London Care (Bristol Court)

Updated 24 November 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was conducted by two inspectors and a member of CQC medicines team. An Expert by Experience supported the inspection by making phone calls to people using the service and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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 and support service.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 9 November 2021 and ended on 11 November 2021. We visited the office location on 9 and 10 November 2021.

What we did before the inspection

We looked at all the information we held about the service, including the last inspection report, the provider's action plan following this, records of complaints, safeguarding alerts and statutory notifications about significant events.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We spoke with a representative of the local authority who worked closely with the service.

During the inspection

We met five people who used the service and the relative of one person. We also spoke with the registered manager, a care manager, a care worker, the regional manager and the head of quality and governance.

We looked at the care records for eight people who used the service, staff recruitment and support records for seven members of staff and other records used by the provider for managing the service, such as records of complaints, incidents, meeting minutes and quality monitoring.

We looked at how medicines were being managed and records relating to this.

After the inspection

The registered manager sent us some additional records to view. We also spoke with 10 people who used the service and the relatives of six other people and received written feedback from nine members of staff.

Updated 24 November 2021

About the service

London Care (Bristol Court) is an extra care scheme which opened in 2019. This is purpose-built accommodation which has 94 flats in total comprising of one and two bedrooms. There were 12 homes which provided specialist dementia support and 15 homes providing specialist support for people with a learning disability. Assisted living (also known as extra-care housing) is a type of 'housing with care' which means you retain independence while you're assisted with tasks such as washing, dressing, going to the toilet or taking medicines.

At the time of our inspection, 87 people were using the service. This included older people, people living with the experience of dementia, people with physical disabilities and people with learning disabilities. Everyone living at the scheme required some degree of support with personal care.

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

People were generally happy with the service they received from London Care (Bristol Court). They liked the staff who supported them and felt their needs were being met. People raised some concerns about the building and catering arrangements, but these were not provided by London Care and did not form part of our inspection.

There were times of staff shortages and these impacted on people's experience. People still received visits from staff to provide personal care and make sure they had their medicines, but these did not always happen at the time people expected or for as long as people expected. This was the result of short notice staff absences rather than the norm. However, people told us that during these times some staff complained of feeling rushed and this added to the negative experience people had. The provider was aware of these issues and was trying to address staff shortages and give staff opportunities to voice their frustrations to management rather than people using the service.

People felt safe with the service. They received their medicines as prescribed and risks to their safety and wellbeing were assessed. There were systems to help protect people from abuse and to investigate any allegations, incidents or accidents. The provider had learnt from these to improve the service.

Systems for recruiting staff helped to ensure they were suitable. Staff were well trained and supported and had opportunities to learn about people's needs and develop their skills so they were able to meet these needs.

People were involved in making decisions about their care. They told us the staff treated them with respect and supported them to be independent where they were able. Some people were supported to access the local community and the provider was working with other organisations to improve group activities.

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.

The service was appropriately managed. The management team had worked closely with others to continually review and improve quality at the service. They sought feedback from people using the service and other stakeholders and listened to their views.

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/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

The model of care was designed to meet people's needs. People lived in their own flats within a secure building. They were able to live independently, and their privacy was respected. They had opportunities to use communal facilities and be part of a wider community, where people with different needs, abilities and skills lived.

People had individual care packages which were designed to meet their needs. These included different levels of support to learn independent living skills and access the local community. Sometimes, staffing shortages impacted on their experience, although people received essential care and their safety was maintained.

People were able to make choices about their care and take risks.

Right care:

People received personalised care from familiar staff who treated them well. The staff received training to understand equality and diversity and the registered manager was able to give examples of how people's protected characteristics had been respected and valued.

People were supported to access other services, such as health and social care services.

Right culture:

There was a positive culture and ethos. The management team reviewed and monitored the quality of the service, asking people for feedback and listening to their views. They worked closely with other external organisations to continuously improve the service and develop this to help empower and support people.

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

Rating at last inspection (and update)

The rating at the last inspection (Published 17 December 2020) was requires improvement. We found the provider was breaching legal requirements relating to person-centred care, dignity and respect, safe care and treatment, responding to complaints and good governance. The provider completed an action plan to show what they would do and by when to improve the service.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.