Cera Lanehurst Gardens

Updated 21 February 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

There had been concerns reported to us about the management of medicines at the service. We brought this inspection forward. We did this to review overall management and leadership of the service and medicines management to include any risks that may relate to medication at the service.

Inspection team:

This inspection was completed by one inspector and an expert by experience [ExE]. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. This ExE had expertise of supporting older people living with dementia who used the services.

Service and service type:

Caremark [Lanehurst Gardens] is an extra care housing scheme for older people living in their own homes. People were supported by care staff with the regulated activity of ‘personal care.’

The service had a new care manager who was not yet registered with the Care Quality Commission [CQC]. At the time of this inspection the new care manager was applying to become the registered manager with the CQC. They had not yet submitted their application to us but had submitted their DBS check to be reviewed. A registered manager 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 visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started and ended on 22 January 2019. We visited the office location to see the manager and office staff; and to review care records and policies and procedures.

What we did:

We reviewed information we had received about the service. This included details about incidents the provider must notify us about and we sought feedback from the local authority and health professionals who worked with the service.

The provider did not complete the Provider Information Return [PIR]. This inspection took place before they had an opportunity to submit this to us. This is information providers must send us to give us key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

During the inspection we spoke to people, professionals and also reviewed;

• Notifications we received from the service

• Four people’s care records which included risk assessments

• Three staff members recruitment and training records

• Records of accidents, incidents, complaints and compliments

• Audits and quality assurance reports

• Minutes from meetings with staff and people

• We observed activities and the lunch time meal experience for people

• Nine people using the service; 4 relatives

• Spoke with, six members of care staff, the new care manager, the area manager and the supervisor.

• We also spoke with West Sussex County Council’s [WSCC] social services extra care contract coordinator and assistant care manager.

Updated 21 February 2019

About the service:

Caremark [Lanehurst Gardens] provides care and support to up to 40 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. At the time of this inspection 30 people were being supported with their personal care.

There was a dedicated office for staff within the building. One member of staff was on duty overnight to respond to people’s care needs when required. People did not have planned care needs during the night at the time of this inspection. A further senior member of staff was ‘on-call’ during out of hours to support the night care worker.

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

People’s experience of using this service:

People told us they were happy using the service. They received a reliable service from a committed care staff and management team. People felt safe with staff support. Systems and processes protected people from the risk of abuse and avoidable harm. Staff were recruited safely. Checks were made which ensured new staff were of good character.

People’s needs were assessed, and person-centred care plans were developed which reflected their needs, choices and personal preferences as well as their past histories. This enabled staff to get to know people well. People had ‘lifelines’ ['call-bells'] in their flats that they could use to summon staff support as needed. Some people chose to wear their lifelines on them, so they could more easily access the ‘call-bells’ if they needed help from staff.

People received their medicines safely. Systems monitored medicines management to ensure that medicines were given to people as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. One person told us, “I do feel free and am able to move about [without restrictions].”

People had enough to eat and drink. The landlord at this extra care scheme provided lunch time meals for people as part of their tenancy agreement. People often came together at lunch time and shared their meal in the communal dining area. The on-site care team helped people who needed support to eat their meals. Care staff provided support with breakfast and tea time meals in people's individual flats when this assistance was required.

Staff were trained and received support from the management team with regular supervisions, ‘spot checks’ and competency assessments of their abilities to perform their roles.

People and their representatives, as appropriate, were involved in their care planning and actively participated in the management of risks to themselves, when they were able to do so. This included self managing medicines and awareness of behaviours that may challenge.

Activities were provided by staff each afternoon in the communal lounge area. Links to the local community were made. One person completed a computer course with staff support at a local library.

People had access to healthcare support as they needed it.

The service was well-led by a management team who worked proactively together and with other health and social care professionals from outside of the service. There was a new care manager who told us they were in the process of completing their application to become the registered manager for the service. At the time of this inspection we had not yet received the managers application. The new manager had submitted their Disclosure and Barring Service [DBS] check. Once the DBS had been received they would be able to start the registered managers application with the Care Quality Commission [CQC].

Rating at last inspection:

This was the first inspection for this service so there was no previous inspection rating.

Why we inspected:

This inspection took place on the 22 January 2019 and was announced. This inspection was brought forward due to information of risk or concern.