Archived: Wright's Court

About the service

Wright's Court is an extra care service which provides care and support to people who live in their own flats. The building is owned and maintained by a housing association. It provides personal care to people living in their own homes within a complex of 45 apartments. At the time of the inspection, 3 people were receiving personal care from the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

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

Right Support:

The service supported people to have the maximum possible choice, control and independence. Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests and staff supported them to achieve their aspirations and goals.

Right Care:

Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care. People's care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people's needs and keep them safe.

Right Culture:

People received good quality care, support and treatment because trained staff could meet their needs and wishes. People were supported by staff who understood good practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

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 rating for this service was requires improvement (published 28 April 2021).

Why we inspected

We received concerns about staffing levels in relation to people’s support needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wright’s Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Wright's Court is a registered domiciliary care agency. It provides personal care to people living in their own homes within a complex of forty-five apartments. At the time of the inspection, five people were receiving personal care from the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

At the last inspection on 6 August 2020, we found breaches of Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we identified that improvements had been made to the benefit of people using the service and the service was no longer in breach.

People who used the service had been treated with dignity and respect. They told us they felt safe when attended to by care staff. People had been protected from abuse. Care staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to, or at risk of abuse.

People were protected from potential risks. Risks to people's health and wellbeing had been assessed. Risk assessments contained guidance for staff on minimising risks to people, however improvements were required as reviews of people’s needs were not always being documented by staff.

People received their medicines as prescribed, however mistakes had been made with the recording of the medication. At the time of this inspection a medication action plan was in the process of being implemented.

People had experienced changes in staffing from the service. Care staff were safely recruited, and essential pre-employment checks had been carried out. However not all staff had received an induction when they started working at Wrights Court. There were sufficient staff to enable the service to provide quality care to people.

People received person-centred care and care staff carried out their duties in accordance with agreed care plans. People had been consulted regarding the care provided.

The service had arrangements for responding to complaints. People were aware of the complaints' procedure. The records indicated that complaints had been promptly responded to.

The service had not always been well managed. The provider had not always monitored the quality of the services provided by staff. However, the new manager had implemented checks and audits, which were comprehensive, and deficiencies were still in the process of being rectified. The service worked closely with health and social care professionals to meet the needs of people. There was a written action plan for improving the service.

People received person centred care. Individual decisions made about how they wished to be cared for were reflected in their care plans. Staff promoted people’s independence and respected their rights, privacy and dignity. Staff knew people well and respected their lifestyle and diverse culture.

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 in the service supported this practice, however people's mental capacity and ability to consent to care was not always evidenced in their care plans.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were the underpinning principles of Right support, right care, right culture. The manager and the majority of care staff promoted a positive culture and provided the right support tailored to each person. People had experienced significant change to their usual routines during the pandemic and could not pursue many of the activities they usually enjoyed. Care staff were responsive and considered people’s social wellbeing during the national COVID-19 restrictions. People and their relatives were being involved in the development of their care plans and the care staff to support them, promoting their choices, rights and independence even during this pandemic when normal routines were disrupted.

The service did not have a manager registered with Care Quality Commission (CQC) although the manager had begun the process.

Everyone we spoke with told us the manager was approachable and they were confident concerns would be addressed. The provider had systems in place to monitor and improve the quality and safety of the service provided.

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 last rating for this service was inspected but not rated (published 15 September 2020) and there were two breaches of regulation. 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 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.

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for this service is Requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wrights Court on our website at www.cqc.org.uk.

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.

Wright’s Court is a domiciliary care agency. It provides personal care to people living in their own homes within a supported living service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care which includes help with tasks related to personal hygiene and eating. Where people do receive personal care we also consider any wider social care provided. At the time of the inspection eight people were receiving personal care.

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

Systems and processes to ensure oversight of the service, did not always effectively identify issues; audits had not identified the concerns we found on the day of inspection. However, the provider had created an action plan due to shortfalls highlighted through their internal governance arrangements. At the time of this inspection the action was in the process of being implemented.

People and staff told us there was not always enough staff on duty. Staff were often late to calls and people did not know which staff were due to support them. Staff were not clear on their roles and responsibilities and staff required additional training to ensure they could meet people’s needs.

The provider did not have all the necessary risk assessments in place for people’s known risks. Care plans were not sufficiently updated and didn’t always contain information staff would need to meet all of people’s current care needs.

Systems in place to record safeguarding incidents and to identify areas of improvement were not effective. Staff did not always follow the providers procedures. Therefore, some incidents had not been escalated appropriately.

Medicine management systems were not effective. People had not always received their medicines as prescribed. The provider was in the process of changing medicine systems.

People told us they knew how to make a complaint. There were procedures in place for making compliments and complaints about the service. However, the provider had not consistently responded to or investigated all of the complaints that had been made.

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

Rating at last inspection

This service was registered with us on 3 December 2019 and this is the first inspection.

Why we inspected

We received concerns in relation to the management of support hours, training and medicines. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-Led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them.

We have found evidence that the provider needs to make improvements.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to safe care and management oversight.

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

Please see the action we have told the provider to take at the end of this report.