Background to this inspection
Updated
12 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’
This inspection took place on the 24 and 29 October 2018 and was unannounced on the first day.
The inspection was completed by one adult social care inspector.
Prior to the inspection we look at notifications the registered provider had submitted and used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We spoke with the local authority regarding any concerns they may have about the service.
During the inspection we spoke with four people using the service and two people’s family members. We looked at three people’s care records and the recruitment records for three members of staff. We also looked at records relating to the day-to-day management of the service such as staffing rotas, training records and audit systems.
Updated
12 December 2018
The inspection took place on the 24 and 29 October 2018 and was unannounced. At the last inspection we did not identify any breaches of Regulation, however the service was rated as requires improvement because of issues with staffing and with auditing processes. Following the inspection an action plan was sent to us outlining how the registered provider intended to make the required improvements. At this inspection we identified that improvements had been made. However, we also identified that some improvements were needed to oversight and monitoring systems.
This 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 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 services.
People using the service lived in a large community on the outskirts of Northwich. The premises included a communal area, café and a hair salon which people were able to access. Not everyone using the service received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
At the time of the inspection there were 14 people who were in receipt of ‘personal care’.
There was a registered manager in post within the service. 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.
During the inspection we identified that monitoring and oversight systems needed to be more robust. For example, the registered manager had a good level of knowledge regarding accidents and incidents, however a written analysis had not been recorded. This meant that if she was unavailable this knowledge could be lost. In addition, neither the registered manager or the area manager knew how to generate a report from the registered provider’s system, to provide a clear overview of accidents and incidents and allow trends to be identified.
Training had been provided to staff, however during the inspection the registered manager and area manager were not able to locate dates training had been completed. Instead there was a reliance on the system to identify when this was needed. This showed a lack of robust oversight that allowed for possible errors to be made. Following the inspection the registered manager was able to provide evidence that training had been completed.
A survey had been completed around people’s experiences of the service. This survey identified a level of dissatisfaction in a number of areas. However the results relating to Anderton Place were mixed with the results from a neighbouring service. The manager informed us it was not usual practice to separate the results which meant it was not possible to get a clear understanding of people’s experiences.
We have made a recommendation to the registered provider regarding their oversight and monitoring systems.
There were sufficient numbers of staff in post to meet people’s needs. People told us staff were on time and spent the required amount of time with them. This was an improvement following our previous inspection where people raised concerns regarding the number of staff in post and the timeliness of calls.
People were protected from the risk of abuse. Staff had received training in safeguarding vulnerable adults and had access to the registered provider’s policy and procedures which outlined how they should respond to any concerns they have.
The registered provider had a robust recruitment process in place. This helped ensure that staff were of good character and suitable to support vulnerable groups of people.
Staff had received the training they needed to carry out their role effectively. There was an induction process in place for new staff which included a period of shadowing experienced members of staff. This helped prepare staff for their role.
Staff had received training in food hygiene and people told us they were clean, tidy and hygienic when preparing food. People also commented that staff tidied up and left their kitchens clean when they were done.
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.
Positive relationships had been developed between staff and people using the service. People spoke positively about staff and we observed friendly interactions between them.
People’s confidentiality was protected; however, a more robust system was needed to minimise the potential for breaches in privacy. This was because people walked freely in and out the office where confidential discussions were held. We raised this with the registered manager and area manager for them to address.
People each had a personal care record in place which outlined their needs, the tasks required of staff and people’s personal preferences. This ensured staff had access to relevant information about people. People confirmed that staff provided them with the support they needed.
There was a complaints process in place for people and their families to use. People commented they felt able to make a complaint if they wanted to.
Staff meetings were held on a regular basis. This allowed information to be shared across the staff team and enabled discussions regarding best practice. For example, during one staff meeting a discussion regarding the Mental Capacity Act 2005 and Lasting Power of Attorney had been held.
The registered provider is required by law to notify the CQC of specific events that occur within the service. Prior to and during the inspection we checked to ensure this was being done and found that it was.