Housing 21 - Queensridge Court

People’s experience of using this service:

People and relatives told us they felt safe in their flat and with staff. People were supported safely and protected from harm. There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. The management of medicines was safe, staff had completed training and audits were completed. Staff followed infection prevention and control guidance when supporting people. Lessons were learnt, through accident, incident, safeguarding and complaints. These were shared with staff members to ensure changes were made to staff practice, to reduce the risk of further occurrences.

There were enough skilled and experienced staff to meet people’s needs. An induction was completed by new staff. Staff received appropriate training and support to enable them to perform their roles effectively. Recruitment processes were in place and followed.

Staff involved healthcare professionals to support people's health needs where required. People received support, with eating and drinking, when needed. 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. Staff gained people's consent before providing support.

People and relatives said staff were kind and caring. The registered manager and staff team were extremely focused on people’s human rights being respected and people living the life they wished to live. Staff showed a genuine motivation to deliver support in a person-centred way and described how individual people preferred their support delivered. Staff told us about the importance of treating people with dignity and respect. Initial assessments were carried out to ensure people’s needs could be met. Support plans showed people were involved in their support and they contained appropriate detail for staff to provide effective care and support.

People, relatives and staff had the opportunity to provide feedback about the service. Information was provided so people knew who to speak with if they had concerns. There was a system in place to respond to any complaints. The registered manager worked in partnership with other services to support people quality of life, when needed. Effective systems were in place to monitor the quality of service and action was taken where areas for improvement had been found.

Rating at last inspection: Rating at last inspection: At the last inspection the service was rated Good. (published 6 May 2016). The overall rating has remained the same.

Why we inspected: This was a planned inspection based on the previous rating of good.

Follow up: We will continue to monitor the service through information we receive. Further inspections will be planned for future dates as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

Queensridge Court provides Extra Care Housing provision for people aged 55 years and provides personal care and support to people within a complex of flats. Staff provide care at pre-arranged times and people have access to call bells for staff to respond whenever additional help is required. People have access to communal facilities including a lounge and a restaurant, which offers hot and cold meals daily. At the time of our visit the service was providing personal care and support to 53 people.

The service did not have a registered manager at the time of our inspection. The service was being overseen by an interim manager from one of the provider’s other extra care housing schemes. A new manager had been appointed and at the time of our inspection was completing the provider’s induction training. 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 were supported with their medicines by staff who were trained to do so and had been assessed as competent. Completion of stock level checks and written guidance for staff in relation to ‘as required’ medicines was lacking, however the manager agreed to review this. People told us they felt safe and that they could raise concerns with staff at any time. Staff demonstrated that they understood what action they should take in order to protect people from abuse or harm. Systems were in place to minimise any risks to people’s safety and risk assessments were reviewed and updated as necessary. People felt there were enough staff to meet their needs. Appropriate checks were carried out prior to staff starting work to ensure their suitability to support people.

Management and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and supported people in line with these principles. Staff established consent from people before providing care. Staff had access to a range of training to provide them with the level of skills and knowledge to deliver care safely and efficiently. Structures for supervision allowing staff to understand their roles and responsibilities were in place. People were supported to take food and drinks in sufficient quantities to prevent malnutrition and dehydration. People were supported to access external health professionals whenever necessary and we saw that the care and support provided by staff was in line with what had been recommended.

People were complimentary about the approach and attitude of staff. People told us that staff acted in a way that maintained their privacy and dignity whilst encouraging them to remain as independent as possible. People told us they were provided with the information about the service and their care and treatment that they needed. Staff were knowledgeable about how to access independent advice and support for people.

People’s care records were written in a way which helped staff to deliver personalised care. People were involved in deciding how their care and support was delivered and they felt able to raise concerns about their support with staff and/or the manager if they were not happy with it. Information about how to make a complaint was provided to people.

The service had been through a period of upheaval due to a change in management and staffing but people felt that the service had begun to settle down again. Staff told us the registered manager actively promoted an open culture amongst them and made information available to them to raise concerns or whistle blow. The service sought people’s feedback through surveys but failed to share this with people and demonstrate how they planned to improve based on the analysis findings. The registered manager and the provider undertook regular checks on the quality and safety of the service; however the effectiveness of these needed to be reviewed.

One inspector carried out this inspection. During our inspection we met and spoke with 12 of the people who lived there, seven staff and the registered manager.

We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead? Below is a summary of what we found. The summary is based on our observations during the inspection, discussion with people who lived at the home, their relatives, the staff supporting them, and by looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

All the people we spoke with told us that they felt safe living at the service. One person told us, 'I do feel safe and wouldn't be happier anywhere else'.

We saw that people were treated with respect and dignity by the staff. Interactions were friendly and relaxed.

Safeguarding procedures were in place and staff had a general understanding of their role in safeguarding people. The registered manager told us that they understood their responsibilities to refer to the Deprivation of Liberty safeguards.

Systems had been put in place to promote learning from events including medication errors.

Is the service effective?

People's health and care needs were assessed and care plans told staff what people's care needs were. People told us that they had been involved with planning their care and support.

Staff told us that the handover arrangements between staff had been improved and they received the information they needed to support people effectively.

The registered manager had arranged for an advocacy service to be available to people. This meant that if needed people could access additional support.

Staff had received most of the training they needed to carry out their role. However some training updates were needed to ensure that they had the skills and knowledge to care for people effectively.

Is the service caring?

We observed interactions between people and staff in the communal areas of the service. We saw that people were supported by staff that was caring and kind. We saw staff sitting and talking to people and responding to people's request for help and advice.

Most people told us that the staff were very good. One person said, 'The staff are really good. They treat me well. They always ask me how I want things to be done'.

When we spoke with staff they demonstrated that they cared for the people they supported.

Is the service responsive?

All the people we spoke with told us that they knew how to make a complaint if they needed to. One person told us, 'I know the manager and I would go and speak to her if I needed to'.

The registered manager recorded complaints and their outcome so trends were identified.

Regular meeting had taken place with the people that used the service and people were asked their views about improving the service.

A variety of social and community activities take place which people were able to access if they wanted too.

Is the service well-lead ?

The manager had registered with us, CQC.

We found that previous compliance actions had been met. This meant that steps had been taken to continually improve the service, for the benefit of the people that used the service.

Staff told us that many improvements had been made at the service since our last inspection. They told us that the registered manager is approachable and had an open door policy.

We spoke with eight people who used the service, two relatives, eight staff and the manager.

Most of the people we spoke with told us that many of the staff were very good however they also told us that some staff were not patient, friendly or confident in their role.

Care plans in place for staff to refer to did not always reflect people's care needs.

Appropriate staff recruitment checks were in place so people were protected from unsuitable staff providing care.

Arrangements in place for medication administration did not always ensure that people had received their medication safely.

The provider had some systems in place for making improvements to the service however these had not always been robust.