Applegrove (Domicillary Care)

Applegrove (Domiciliary Care) 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 and this inspection looked at people's personal care and support service. At the time of the inspection, 5 people were being supported by 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

People felt safe, and were supported by staff who understood safeguarding procedures. There were sufficient staffing numbers in place to support people.

Risks were assessed and staff understood what risks were present in people’s lives. Medicines were administered safely by staff who were trained to do so. Staff were recruited using safe recruitment measures.

Accidents and incidents were recorded and responded to in a timely manner.

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 staff team were well supported and understood their roles. Staff were supervised and monitored by the management team.

Audits and checks were in place to identify any issues, and prompt action was taken as required. Staff and people told us that communication was good within 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

The last rating for this service was good published on 20 December 2017.

Follow up

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

At the last inspection, the service was rated Good. At this inspection on 8 November 2017, we found the service remains Good.

People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or avoidable harm. There was sufficient numbers of staff to support people safely. Staff took appropriate precautions to ensure people were protected from the risk of acquired infections. People’s medicines were managed safely, and there was evidence of learning from incidents.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences, and choices. Staff had regular supervision and they had been trained to meet people’s individual needs effectively. The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people’s consent prior to care and support being provided. Where required, people had been supported to have enough to eat and drink to maintain their health and wellbeing. They were also supported to access healthcare services.

People were supported by caring, friendly and respectful staff. They were supported to have maximum choice and control of their lives, and the policies and systems in the service supported this practice.

Staff regularly reviewed the care provided to people with their input to ensure that this continued to meet their individual needs, in a person centred way. The provider had an effective system to handle complaints and concerns. Where people were able to remain in their own homes, staff ensured that they remained comfortable, dignified and pain-free at the end of their lives.

The service was well managed and the provider’s quality monitoring processes had been used effectively to drive continuous improvements. The registered manager provided stable leadership and effective support to the staff. They worked well with staff to promote a caring and inclusive culture within the service. Collaborative working with people, their relatives and other professionals resulted in positive care outcomes for people using the service.

Further information is in the detailed findings below.

We saw that each person received an assessment of their care needs, including any risks associated with their care provision. In all the cases we looked at, we found that the care provided matched with the care required and was what people had agreed to. We saw that people's care was provided by a sufficient number of suitably qualified staff.

We saw the service had effective systems to regularly assess and monitor the quality of service that people received. These included customer consultation visits, care documentation audits and surveys. There was an effective complaints system available and comments and complaints people made were responded to appropriately.