Housing 21 - Deighton Court

Housing 21 – Deighton Court is an Extra Care Housing provision and domiciliary care service providing personal care for people aged 55 years and over. 23 people were supported at the time of the inspection.

People using the service lived in their own flats within one adapted building. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

We rated the ‘Safe’ key question as Requires Improvement and identified a breach of the regulations related to safe care and treatment. This was because systems had not ensured people always received safe medicines support. The registered manager took action shortly following our inspection to address these concerns. We have made a recommendation about medicines management that the provider continues with those improvements to ensure consistently safe ordering and medicines support. People and relatives did not raise concerns about the medicines support provided and told us errors had been appropriately responded to.

People and relatives told us they felt the service was safe. Systems helped to ensure suspicions of abuse would be appropriately responded to. People’s risks were monitored, incidents learned from and staff knew how to help keep people safe. Recruitment processes were safe and people we spoke with told us they got their calls on time and for the planned length of time.

People and relatives all spoke positively about the care provided. People were supported to access healthcare services and with their meals if needed. Staff felt supported and that they had enough training and guidance for their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

All feedback we received showed the service was caring. People were involved in reviews about their care. People were treated with respect and their privacy, independence and dignity was promoted.

People’s care plans showed how they wished to be supported. We received consistently positive feedback about how people’s needs were met. The registered manager told us end of life care plans would be developed if people wished. People and relatives felt comfortable complaining and confident that complaints would be addressed.

People were encouraged to make community links and get involved in activities. People and staff told us the registered manager was approachable and they would recommend the service to loved ones. Improvements were underway to ensure audits were robust and we shared some records inconsistencies with the registered manager. The provider met their responsibilities to the Commission, to display ratings and notify us of specific events when needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 05 April 2016).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Housing 21 – Deighton Court on our website at www.cqc.org.uk.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led key questions of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified a breach in relation to safe care and treatment in relation to medicines management. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post at the time of our inspection. 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 told us they felt safe with staff when staff were in their homes providing care. Staff knew how to recognise the signs of potential abuse and of the systems used to report any issues. People’s individual risks had been identified and assessments had been completed to ensure people received safe care. People received calls from staff they knew, visits from staff were on time and for the full length of time agreed. The provider had systems in place to ensure people received their calls when staff were on leave or off sick. People were supported with their medicines where needed by staff who had received training.

People received care and support from staff who knew them well. Staff were provided with training and information to support people’s care and health needs. The provider had safe recruitment processes in place to reduce the risk of unsuitable staff being employed.

Staff understood the need to gain people’s consent to care before providing any support or assistance. Staff knew how to support people’s choices. People told us staff were kind and caring and said that they received care from a consistent staff group which ensured a continuity of care. People said they were supported by staff to maintain their independence and their dignity and privacy was always respected by staff.

People said they received care that met their needs and felt fully involved in developing their care plan. People said any issues were responded to quickly by the provider. People were happy that their care needs were met by staff who knew them well. People knew how to raise issues with the provider and were confident any concerns would be addressed.

People and staff were positive about the service and said the service was well managed. The provider listened to people’s views and feedback to continually improve the service. Regular checks were completed to review and monitor the quality of the care that people received; this included observing staff practice and reviewing records.

On the day of the inspection, we found staff were onsite and available 24 hours a day. As an extra care housing provision, Deighton Court were not required to be registered with CQC for accommodation, this was because people were living in their own homes. They were however, registered to deliver personal care to people. This is the area we looked at during the inspection in order to check the care and welfare of people using this service.

We involve people in our inspections that have experience of social care services; we call them experts by experience. An expert by experience joined us for this inspection and we spoke to five staff members, 16 people who used the service and one family member.

We looked at two care plans and saw that people had been given the opportunity to discuss and give signed consent to the care delivery prior to it taking place. All of the people we spoke with were complimentary about the staff and care provided at Deighton Court. One person said, 'Staff talk to me about how I am feeling, I'm asked if everything is ok. They look after me lovely'.

Where people were supported with medication we saw that staff completed records appropriately.

Systems were in place to review the quality of the service they provided. This included a satisfaction survey which people living at Deighton Court and family members had been invited to complete.

During our visit we spoke with ten people who lived at, or were visiting the court, six staff members, and the manager. Through a process called 'pathway tracking' we looked at care plans, spoke with people about the care they received and asked staff about how they provided support. This helped us establish that people were getting appropriate care that met their needs and supported their rights.

The service had systems in place to ensure that staff understood their responsibilities in safeguarding (protecting vulnerable adults) and reported concerns appropriately.

Systems were in place to ensure people's medication was managed and recorded appropriately.

We spoke to staff and looked at the training and support available. Staff told us they were supported and had the opportunity to meet with the manager regularly. The manager had identified gaps in staff training and was addressing the issue.

During the inspection we looked at the process the service had in place to monitor the quality of the service provided. We found systems were in place for auditing and monitoring the service.