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Inspection carried out on 13 April 2018

During a routine inspection

This service is a domiciliary care agency. It provides personal care to people living in their own flats in a sheltered housing complex. It provides a service to adults. At the time of this announced inspection of 13 April 2018 there were 29 people who used the service. We gave the service 24 hours’ notice of our inspection to make sure that someone was available.

At our last inspection of 28 October 2015, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service provided a safe service to people. This included systems designed to minimise the risks to people, including from abuse. The service ensured there were sufficient care workers to cover people’s planned care visits. Recruitment of care workers was done safely. People received their medicines as prescribed and were supported as required. There were infection control procedures in place to guide care workers in how to minimise the risks of cross infection.

People’s needs were met by care workers who were trained and supported. The service understood the principles of the Mental Capacity Act 2015 and people were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people required support with their dietary needs, systems were in place to support them. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

People had positive relationships with the care workers. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued.

People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place and complaints were acted upon and used to improve the service.

The service had an open and empowering culture. The service used comments from people and incidents in the service to learn from and to drive improvement. The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.

Further information is in the detailed findings below.

Inspection carried out on 28 October 2015

During a routine inspection

Deben View is very sheltered accommodation providing personal care to people living in their own flats. When we inspected on 28 October 2015 there were 30 people using the service. This was an announced inspection. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available.

A registered manager was in post. 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 we spoke with including their relatives and a visitor to the service were complimentary about the care provided. They told us they received safe and effective care by care workers who were attentive and kind. One person said, “Nothing is too much trouble for the staff here. They look after me well and can do no wrong in my eyes. They genuinely care how you are and always check what they can do to make things better or help you.”

Systems were in place which safeguarded the people who used the service from the potential risk of abuse. Care workers understood the various types of abuse and knew who to report any concerns to. They understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

There were sufficient numbers of care workers who had been recruited safely and who had the skills and knowledge to provide care and support to people in the way they preferred. People were treated with kindness by the care workers. We observed care workers respect people’s privacy and dignity and interacted with them in a caring and compassionate manner.

People or their representatives, where appropriate, were involved in making decisions about their care and support. People received care and support which was planned and delivered to meet their specific needs.

Where people required assistance with their dietary needs there were systems in place to provide this support safely. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

The atmosphere in the service was friendly and welcoming. People received care that was personalised to them and met their needs and wishes. Care workers listened to people and acted on what they said.

There was an open and transparent culture in the service. All the staff we spoke with were passionate about their work and understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The management team demonstrated good leadership skills and care workers said they felt valued and supported.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. The service had a quality assurance system with identified shortfalls addressed promptly; this helped the service to continually improve.

Inspection carried out on 29 August 2013

During a routine inspection

We talked with seven people who used the service to gain their views and experiences. People told us that they received good care and their views and choices were listened to and acted on. One person told us, �It�s very nice indeed, the staff are very good.� Another person told us, �The staff treat me with respect, if not I would tell them as I speak my mind. But I have not had to tell anyone off as they (staff) are very good to me.�

All seven people told us that they were very happy with their care, treatment and support from the service. One person said, �I have no complaints. I love it here. People and the staff are very friendly.� Another person told us, �It is really hunky dory here; it�s a great place, and wish I had come here sooner. There is plenty to do if you want to join in or if you prefer your own company that�s fine also. They (staff) don�t push you but always ask which is nice as it stops you getting lonely.�

People confirmed they were consulted about the care and support that they were provided with and understood the care and treatment choices available to them. One person told us that they had been involved in a review of their care with a member of staff and had signed paperwork afterwards to show they agreed with the content. They said, �I sat with (member of staff) and we discussed if everything was ok and I was happy with my care. I said that nothing had changed and I was happy with everything.�

We looked at four people�s care records which provided information for staff on how to meet individual�s health and care needs. We saw that people�s choices and preferences were reflected in the care records and written in a way that promoted independence.

We saw that the service provided enough qualified, skilled and experienced staff to meet people�s needs. We looked at staff records and spoke with three members of staff who told us they were being appropriately supervised and supported. Staff we spoke with were knowledgeable about the people they supported and how to meet their needs.

We saw that the provider had systems and procedures in place to regularly monitor and assess the quality of the service provided. We also looked at the way that complaints were recorded and dealt with, and saw that they were handled in line with the provider's policy.

During our inspection we observed that the interaction between staff and people using the service was friendly, respectful and professional. Staff respected people�s privacy and dignity and sought their agreement before providing any support or assistance. One person told us how they were supported with their personal care needs and their choices and preferences were taken into account. They said, �I prefer female carers to men when it comes to personal matters and the manager has accommodated this. It�s never been a problem. I am sure the male carers are just as fabulous but I would feel uncomfortable. I told the manager how I felt and they listened to me. It�s never been an issue.�

Inspection carried out on 19, 21 September 2012

During a routine inspection

We had the opportunity to talk with five of the people who use the service. All of the people we spoke with were happy with the care they received. They told us that they were supported in the way they wanted to be and were able to make their own minds up about the decisions they took regarding their care. They were complimentary about the people who supported them.

One person who we asked what they thought of the quality of care said, �I didn�t want to leave my old house, but I�m glad I did now,� Another person told us that, �The carers are so helpful, they couldn�t do anymore.�

Inspection carried out on 6 February 2012

During a routine inspection

We visited three people in their own homes to hear their views of the service. We also met people who used the service who were visiting the communal areas of Deben View to gain their feedback. Visiting health and social care professionals also gave us feedback.

People using the service told us they were well informed about the service they received. One person told us how staff had visited them prior to moving to Deben View to identify the level of care and support they wanted. Staff had then written this information into a care plan for them to keep as a record of their discussion.

People told us staff tried to accommodate their preferred visit times. Where they were unable to, staff had monitored the situation and let them know when it had become available.

People we met told us staff gave them the agreed level of support and care and that staff mostly visited them when they said they would. Two people told us that it gave them comfort to know that if they ever required help in an emergency, staff would be around to give it.

People we visited told us they had confidence in the staff's abilities to support their individual needs. We also received feedback that the staff�s skills and knowledge did not always meet the needs of the people staff supported. They felt this would be addressed with further training and less reliance on agency staff.

The majority of people found staff to be approachable and treated them in a respectful manner. Where they had not, they said they had reported the incident so it could be looked into. People knew who their support carers were, who was in-charge and who they could talk to if they had any concerns.

We were given several examples of how staff supported people to maintain their independence and feedback their views on the service. This included attendance at the tenant�s meeting.