We carried out a review of the data available to us about Housing 21 - Saxon Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Housing 21 - Saxon Court, you can give feedback on this service.
People’s experience of using this service and what we found
People were protected from the risk of harm or abuse by staff who were trained to deliver safe care and knew about action to take if they felt people were at risk. People and their relatives expressed confidence in the care and support provided by staff who they found to be reliable and caring. Staff recruitment processes were safe and robust to ensure people were supported by suitable staff of good character.
People's care and support needs were assessed and regularly monitored to ensure they were still current and being met. People’s wishes, and legal rights were promoted and protected by staff who had received up to date training which the staff felt equipped them well to deal with any issues.
People and their relatives said staff safely supported them when they needed assistance to move, and any administration of medication by staff was well managed.
People were supported to have maximum choice and control of their lives and staff advised they had been trained to support people in the least restrictive way possible and in their best interests. People made positive comments about the care and support they received from staff who regularly worked with them.
People and relatives said the staff responded well to changes in how people were to be supported, providing prompt support when people were unwell or had increased care needs. Agreed plans of care reflected the full care and support needs of people.
People and their relatives expressed confidence that any concerns or complaints would be properly addressed. The registered manager was known by people and relatives who regarded them as approachable. Concerns or complaints were responded to in line with the providers policy and procedures.
People were supported to join in a wide range of activities which were arranged in the service to support their well-being and maintain or develop relationships and interests.
The provider had regularly sought feedback on the quality of the service using questionnaires with people and their relatives. The registered manager also had plans to improve how information from the analysis of the questionnaires was shared. The quality of care provided was regularly checked by the registered manager to ensure the provider’s set standards were maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating.
Rating at last inspection
The last rating for this service was good (report was published in October 2017)
Follow Up
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.
We last carried out a comprehensive inspection of the service on 29 May and 01 June 2015. At that inspection we found that the provider was providing a good service and the service was given a rating of Good in all the questions we asked.
Saxon Court is housing with care scheme which provides housing with personal care support for people living in Saxon Court. Support is provided to people who require it following assessment of their needs and care is provided by a team of staff based within the scheme. At the time of this inspection 33 people were receiving support.
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 continued to receive a safe, good quality service that met their needs. Everyone spoken with told us that they felt a safe service was being provided. People told us that they were happy with the care provided, felt safe with the staff and generally had the same staff to support them. Staff were aware of their responsibilities in respect of raising any concerns they had and able to use the systems in place to escalate their concerns.
People were supported to receive an effective service because there were sufficient numbers of suitably recruited and trained staff available. People were supported to eat and drink sufficient amounts to remain healthy and to have their personal preferences met.
Systems were in place to keep people safe in emergency situations and to have their medical needs met if needed.
People were supported by staff that were caring, kind, friendly and that helped people to maintain their independence and privacy and dignity.
People’s needs were regularly reviewed to ensure the service continued to meet their needs.
Systems were in place to gather the views of people and to ensure that the quality of the service was regularly reviewed and monitored so that people continued to receive a good quality service.
This was an announced inspection which took place on 29 May and 01 June 2015. We gave the provider 48 hours notice that we would be visiting the service. This was because the service provides domiciliary care and we wanted to be sure that staff would be available.
We last carried out a comprehensive inspection of the service on 29 and 30 April 2014. At that inspection we found the provider required improvement in the management of medicines, safe staffing levels, and the management of safeguarding, missed calls and complaints. We found at this inspection that improvements had been made across all areas needed and the provider met the regulations.
Saxon Court is a housing with care scheme which provides housing with personal care support for people over 55. Domiciliary care packages are allocated according to people’s assessed needs with care provided from a designated team of carers based within the housing scheme. There were 108 people living within 87 flats and eight bungalows and 28 people were using the domiciliary service. In addition the provider also run Birmingham Domiciliary care from the same location and this provided 40 care packages to people living in their own homes in the South Birmingham area.
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.
All the people that we spoke with told us that they received a safe service. Procedures were in place to ensure that people received a safe service. The risk of harm to people who used the service was assessed so that people received care and support in a safe way.
People received their medicine as prescribed and systems were in place to ensure that risks to people was minimised.
People told us that there was enough staff employed to provide a reliable service and to meet planned and scheduled calls. However, some people living at Saxon Court told us that there should be more staff at night to respond to emergency calls.
Staff received the training and support needed to ensure they did their job well and provided an effective service.
People received support with their food, if needed and people told us that staff helped them to access healthcare support and emergency services where required.
People and relatives told us that they were able to raise their concerns or complaints and were confident that they were listened to.
The management of the service was stable and there were systems in place to monitor the quality of the service.
Saxon Court provides personal care and support to 38 people living in their own homes and to 38 people who live in an extra care facility. The extra care facility had a number of communal areas and provided dining services, a shop and a hairdresser which were available to people using the service.
Our inspection took place over two days and was carried out by a Lead Inspector and an Expert by Experience. We needed to follow up on some areas where we asked the provider to make improvements as they had not met the regulations at their last inspection in September 2013. These were in relation to the administration of medication, monitoring and assessing the quality of the service and record keeping. We have reported on our findings in these areas as part of this report.
People who used the service said they received care from kind and compassionate staff. Some people felt staff were rushed and some people commented that the management of the service could be improved upon. The majority of people felt that they were listened to and were generally happy with their care and support.
Staff described being supported by the service and told us they had received training in delivering safe and appropriate care. However, several members of staff told us that the training they had received in relation to administering medication had been “basic”. Many staff did not feel confident in this area. Staff also commented that the service lacked a consistency of management and that this impacted on the quality of care.
We found that medication was not being administered to people safely. We found a high number of medication gaps in recording and medication errors and saw that management checks had not been carried out effectively in relation to the administration and recording of medication. This posed a risk to people using the service. We found that one person had missed their care calls and as a result had not received their required medication. Staff training in this area was not adequate and needed to be improved to ensure that staff were safe and competent in administering medication.
Although safeguarding policies and procedures were in place we found that one allegation of abuse had not been responded to appropriately. This put vulnerable people at risk.
Care plans and risk assessments were detailed and relevant to the person they were written for. Staff had enough information about the people receiving care and people’s personal preferences and histories were included. People’s health and well-being was being recorded and responded to.
The service did not have a registered manager in place at the time of our inspection and there had been no consistent leadership at the service for some time. Staff were not clear when this would be resolved.
Complaints and concerns had not always been recognised as such and so had not been dealt with appropriately.
We spoke with ten people who used the service, one relative, nine staff, two team leaders and the operations manager. All the people we spoke with were positive about the care that they or their relative had received. One person told us, 'I have nothing but praise for the staff". A relative told us, 'They know my wife's needs and the staff treat her very well'.
Staff had received the training and support needed so that they cared for people in a way that met their needs.
Arrangements in place for supporting people to take their medication did not always ensure that people had received their medication safety.
There were arrangements in place for monitoring the quality of the service people had received although these had not always been effective in identifying problem areas.
Some of the records that we looked at had not been maintained in a way that promoted the health and well-being of people who used the service.
People that we spoke with said that they and their relatives were involved in agreeing and planning their care. We found that people's views and experiences were taken into account in how the service was delivered.
People told us that their needs were being met. One person told us, 'They seem alright and they do what they have to do. I have no complaints.' We found that people experienced care, treatment and support that met their needs, but that not all risks associated with their care was being adequately identified.
People told us that they felt safe with the staff that visited the. One person told us.' We found that the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
People told us that they had no concerns about the staff that visited them. We found that staff were suitably recruited into their role.
People that we spoke with were confident that their complaints would be listened to and acted upon. One person told us, 'I know how to complain. In the past if I have been unhappy I have told the office and they have dealt with it.' We found that systems were in place to investigate people's complaints.
People told us they were happy with the support they received and that it made a difference to their everyday living. They told us that they were treated with respect and that care staff maintained their privacy and dignity. They told us that care staff completed the care and support required. People told us that care staff arrived at the correct time to assist with their care needs.
People made the following comments:
'Absolutely fine, everything is OK.'
'Carers are good.'
Some people we spoke with who received personal care from the agency were happy with the quality of care received, others told us that calls were made late and that staff did not always stay for the allocated period of time. We reviewed care and support plans of the people who use the service. The log books completed by care staff at the end of each visit confirmed some calls were made late and that staff may not stay for the full time.
We found that some care and support plans for people who used the service were appropriate for them; one care plan included shortened times for each of the four visits per day. The instructions provided by Birmingham City Council were for longer calls to be made. People who had mental health illness did not have risk assessments in place for this aspect of their care. There were ongoing failures of care staff to record administration of peoples prescribed medications.
People told us that they were treated with respect and that care staff maintained their privacy and dignity.