Charles Clore Court Extra Care Sheltered Housing

Charles Clore Court extra sheltered housing is a domiciliary care agency run by Reading Borough Council. It provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. Charles Clore Court provides people with ordinary flats within the purpose-built building. They can make use of shared facilities such as a dining room, specially adapted bathroom and lounges. The accommodation is rented, and is the occupant’s own home.

The agency has an office within the building and are currently providing a service to approximately 30 of the 47people who live in the complex. However, this number fluctuates depending on the needs of individuals. The service supports people with diverse needs including dementia, learning disabilities, sensory impairment and physical disabilities.

People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support.

At the last inspection, on 08 July 2016, the service was rated as good in all domains. This meant that the service was rated as overall good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People, staff and visitors were protected from harm by staff who were regularly trained in safeguarding vulnerable adults and health and safety policies and procedures. They understood what they needed to do if they had any concerns about safety. Risks were identified and action was taken to reduce them, as far as possible. People were supported to take their medicines safely (if they needed support in this area). People were supported by care staff whose values and attitudes had been tested and who had been safely recruited.

Staff met people’s needs safely and effectively. There were enough staff who were given enough time to meet people’s needs. The service did not accept care packages if they could not meet individuals' identified needs.

Care staff continued to be trained and supported to enable them to meet people’s individual needs. Care staff were effective in meeting people’s needs as described in plans of care. The service worked closely with health and other professionals to meet people’s specific or complex needs.

People were assisted to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were provided with kind and compassionate care. Consistent care staff built good working relationships with people. Care staff encouraged people to be as independent as they could be.

The service continued to be flexible and responsive and could meet people’s current and changing needs and preferences. People’s needs were reviewed regularly to ensure the care provided was up-to-date. Care plans included information to ensure people’s individual communication needs were understood.

The registered manager was described as very supportive. The service assessed, reviewed and improved the quality of care provided. The service worked closely with other professionals to respond to the changing needs and expectations of the local community.

Further information is available in the detailed findings.

There was a registered manager in post. 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 were happy with the service they received and said they felt safe. Risks assessments were undertaken and where identified, risks were managed effectively to keep people and staff safe.

Staff had received training in safeguarding people and were knowledgeable about the signs and symptoms which may indicate abuse. They knew the reporting procedure to raise alerts if they had concerns regarding people’s safety. Staff were confident that issues reported were taken seriously and dealt with promptly.

Staff received on-going training and support and were encouraged to gain recognised qualifications. There was an open door to the registered manager and extra care co-ordinator. Staff felt they could seek advice or raise concerns whenever they needed to and they would be dealt with. Staff skills were checked to help ensure they were competent to care for people effectively.

Medicines were managed safely and audited regularly. Where people required support with their medicines this was provided by competent staff who ensured they received their medicine at the appropriate time.

People’s rights were protected. Staff understood their responsibilities in relation to gaining consent before providing support and care. People had been involved in planning and reviewing their care. They felt their decisions were respected.

People were treated with kindness and compassion by friendly open staff. People’s dignity was respected and they were supported to remain as independent as they wished.

Communication in the service was efficient and staff were promptly provided with up to date information concerning people’s care. When necessary staff contacted healthcare professionals to seek advice regarding people’s well-being.

Audits and regular feedback from people enabled the registered manager to monitor the quality of the service.

Below is a summary of what we found. The summary describes what was observed, the records looked at and what people using the service, their relatives and the staff told us.

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

Is the service safe?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People's care plans included risk assessments which highlighted risks in specific areas for example moving and handling. They contained actions to minimise these risks and keep people safe.

We inspected the staff rotas which showed that there were sufficient staff on duty to meet people's needs throughout the day. People received a consistent and safe level of support.

Procedures for dealing with emergencies were in place and staff were able to describe the action they would take to ensure the safety of the people who use the service. We saw these procedures in action on the day of our visit when the fire alarm sounded.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). A recent Supreme Court judgement had widened and clarified the definition of deprivation of liberty. The manager was aware of this judgement and how it may impact on supported living. They had been in contact with the Local Authority DoLS team and were awaiting further advice.

Medicines were managed appropriately. There were systems in place to order, store, record and dispose of medicines in a safe manner. People told us they were supported to take their medicines as they wished.

Is the service effective?

People's privacy and dignity were respected. People told us that staff respected their wishes as well as their dignity and privacy: One person said; 'they (staff) ring the bell and wait, they never charge in.'

People all had an individual care plan which set out their care needs. People told us they and their relatives were fully involved in the assessment of their health and care needs and had contributed to developing their care plan.

People we spoke with told us the staff were supportive and encouraged them to maintain their independence as much as possible. One person said they had gained independence since living at the service and having support.

People had access to a range of health care professionals. For example: Doctors, District Nurses and Opticians.

Is the service caring?

People were supported by friendly and attentive staff who spoke politely to them. We saw that care workers showed patience and gave encouragement when supporting people, offering explanations when necessary. People we spoke with told us staff listened to them and took note of what they said.

Staff were aware of people's preferences, interests, aspirations and diverse needs. Our observations, discussions with people and the records we looked at, told us that individual wishes for care and support were taken into account and respected.

One relative we spoke with said: 'I never have to worry, staff are kind and caring, my X gets the best care possible.' A person who uses the service said '(I) can't fault the service; they do their best for you always.'

Is the service responsive?

People told us they were involved in reviewing their plans of care when their needs changed and if they wished they could involve their relatives.

The service had a system to assure the quality of service they provided. The way the service was run had been regularly reviewed and action taken when necessary to address any shortfalls.

Trends in accidents and incidents had been monitored, if appropriate advice was sought and action taken to prevent reoccurrence.

Complaints were documented and investigated fully. Actions were taken appropriately and the outcome discussed with the complainant.

Is the service well-led?

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

The service had quality assurance systems; we saw that any identified shortfalls were addressed promptly. Staff had a good knowledge of their roles and responsibilities and could seek advice from senior staff and managers.

Staff had a good understanding of the service and the quality assurance processes in place. This helped to ensure that people received a good quality service at all times.

People who we spoke with and their relatives told us that they were happy with the care and support they received. One person said 'they're brilliant, a real life saver' and 'I'm unlikely to get a better quality of life anywhere else'. Another person told us 'staff are excellent, patient and understanding'. They always arrive with a smile on their face'.

Care records contained assessments and guidance detailing the care and support a person required. We saw that these had recently been reviewed and in most cases any changes to care noted.

The agency liaised where appropriate with other providers and agencies. Staff we spoke with explained how they worked with the sheltered housing landlord and district nurses to ensure that consistent care was given to people using the service.

Appropriate recruitment checks were carried out and recorded. New staff members completed an induction and attended core training. Staff we spoke with told us that they had been through an application and interview process before starting in their role.

We found that appropriate systems were not in place for the safe handling and disposal of medication. We have asked that the provider make some improvements in this area.

We reviewed the provider's complaints policy and procedure. This showed that the provider had a system for receiving and responding to complaints. People we spoke with told us that they knew how to make a formal complaint but had no reason to because the manager and staff addressed issues and concerns raised.

The people we spoke with told us that care staff were mostly on time and always stayed for the right amount of time. They said that if staff were going to be late then they would always let them know. One person told us that 'the staff here were marvellous'. Another person said 'the staff were always happy and chatty'. Staff told us that they followed care and support plans which they felt contained adequate information. We found that sections of the care plans had not been reviewed in the past year which could impact on the care and support people received.

The manager and staff were aware of their responsibilities regarding protecting people from abuse. People we spoke with said they had confidence in the care provided and felt safe with the support provided. They also told us that they knew how to raise their concerns and would feel comfortable making a complaint. Staff told us that they felt supported and the manager had processes in place to ensure that people were assisted and cared for by trained and experienced staff.