About the service
Creative Support – Regency Court provides personal care and support as assessed by the local authority, to people who live in a specialist 'extra care' purpose-built housing scheme. People live in their own home or flat within the shared building of 60 flats. People at the scheme can choose their own personal care agency and not everyone who lived there received personal care from the service. Some people also purchase additional care and support from other agencies. At the time of the inspection there were 53 people using the service. CQC does not regulate premises used for extra care housing; this inspection therefore looked at the personal care and support service.
Rating at last inspection and update
The last rating for this service was 'Requires Improvement' (published 19 June 2018). At this inspection the rating remains 'Requires Improvement'. This service has been rated 'Requires Improvement' for the last two consecutive inspections.
At the last inspection in May 2018 we found a breach of regulations as medicines were not always managed safely. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found some improvements had been made to the systems to manage medicines, but these were not always consistently sustained, to ensure medicines were always safely managed. The provider was still in breach of this regulation.
People’s experience of using this service and what we found
We found there remained areas for improvement needed with the service. We had mixed feedback about the staffing levels at the service particularly to meet any needs outside of planned care times. There was a high level of agency staff at the inspection. The service had recently recruited new staff, but they had not yet started.
We have made a recommendation that the provider reviews their systems for assessing safe staffing levels to meet people’s needs at all times.
People’s risk assessments and care plans were not always up to date or reflective of their current needs. This had been identified by the provider and the service was being supported to address this issue.
While formal complaints were responded to appropriately; people and their relatives said that sometimes minor concerns were not always addressed. There had been several changes in the management and leadership of the service which had impacted on the provider’s ability to make sustained changes. The provider told us they were confident in the new management team that had been appointed.
There were quality monitoring systems in place but some improvements were still needed to the provider’s quality monitoring to ensure improvements were sustained. For example, checks were carried out on people’s pendant alarms and the response times; however, these did not track the response in the evening or at night.
There had been some improvements made since the last inspection, accidents and incidents were monitored for learning, to improve the quality and safety of the service. Staff received training and support to meet people’s needs. Areas of medicines management had improved. People told us they felt safe and staff understood how to keep people safe. There were robust recruitment practices in place.
People’s nutritional needs were assessed and supported where this was part of their planned support. 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.
People told us staff were kind and caring and respected their privacy and dignity. They said they were encouraged to be as independent as possible. People’s communication needs and needs with regards to their protected characteristics were considered as part of the assessment process to understand how they could be best supported.
Staff told us the provider and registered manager were working to make improvements, they felt well supported and worked well as a team. People’s views about the service were sought and considered to make improvements. The registered manager worked in partnership with other agencies, local authority and health and social care professionals to meet people’s needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating.
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.