Lisbon Court

Lisbon Court is a housing with care scheme. People live on site in their own flats and have secure tenancies with a housing provider. Norse Care provides care and support over a twenty-four-hour period. This was usually up to thirteen hours a week but if the care needed exceeded this the registered manager would negotiate additional hours, but these were provided by an external, regulated care agency. The service can accommodate up to thirty people and had two vacancies at the time of the inspection which were due to be filled.

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

People were supported to live well, and staff encouraged them to remain independent and to achieve what they wanted to in line with their personal goals. There was a strong person-centred

culture which put people at the centre of the care provided which meant people received an outstanding service. Everyone we spoke with had high praise for the care provided and the exceptional ambiance which enhanced people’s well- being. Staff were motivated and worked in innovative ways to best benefit people they supported. They went above and beyond what was expected of them to help ensure people were not isolated and continued to be engaged in the service and wider community and take part in meaningful activity.

People benefited from security of tenancy and a service which was flexible around their assessed and changing care needs. Staff were quick to identify changes and supported people to either continue to live at Lisbon Court or move to a more appropriate setting. Staff gave people and their families time to transition and liaised regularly with multidisciplinary teams to help ensure change was managed effectively putting the person at the centre.

Care plans and assessments were comprehensive and focused on enabling people to live well and to take risks which were both proportionate and appropriate to need. The service facilitated people’s independence and only intervened when people lacked capacity to make informed decisions. Many people continued to take their own medicines and received minimal support from staff. Where extra support was needed this was provided and support was flexible.

The service took into account people’s back ground and interests and were able to adapt the service provided in line with people’s needs. People were given regular opportunity to voice their views and preferences and staff received training around equality and diversity to help ensure they recognised people’s individuality and did not discriminate.

Staff when providing care and support to people considered people emotional and physical health and encouraged people to undertake activities of daily living. Staff supported people to retain their existing skills and learn new ones by participating in their routines and taking part in planned activity or planning activities for others.

The registered manager was a good motivator and supported her staff to be the best they could be. Equally the registered manager told us how staff and the wider organisation had supported her well after a recent illness. The service was inclusive and caring which attributed to people receiving consistent and positive outcomes of care from well trained, considerate and cheerful staff.

Staff continued to be well recruited and well trained which contributed to people feeling safe. Two people told us how staff had saved their lives through quick and decisive actions. Staff said training had equipped them for their role and helped them to act instinctively. There was a strong culture of positive teamwork and accountability which helped ensure the care and support people received was seamless.

There continued to be robust audits which took into account the safety of the service and how effective the service was at meeting people’s needs. This took into account people’s views and experiences. Any known or potential risk was considered in line with people’s individual needs and steps taken to reduce or eliminate risk. There were strong governance processes and evidence of lessons learnt to maximise people’s safety.

Staff received medicines training and were assessed to ensure they were competence before being able to administer medicines. Audits also helped to determine people received their medicines as intended. Staff received support from other health care professionals to ensure people’s needs were met in a holistic way.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Rating at last inspection

The last rating for this service was good, (published 24 August 2016)

Why we inspected

This was a planned inspection based on the previous rating.

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

Lisbon Court is a ‘housing with care’ service that provides people with personal care in their own homes. At the time of the inspection, 29 people were receiving care.

There was a registered manager at the service. 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 received care from staff who were kind and caring and who treated them with dignity and respect. The staff knew people well which enabled them to provide people with care that met their individual needs.

There were enough staff to meet people’s care needs and people received their medicines when they needed them. The staff knew how to keep people safe and people’s consent was requested before the staff performed any tasks. People were involved in making their own decisions about the care they wanted to receive and this was respected.

There was an open and transparent culture at the service where people and staff felt listened to and could raise any concerns they had without hesitation. Both people and staff could be confident that action would be taken to address any concerns if made.

Where part of their care package, people received support to eat and drink enough to meet their needs. They were supported to maintain their health and advice from specialist healthcare professionals was sought when necessary.

There was good leadership at the service. The staff understood what was expected of them and they had received enough training and supervision to give them the skills and knowledge to provide people with safe and effective care.

The quality and safety of the service was regularly assessed and monitored to make sure the care that people received was of good quality and met their individual requirements.

Medicines were stored appropriately and administration records were maintained to show that people received their medicines in a safe way.

Staff rotas and other information showed that there were enough staff members available to assist people. However, people using the service said they felt that staff members were very busy.

The service had a policy and procedure to guide people in how to make a complaint but there was inadequate information about taking complaints further. People said they would be able to make a formal complaint if they needed to, but that they would talk to a staff member first.