinary domiciliary care agencies. There is a care provider based at the scheme able to provide emergency support to everyone living there. Not everyone living in extra care housing receives regulated personal care.
There are 106 apartments and also access to communal facilities such as a bistro, library, gym, laundry and an assisted bath room.
There was a registered manager. This 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.
We found the service had breached a number of regulations. You can see what action we told the provider to take at the back of the full version of the report.
The registered provider failed to identify, assess and manage risks to the health and safety of people of using the service. Medicines were not managed safely and some people did not get their medicines as required.
The provider did not have effective quality assurance processes to monitor the quality and safety of the service provided and to ensure that people received appropriate care and support.
Processes and procedures were in place to ensure people were protected from abuse and harm. Staff spoke about the actions they would take if they thought a person was at risk of harm. However, we found that not all concerns were reported and fully investigated.
People were not always supported to have maximum choice and control of their lives. Staff did not have a clear understanding of restrictive practices. There was a lack of documented evidence around a person’s ability to make a decision or to make an unwise choice which may have put them at risk.
The service ensured trained staff were deployed to support people. The registered provider had a robust recruitment process in place, with staff being fully checked before starting working with people.
There were enough staff employed to carry out all the visits that were required. People told us they were regularly supported by the same team of care workers.
People were supported to maintain good health and access to healthcare professionals.
Feedback was regularly sought from people using the service and staff.
Staff said they felt supported by the management team. Staff we spoke with confirmed they could raise issues with the management and said they were “Approachable”.