Archived: Housing 21 - Handyside Court

People’s experience of using this service:

People that we spoke to said that Handyside Court was a good place to live and that staff treated them with respect and kindness.

People’s health and social care needs were managed well by management and the staff team. There were positive relationships with professionals which supported people’s overall wellbeing.

Medicine was administered safely and there were clear protocols in place for medicine which was taken when required. Records were kept up to date and medication administration records (MAR) were all correct and checked by staff and the registered manager.

The registered manager showed evidence of ongoing quality monitoring across all aspects of the service. Any concerns raised by residents’ relatives or staff were investigated and addressed. This was also used to inform improved practices throughout the service.

People had enough to eat and drink. People were offered choices and had the opportunity to pay for a meal in the restaurant or prepare their own food in their apartment. There was a choice of socialising with other people using the service or remaining in their own space.

There were a variety of activities, both to keep people occupied and to entertain them. There were also physical activities to assist with people’s mobility. People were consulted on what they wanted to do, giving people choice and control.

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 inspection rating was requires improvement (published 7 September 2018) we found at this inspection that the service had improved to good. At the last inspection we found that the provider had failed to ensure that risks were effectively monitored and managed and there was insufficient staffing. This was a breach of Regulation 12 (Safe Care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Enough improvement had been made at this inspection and the provider was no longer in breach of Regulation 12.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This service 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. The accommodation is rented, and is the occupant’s own home. 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 service.

The service provides personal care for older people and younger adults. This was the first inspection of the service. It was a comprehensive inspection. The registered manager stated that 20 people were receiving a personal care service at the time of the inspection.

The inspection was announced because we wanted to make sure that the registered manager was available to conduct the inspection.

A registered manager was in post. This is a condition of the registration of the service. 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 and associated Regulations about how the service is run.

We identified concerns about a number of issues. A requirement notice has been issued due a breach of regulation in relation to the service not comprehensively meeting requirements of safe care and treatment.

Staffing was not always in place to always provide people with the safe personal care they needed. Risk assessments were not always comprehensively in place to protect people from risks to their health and welfare. Lessons had not always been learned from complaints.

Calls to people had not always been timely and some calls had been less than the agreed times.

People and relatives said that concerns had been followed up. However, a written response was not always provided to the complainant to indicate how their complaint had been investigated and action taken if needed.

Most staff members said they had not been fully supported in their work by the registered manager.

Management had not carried out comprehensive audits in order to check that the service was meeting people's needs and to ensure people were provided with a quality service.

Policies set out that when a safeguarding incident occurred management needed to take appropriate action by referring to the relevant safeguarding agency. Incidents have been reported to us, as legally required.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives. A capacity assessment was in place to assess whether any restrictions on choice were needed in the person’s best interests. Staff had asked people’s consent when they provided personal care.

Staff had largely received training to ensure they had skills and knowledge to meet people's needs, though training on some other relevant issues had not yet been provided.

People and relatives told us that staff were friendly, kind, positive and caring, when providing personal care. People had been involved in making decisions about how and what personal care was needed to meet their identified needs.

Care plans contained detailed information individual to the people using the service, to ensure that their needs were met. Staff had not read all the care plans for people, which meant a risk that people’s individual care needs may not be fully met.

Staff recruitment checks were in place to protect people from receiving personal care from unsuitable staff.

Most people and their relatives told us that they thought staff provided safe personal care.

Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

People and relatives told us that medicines had been supplied so that people could take their medicine safely. Procedures to protect people from infection had been followed.