Gospel Oak Court

Updated 13 February 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: This inspection was carried out by two ASC inspectors and one Expert by Experience. An Expert-by-Experience (EXE) is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type: Gospel Oak Court 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.

There was a registered manager in place at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Notice of inspection: We gave the service 48 hours’ notice of the inspection visit because we wanted to make sure the registered manager and staff we wanted to speak with were available on the day of our inspection.

What we did when preparing for and carrying out this inspection:

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the completed PIR and previous inspection reports before the inspection. We reviewed other information we had about the provider, including notifications of any safeguarding concerns or other incidents affecting the safety and wellbeing of people.

What we did during the inspection:

An inspection site visit took place on the 5th and 6th December 2018. It included speaking to the registered manager, operations manager and four staff members. We also spoke with 12 people who used the service and three relatives. During the inspection we reviewed six people's care records, which included care plans, risk assessments and daily care notes. We also looked at medicines administration records (MARs) for six people. We also looked at six staff files, complaints and quality monitoring and audit information.

What we did after the inspection:

Following our visit, we contacted a number of health and social care professionals who worked regularly with the agency. We received feedback from one of them.

Updated 13 February 2019

What life is like for people using this service.

People using the service, relatives, staff and external professionals spoke positively about the leadership at the service and they thought it was well managed. We saw that managers were engaging with everyone using the service and stakeholders.

During this inspection we found shortfalls within some areas of the service provision. We disused these with the senior management team who were responsive to our feedback and assured us action would be taken to address identified issues by us.

Staff had received regular, formal supervision from their line manager. We noted that annual appraisal of staff performance had not been carried out since 2017. Consequently, staff skills to perform their role had not been reviewed and the need for further training had not been explored with them.

New staff received an induction before they started supporting people. Other staff received mandatory training which was mostly up to date or was planned for the near future. We observed that staff required further training in dementia awareness and epilepsy, which was still to be scheduled at the time of our inspection.

Medicines were managed safely and people received their medicines as prescribed. We noted that records related to medicines non-administration and creams application had not always been clearly maintained. These had not always clarified why people refused to take their medicines and what creams people were using.

Risk to people’s health and safety had been assessed and reviewed. However, some risk assessments could have more information on risk management strategies, to ensure all staff had easy access to it and could support people in a consistent way.

Care was provided with the consent of people. When people had reduced capacity to make decisions about their everyday care, staff had not always been provided with sufficient information on what decisions they could make and how staff could support them.

The senior management team had carried out monthly quality audits. Actions following these audits had been agreed, recorded and monitored to ensure highlighted shortfalls had been addressed. However, these audits had not been effective in identifying shortcomings identified by us during our visit.

The senior management team knew and understood their roles and responsibilities set by the Health and Social Care Act Regulations and current national guidance on best care practice.

Staff helped to support people to stay safe from harm and abuse from others. There were appropriate safeguarding procedures in place and staff followed them. Safe recruitment procedures ensured that people were supported by suitable staff. There were enough staff deployed to support people when needed. Infection control measures used by staff helped to protect people from the risk of infections. Accidents and incidents had been recorded and discussed with staff to avoid reoccurrence.

People’s needs and related risks had been assessed before they started using the service. We saw that support plans formulated were based on the initial assessment and explained how each assessed need would be met.

People were supported to have enough food and drink and had a diet that suited their nutritional requirements and personal preferences. Staff supported people to live a healthy life and have access to health professionals when needed.

People and relatives told us that the staff that supported them were kind and compassionate. Staff encouraged people to make decisions about their lives and were involved in their everyday care where possible. People’s support plans had been reviewed together with people and their representatives when appropriate.

Staff respected people’s privacy and dignity. People’s preferences as to entering their flats was discussed with them and respected. We saw staff knocking on the door before entering people’s flats. Peoples preferences regarding support of a male or female staff had been discussed with them and followed.

People’s care plans were person centred and they outlined how people would like to receive their care, information about people’s hobbies, religious and cultural needs and preferences. Where people had specific care needs, for example, continence management and epilepsy, this had been reflected in their care plans. Care plans were regularly reviewed and people participated in these reviews.

The provider had a complaints policy and people and relatives knew how to make complaints should they need to. Those who had made a complaint said their concerns had been addressed and resolved. We saw all three complaints received in 2018 had been dealt with promptly, as per the providers policy.

People were encouraged to have their say about the service. This could be done through periodic meetings, individual care reviews or formal complaints procedure. We saw that the service had been responsive to feedback received from people.

We made three recommendations which were related to staff appraisals and training, management of medicines and Mental Capacity Act 2005 (MCA).

More information is in the full report

Rating at last inspection: Good (18 May 2016)

About the service: Gospel Oak Court is an Extra Care Housing Scheme and is registered to provide personal care to people living in their own flats within the scheme. This enabled people to live independently and have access to tailor made and flexible care support when required. At the time of the inspection the service was providing care and support to 33 people some of whom were living with dementia or had a physical disability.

Why we inspected: This was planned inspection based on previous rating.

Follow up: We will continue to monitor the service and we will revisit it in the future to check if they continue to provide good quality of care to people who use it.