Robert Kett Court

About the service

Robert Kett Court provides Housing with care. People have their own tenancies with Broadland Housing and Norse care provides care according to people's individual needs. There is a dedicated extra care unit for people living with dementia and a separate unit for older people. At the time of the inspection, there were 36 people using the service, including 9 people living with dementia.

Not everyone who used the service received personal care. CQC only inspects where people receive a regulated activity such as personal care. This is help with tasks related to personal hygiene and eating.

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

There were systems in place to ensure staff knew how to report any safeguarding concerns, and how to mitigate risks to people.

There were enough staff to meet people’s needs, and further improvements had been identified and planned for in staffing levels. The provider continued to implement safe recruitment practices to ensure suitable staff were employed.

Staff administered medicines safely and kept detailed records of this. Staff received enough training to be competent in their roles and meet people’s needs.

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.

Staff supported people to access healthcare and followed any recommendations in people’s care from healthcare professionals.

People and staff developed positive relationships and staff were kind and compassionate, ensuring people’s dignity, privacy and independence were upheld.

People received care that was individualised according to their needs and preferences, and families were kept involved and consulted. People knew how to raised concerns and felt the registered manager was approachable.

There was good leadership in place and a staff team who worked well together. Quality assurance systems ensured that the service identified any shortfalls and took action to improve the service. The registered manager and provider kept up to date with current research and new approaches to improving care.

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 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

The service provides Housing with care. People have their own tenancies with Broadland Housing and Norse care provides care according to people’s individual needs. There is a dedicated extra care unit for people living with dementia and a separate unit for older people.

The manager is registered with the Care Quality Commission.

‘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.’

During our inspection we received mostly positive feedback from people using the service. The service supports and enables people to live independently and have their own tenancies whilst also providing variable support around their individually assessed needs.

Staffing levels were based on the assessed level of support people required with higher staffing ratios on the Extra Care Unit. Some people using the service and a number of staff told us that at times the levels of staffing were not sufficient to meet people’s needs. They gave us examples of when people’s needs had rapidly declined and they had needed additional support. Staff said the service was sometimes stretched really thinly. However within the staffing structure the team leaders, deputy manager and manager were not directly rostered on shift to provide care which meant they were able to help staff at busier times. Reassessments of people’s needs meant gaps in provision and funding could be identified and decisions made if this was the right service to continue to meet a person’s needs or if additional funding could be made available to continue to support the person.

We have made a recommendation about staffing.

Risks to people’s safety were managed as far as possible and risk assessments identified what actions staff should take to mitigate risk. Joint meetings between care and housing providers meant environmental and risks associated with care were discussed and addressed by the right service, (housing or care) with clear lines of accountability and responsibility.

People received support as required with their medicines by staff who were trained to administer medicines. Audits were in place to ensure people got their medicines as required and mistakes could be quickly rectified.

We have made a recommendation about medicines.

Staff received sufficient training to help them support people with their care needs and to assess risks to people’s health and safety. Additional training in specific health care conditions could be accessed as required and more training would benefit some of the less experienced staff.

Staff spoken with knew how to safeguard people in their care and felt comfortable in raising concerns through their internal procedures or through external agencies when this might be necessary. Staff had received training in protecting adults from abuse and said they had policies they could follow.

Robust staff recruitment processes helped to ensure that only suitable staff were employed. Once staff were employed they were supported through an adequate, induction and training programme to ensure they had the necessary skills and competencies. Supervisions had recently taken place and there were direct observations of practice linked to staff supervision and annual appraisal of staff performance.

People were supported to remain healthy. Staff monitored people’s health and reported any changes to family and relevant health care professionals. Staff supported people in staying active and provided activities to keep people stimulated. People were supported around meal times if required and if people were not eating enough for their needs staff would monitor their food and fluid intake and refer appropriately to the GP

Staff were familiar with people’s needs and had care plans to refer to which told them what support people needed. These plans were kept under review to ensure the support provided remained appropriate to need.

Staff supported people lawfully and took into account people’s wishes and where they lacked capacity engaged other professionals and family to ensure decisions reached were in the persons best interest. The MCA ensures that, where people have been assessed as lacking capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. DoLS ensure that people are not unlawfully deprived of their liberty and where restrictions are required to protect people and keep them safe, this is done in line with legislation. People were supported to make decisions and any restriction on people with carried out lawfully.

The service was well managed and ran in consultation with people that used it. There were systems in place to assess and monitor the quality of the service so improvements could be identified as and when required. The service learnt from incidents, safeguarding concerns and adverse events.

After that inspection we received confirmation from the 'line manager' for the service that action had been taken to remedy this. This showed that outdated information had been identified, removed and replaced. It also confirmed that staff had been made aware of where to find the guidance in both paper and electronic form. We concluded that systems for responding to and reporting abuse had been strengthened.

People told us that staff asked for their consent before providing care and support. The provider had systems in place to ensure people's consent was documented.

Care records were detailed and accurate. People had completed risk assessments appropriate to their needs. We noted that the care plans and risk assessments were audited and reviewed on a regular basis.

We observed the different activities available to people during this visit. Care staff spent time with people who chose to stay in their room and undertook reading, talking and reminiscing activities with them.

The people we spoke said that they felt safe in Robert Kett Court and did not have any concerns. We noted that staff had received appropriate training in relation to safeguarding and could recognise the signs of actual and potential abuse. However, the provider's policies and procedures were out of date and referred to the previous service provider.

Staff were well supported and there was an effective training and education schedule in place to ensure they were able to meet the needs of the people who used the service.

The provider had a complaints policy and procedure and we noted that this was readily available to people who used the service, their relatives and the staff. We saw evidence that staff supported people if they wished to complain.

We found that the provider had taken action to comply with regulations. The information told us about the improvements that had been made to ensure people were cared for by staff who were properly supported by means of supervision and appraisal of their work.