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Haddington Vale Extra Care Scheme Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 February 2019

The inspection took place on 10 December 2018 and was announced. We last inspected the service on 2 and 6 October 2017. We found the provider had breached the regulations relating to safe care and treatment, person-centred care, need for consent and good governance. We rated the home as requires improvement.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; is the service safe, effective, caring, responsive and well-led, to at least good.

During this inspection we noted improvements had been made and the provider was now meeting the requirements of the regulations. For example, improvements had been made to medicines management and risk assessments contained more information than previously. However, we noted risk assessments would benefit from more detailed information about the measures required to mitigate risks. The provider had implemented systems to support staff when making Mental Capacity Act (MCA) assessments. We have made a recommendation about this as, although staff followed the correct process, the decisions considered were not always relevant. Improvements had also been made to the quality assurance processes.

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 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.

Not everyone using Haddington Vale receives 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.

The service 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 said they were very well cared for and told us the staff were kind, considerate and caring. Care records provided staff with a summary of people’s preferences.

People and staff told us Haddington Vale was a safe place to live.

Staff had a good understanding of both safeguarding and the provider’s whistle blowing procedure. They told us they hadn't needed to use the procedure but wouldn't hesitate to do so if required.

Staffing levels were sufficient to meet people’s needs. People told us staff were very reliable and responded to their needs well.

There were robust recruitment procedures to ensure new staff were suitable to work at the service.

Incidents and accidents had been logged, with details recorded of the action taken to keep people safe. These were monitored to identify any trends.

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.

Current care plan audits were infrequent which presented as risk issues would not be addressed quickly.

Staff were well supported and received the training they needed. Records confirmed supervisions, appraisals and training were up to date. The provider made resources available for the training and development of staff.

People were supported to meet their nutritional needs as required. Where necessary, staff supported people to attend healthcare appointments.

The service user guide provided details of important information, such as the availability of advocacy services and the provider’s c

Inspection areas

Safe

Requires improvement

Updated 12 February 2019

The service was not always safe.

Improvements had been made to medicines management and risk management. Risk assessments were completed but required more detailed information.

People and staff said the service was safe.

Staff knew about safeguarding and the whistle blowing procedure, including how to report concerns.

Staff were consistent and reliable. New staff were recruited safely.

Incidents and accidents were investigated and monitored.

Effective

Good

Updated 12 February 2019

The service was effective.

We have made a recommendation to improve the application of the Mental Capacity Act. People were supported to make decisions and choices.

People’s needs had been assessed.

Staff were supported well and received the training they needed.

Staff supported people with their nutritional and healthcare needs.

Caring

Good

Updated 12 February 2019

The service was caring.

People and relatives gave positive feedback about the care provided.

People were treated with dignity and respect.

Staff supported people to be as independent as possible.

Responsive

Requires improvement

Updated 12 February 2019

The service was not always responsive.

Most care plans were person centred and reviewed consistently to keep them up-to-date.

Some care plans for complex needs lacked detail or were not in place.

People gave only positive feedback about the service.

There had been no complaints made about the service.

Well-led

Requires improvement

Updated 12 February 2019

The service was not always well-led.

Care plan audits were infrequent and had not addressed some inaccuracies in care records.

Other quality assurance checks were effective.

There were opportunities for people and staff to give feedback.

People described the registered manager as supportive and approachable.