Background to this inspection
Updated
20 July 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 31 May and 1 June 2017 and was announced. The provider was given 24 hours’ notice because the location provides an extra care service and we needed to be sure that someone would be available for the inspection. One inspector undertook the inspection.
Prior to the inspection the service completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Additionally we looked at all the information we held on the service including notifications of significant events and safeguarding. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about. We also contacted the local authority’s Safeguarding and Commissioning Teams.
During the inspection we spoke with nine people using the service, four relatives, the registered manager and the team leader, Carewatch’s regional director and six support workers. Additionally we spoke with a pharmacist and one social care professional.
We looked at the care plans for six people who used the service. We saw files for seven staff which included recruitment records, supervisions and appraisals and we looked at training records. We reviewed medicines management for six people who used the service. We also looked at records for monitoring and auditing.
After the inspection we communicated with two more healthcare professionals and an appointeeship officer to gather information on their experience of the service.
Updated
20 July 2017
The inspection took place on 31 May and 1 June 2017 and was announced. We gave the registered manager one working days’ notice of the inspection as the location is an extra care service and we needed to confirm the registered manager would be available when we inspected. The service has 35 flats and each person has their own tenancy. One flat had two people sharing and one flat was vacant.
The housing support is provided by Hanover Housing which also provides support in terms of catering and activities. In the past four years, the service has had three different care providers. The current care provider, Carewatch, began providing a service in February 2016. For the staff, the change in care providers has meant ongoing changes in processes and record keeping which staff told us had been difficult.
People had their own flats based in a community setting within an extra care housing complex. The service provided support to people in their own homes with additional flexible care and support services available on-site to enable people to live as independently as possible. Support included personal care and support with medicines, meal preparation, shopping and cleaning. At the time of the inspection there were 35 people being supported by the service.
This was the service’s first inspection since becoming registered with the Care Quality Commission in July 2016.
The service had a registered manager. The registered manager had been with the service for eight years and had been the registered manager for four years. 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.
PRN (as required) medicines protocols were not kept in the people’s flats with their medicines administration records (MAR). We recommended that the provider develop systems in line with the Royal Pharmaceutical Society guidance on the management of medicines to ensure the proper and safe management of medicines at all times.
People using the service said they felt safe. The service had appropriate safeguarding policies and procedures in place and staff were aware of how to respond to any safeguarding concerns. We saw risk assessments and management plans in place to minimise the risk to people using the service.
There was an adequate number of staff to meet the needs of the people who used the service.
The service was working within the principles of the Mental Capacity Act (2005). People were happy with the level of support they received and told us they were involved in their day to day care decisions.
Support workers had inductions, supervision, appraisals and relevant training to support the people using the service.
Stakeholders we spoke with said the registered manager and team leader were accessible and responsive.
The service had a number of systems in place to monitor and manage service delivery and staff performance. There was a complaints system, people felt able to raise concerns and satisfaction surveys were completed.