Archived: Flourish House

The last inspection of the service was carried out on 17 July 2014. No concerns were identified with the care being provided to people at that inspection.

Flourish House is part of Aster Living and operates four extra care schemes for elderly people and a supported living service for people with learning disabilities. Extra care schemes and supported living services allows people to live independently while getting the care and support they need. A total of 152 people may be catered for. Flourish House also operates a domiciliary care service to provide person care for people living in extra care schemes, if this is required.

There were two registered managers in post, one to manage the supported living service in Somerset, and one to manage the extra care scheme in Somerset, Devon and Cornwall. 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.

The provider and senior management team were open and approachable and supported people receiving a service and staff well. People and their relatives were very complimentary about the quality of the service provided and about the management and staff team. They felt the care was good. One person told us, “Carers are a 100%. They know their job and they’ve got passion for everything they do”.

People had positive relationships with the staff members who supported them. Staff knew peoples’ individual histories, likes and dislikes and things that were important to them. People’s privacy and dignity was respected and information personal to them was treated in confidence. People felt they received support from familiar and consistent care workers. They told us they would recommend the service to other people.

There were systems in place which provided guidance for staff on how to safeguard the people who used the service from the potential risk of abuse. Staff understood their roles and responsibilities in keeping people safe.

Comprehensive risk assessments were in place in all care records. They included a wide range of areas: including communication; medical conditions; medication; diet; independence; continence; memory, self-neglect. There were separate risk assessments regarding environmental risks.

Where people required assistance to take their medicines, there were arrangements in place to provide this support safely. There were clear protocols to show at what level the assistance was required, for example just prompting or reminding the person to take prescribed medication from a blister pack.

There were sufficient numbers of staff who were trained and supported to meet the needs of the people who used the service. Care workers were caring and respectful and had good relationships with the people they cared for. People were involved in making decisions about their care and support and people received care and support which was planned and delivered to meet their specific needs.

Where people required assistance with their dietary needs, there were systems in place to provide this support safely. One person told us, “We do a weekly shop and plan our menu each week with staff”. Staff confirmed they tried to ensure a healthy balanced diet was promoted whilst recognising choice.

Care plans showed people had access to healthcare professionals including doctors, community nurses, speech and language therapists, opticians and chiropodists.

A complaints procedure was in place and people’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service. Each person received a copy of the complaints procedure including in easy read format once commencing the service.

There was good leadership in the service. The service had a quality assurance system and shortfalls were addressed and used to promote on-going improvement. People were kept up to date about any changes to the service by meetings, newsletter and discussions.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found the service to be safe because people's rights and dignity were respected and they were involved in making decisions about any risks they may take. When people were at risk, staff followed effective risk management policies and procedures to protect them. Staff supported people to take informed risks with minimal necessary restrictions to as far as possible protect their welfare.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The service understood the requirements of the Mental Capacity Act 2005, its main Codes of Practice and Deprivation of Liberty Safeguards, and put them into practice to protect people. This meant that people were protected from discrimination and their human rights were protected.

People received their medicines as prescribed. Prescribed medicines (including controlled drugs) were stored and administered safely in line with current and relevant regulations and guidance. People could administer their own medicines safely. One person told us, 'They come over every night and help me with my tablets. They're always there and on time'.

People were safe because the service considered skill mix and experience when arranging staffing and staffing levels were sufficient to meet their identified needs.

Is the service effective?

We found the service to be effective because there was an advocacy service available if people needed it, this meant when required people could access additional support.

Care plans reflected people's current individual needs, choices and preferences. People were involved in the assessment of their needs. People's health was regularly monitored to identify any changes that may require additional support or intervention. People we spoke with said 'They're excellent', 'Lovely girls', 'Very helpful'. People said that staff knew their needs 'very well' and 'They organise everything for you'. Staff said, 'I think we know people really well', 'We're a small team and we see the same people every day'.

Staff supported people to take informed risks with minimal necessary restrictions. The environment enabled staff to meet people's diverse care, cultural and support needs. People's identified needs were monitored and managed.

Is the service caring?

We found the service to be caring because people were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. Staff responded in a caring way to people's needs when they needed it.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. Appropriate professionals were involved in planning, management and decision making.

Staff knew the people they were caring for and supporting. People were as independent as they wanted to be.

Is the service responsive?

We found the service responsive because, staff actively sought, listened to and acted on people's views and decisions. Staff responded to changing needs in line with people's choices and wishes.

People had their individual needs regularly assessed and met. There were arrangements in place to speak to people about what was important to them. People we spoke with said, '

People completed a range of activities in and outside the service regularly. People had access to activities that were important and relevant to them and were protected from social isolation.

Is the service well-led?

We found the service to be well-led because there was an emphasis on fairness, support and transparency and an open culture.

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving. Robust quality assurance and governance systems were in place and used to drive continuous improvement. The management team recognised innovation.

Concerns and complaints were used as an opportunity for learning or improvement.

People we spoke with told us that they felt involved in the care and support they received. One person told us they 'like to be part of things'.

People told us the staff were respectful towards them at all times. One person said 'all the staff are very nice'. Another person told us 'oh yes, lovely staff'.

Staff we spoke with told us they felt supported by the service. Each staff told us they received good training and said they enjoyed their roles.

Staff were knowledgeable about keeping people safe and were confident to raise concerns if they saw anything they were worried about.

People told us they felt confident to talk to staff if they had any concerns and said they felt safe with the staff who visited them.

The service had a good quality assurance system that took people's views into account.

People spoken with told us that they were consulted and the care they received was very good. One person spoken with was a member of the Customers Board for the organisation and said, 'I with others have been consulted about how to spend money.' and 'I feel able to say what I want and suggest changes.'

People using the service told us the staff were respectful and polite and had met their needs in the way they wanted them to. One person told us, 'The girls are polite and respectful at all times.' also 'I am very happy with the care." and "The staff are polite."

The care workers spoken with told us they had been supported to carry out their roles. One told us, 'I feel supported and involved in the scheme.' and "We have regular meetings and share information.'

Another member of staff told us, 'I have completed safeguarding training and would report anything that I felt was wrong to my manager.' Posters that gave information about abuse and reporting abuse were on notice boards at the two schemes visited.

People spoken with also told us, 'I am involved in deciding what care I need.' Another told us, 'We are both supported by the staff."

Flourish Court had robust procedures in place that supported compliant and safe care.