Aurelia Branch Also known as MHA Care at Home - Aurelia Branch

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and autistic people and providers must have regard to it.

Right Support

Care staff had not received specific training to meet the needs of people with a learning disability. However, 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.

Right Care

Care is person-centred and promotes people’s dignity, privacy and human rights.

Right Culture

The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services led confident, inclusive and empowered lives.

Quality assurance checks were not all effective and had not identified some issues identified in our inspection, such as gaps in individual’s risk management.

In the main, we were assured infection prevention controls were being followed.

People felt safe using the service. Staff understood how to recognise and report abuse. Staff recruitment processes included background checks to review their suitability to work with vulnerable adults.

People spoke positively about the staff and the care they provided. Staff felt supported by the registered manager and the care manager.

The registered manager was open and honest and worked in partnership with outside agencies. They were committed to making improvements to the service.

Rating at last inspection and update

The last rating for this service was good (published 26 June 2019).

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all extra care housing inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We received concerns in relation to the management of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow-up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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

Aurelia Branch is a purpose-built "housing with care scheme" and is registered to provide personal care to people in their own homes. Aldersgate consists of 34 flats across two floors, a passenger lift provides easy access to the ground floor communal lounge and bistro-style dining restaurant. There is also a communal garden. Care and support was provided to people, in their own flats, by care workers at pre-arranged times. People have access to call bells for care workers to respond whenever help is required. At the time of our inspection visit, 11 people were supported with personal care.

People’s experience of using this service:

People felt safe living within the housing scheme flats because a member of staff was always on call if needed. People felt well supported by kind, caring and considerate staff. Staff supported people to maintain their independence, such as making their own decisions and doing the things they wanted to do.

People were funded by the local authority, or self-funded packages of care to meet their support needs. People told us staff always arrived at the agreed times to undertake agreed tasks, such as support with washing and dressing. Risks were assessed, and staff respected people’s choices in positive risk taking. People could chose to contribute to a ‘social fund’ and this funded group activities. People were involved in pursuing personal interests and hobbies.

Staff ‘s focus and attention to detail was evident. Staff knew people well, and how they liked to be supported.

There were enough staff to undertake the agreed care calls to people. A ‘wellbeing’ staff member was available at night time to respond to people's call bells.

Records supported safe care and risk management. People were involved in the planning and review of their care. Care plans contained detailed information for staff about the tasks to be undertaken during care calls. Personalised information was included, such as dietary information.

People received their medicines safely from trained and competent staff. Regular checks and safe medicines management ensured any errors were kept to a minimum. Lessons were learned to reduce risks of reoccurrence when an incident had occurred.

Staff received training and understood their own and other roles and responsibilities, such as safeguarding people from poor practice. Staff understood the importance of gaining consent from people and worked within the principles of the Mental Capacity Act 2005.

Quality assurance systems were effective. Team leaders undertook health and safety, infection control and fire safety checks and the registered manager had oversight of these to ensure they were regularly completed.

Rating at last inspection: The service was given a rating of Good. (The last report was published on 27 July 2016).

Why we inspected: This was a planned inspection based on the rating of the last inspection. We found the service met the characteristics of a “Good” rating in five areas.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our 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

Aurelia branch is a housing with care scheme that is registered to provide personal care to people in their own homes. Care and support was provided to people in their own flats by care workers at pre-arranged times. People have access to call bells for care workers to respond whenever additional help is required. At the time of our visit the agency supported approximately 20 people with personal care and employed 24 staff.

The service was last inspected on 18 November 2013, when we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

The service had a registered manager. A requirement of the provider’s registration is that they have a registered manager. 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. We refer to the registered manager as the manager in the body of this report.

People and relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Risks to people’s safety were identified and care workers understood how these should be managed.

There were enough care workers to meet people’s needs effectively. People received their care and support from care workers who they knew, and at the times agreed. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people in their homes.

Information about people’s ability to make their own decisions was not always clearly recorded. However, the managers and care workers understood the principles of the Mental Capacity Act (MCA) and their responsibilities under the act. Care workers gained peoples consent before they provided personal care and respected people’s decisions.

People were supported with dignity and respect. Where possible, care workers encouraged people to be independent. People told us care workers were caring and had the right skills and experience to provide the care and support required.

Care workers completed training considered essential to meet people’s needs safely and effectively. Care workers completed an induction when they joined the service and had their practice regularly checked by a member of the management team.

People who required support had enough to eat and drink and were assisted to manage their health needs. People saw health professionals when needed and the care and support provided was in line with what they had recommended. Systems were in place to manage people’s medicines safely and staff had received training to do this.

People and relatives were involved in planning and reviewing their care. Care records gave care workers the information needed to ensure care and support was provided in the way people preferred. However, some care records had not been updated. The manager was aware of this and was working on ensuring all were updated.

People and relatives told us they knew how to raise any concerns and felt these would be listened and responded to effectively. Staff told us the manager and senior staff team were supportive and responsive to their ideas and suggestions. There were systems in place to monitor the quality of the support provided, and the provider regularly sought feedback from people and their relatives. The provider used this feedback to make some improvements to the service where needed.

We spoke with five people on the day of our visit, one person following our visit and 14 relatives to obtain their views about Aurelia Care.

People and their representatives told us they were involved in their care and treatment decisions. They said they were happy with the care provided.

We saw care plans for three people who used the service. The care plans contained important information about people the service looked after.

Comments from people who received a service and their relatives included, 'Lovely here, I have no complaints' and 'X gets a very good service.'

Care staff were able to demonstrate a good understanding of how to protect vulnerable people.

The service had systems in place to support care staff. Staff told us they had regular meetings to discuss their training and to raise any concerns.

We found the service had systems in place to monitor the quality of service provided.

During our visit we met and spoke with the assistant manager, the team leader and two members of care staff. We also met and spoke with three people who lived at the scheme.

People we spoke with told us that they were happy with the service they received. They told us that staff were respectful and that they were looked after by the service well. "They treat me with dignity and respect" and "I'm well looked after, I can't grumble" were two comments made.

We saw that people had been assessed prior to moving into the scheme and that care plans were in place. We found that the care plans contained information to assist staff with meeting people's care needs.

We found that systems were in place to ensure that people's confidential information was maintained securely and in good order.