Archived: Cumberland Extra Care Housing

Updated 13 September 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

This service provides care 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 bought or 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.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the CQC to manage the service. 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.

At the time of our inspection there was a registered manager in post.

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 21 June and ended on 05 July 2022. We visited the location’s office on 21 June 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and three relatives about their experiences of the care provided. We spoke with 12 members of staff including the registered manager, supervisors, seniors care workers, care workers and agency staff. We received feedback from four housing and social care professionals who regularly work with the service.

We reviewed a range of records. This included 10 people’s care records and multiple medicine records. We looked at three staff files in relation to staff recruitment and six staff supervision records. A variety of documents relating to the management of the service were reviewed including medicine audits, training information, rotas and staff meeting minutes. We looked at a sample of the provider’s policies and procedures.

Updated 13 September 2022

About the service

Cumbria County Council Extra Care Housing is an extra care housing service providing personal care. The service provides support to younger adults, older people, people living with a learning disability and/or autism and people living with physical disabilities. At the time of our inspection there were 64 people using the service.

Cumbria County Council Extra Care Housing supports people living across eight separate extra care housing schemes across the county at Appleby, Brampton, Kendal, Keswick, Kirkby Stephen, Whitehaven, Wigton and Windermere. Each housing scheme has adapted facilities and communal areas.

Not everyone who used the service received personal care. The Care Quality Commission (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

People were at risk as the provider did not have effective systems in place to monitor the quality and safety of the service and ensure all relevant records and checks were in place. The registered manager and provider had not identified the issues we found on inspection, including with recruitment checks and mental capacity records. The registered manager told us there were plans in place to develop and introduce a quality assurance policy to support the service to develop and identify areas for improvement. We have made a recommendation about data protection practices.

People were not always supported by staff who had been subject to robust recruitment checks. People’s medicines records did not always contain directions to support their safe and proper use. Despite these shortfalls with records, people felt safe with the staff supporting them and confident they would respond promptly to any emergencies. Staff understood how to keep people safe and how to identify and raise any safeguarding concerns.

Staff understood people’s needs and how to support them to achieve their preferred outcomes. People were confident staff had the skills needed to carry out their duties. It was not always clear what training the provider expected staff to have to support people. We have made a recommendation about this.

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. Records did not always reflect how people’s capacity had been considered and any decisions made in their best interests.

People received kind, compassionate care. Staff worked to ensure people’s independence was promoted. People had choice and control over their care and received person-centred care.

Staff regularly reviewed and monitored people’s care to ensure it met their care needs. Any changes needed were addressed promptly. People were supported to participate in meaningful activities and to develop and maintain relationships. People felt part of their communities.

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.

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

Right support

¿ People’s care was personalised to their needs and preferred outcomes.

¿ Staff promoted people’s independence.

¿ People were able to pursue their interests.

Right care

¿ Staff respected people’s dignity, privacy and human rights.

¿ Staff provided kind, compassionate care.

Right culture

¿ People received good quality care.

¿ People’s wishes and their wellbeing were at the centre of the service.

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 2 October 2020 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 and Recommendations

We have identified breaches in relation to governance and staff recruitment at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.