Archived: Housing & Care 21 - Lincoln Gardens

We undertook an unannounced focussed inspection on 2 May 2017 to check that improvements required had been made following the enforcement action we had taken. We found that action had been taken to improve safety. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link Housing & care 21 Lincoln Gardens on our website at www.cqc.org.uk.

People were supported with their personal care needs to enable them to live in their own homes and promote their independence. Personal care was provided in an extra care housing setting, which meant accommodation was provided under a separate private tenancy agreement to people who used the service. The office was based within the same building where people had their own independent flats. People who used the service also had access to communal lounges. At the time of the inspection the service supported 36 people in their own flats.

At our previous visit the registered manager was receiving training, support and guidance at one of the providers other location and was not in day to day charge of the service. A registered manager from a different service run by Housing and Care 21 was overseeing the management of Lincoln Gardens.

At this visit the registered manager had returned to the service. 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.

Improvements had been made to the systems in place to assess and monitor the quality of the service. Systems to mitigate risks to people had been fully implemented at the time of the inspection.

Further improvements had been made to ensure that people's care records contained an accurate account of their needs. There were care plans in place where required to ensure people specific health condition was well managed.

Care plans were person centred and were audited by the service to ensure accurate information was provided to care workers.

People's risks were planned and managed in a way to protect people from the risk of inappropriate and inconsistent care. Improvements had been made to ensure that the risks associated with people's conditions were identified and staff were given guidance to minimise them.

Improvements had been made to the management of medicines, which ensured people received their medicines as prescribed. All care workers had received up to date training and competency observations to ensure that medicines were managed safely at all times. Improvements had been made in how audits of medicines records were completed.

Training records were up to date. Staff member’s personnel records and comments from care workers identified that all staff were provided with training to meet people's needs effectively.

Staff were provided with regular one to one supervision meetings and spot checks of their work to ensure that they were working in an effective way.

The provider had implemented an improvement plan to make changes to the way people received their care. The registered manager was working through the actions and the provider was involved in the checking and monitoring of these actions.

The provider wrote to us in January 2016 to tell us how they would meet the requirements of the Health and Social Care Act 2008. During this inspection we found the provider had met the legal requirements of the regulation relating to receiving and acting on complaints.

Housing and Care 21 Lincoln Gardens is a purpose built independent living facility and provides personal care to people living there. This comprises of 46 flats and shared communal facilities including a hairdressing salon, bistro, activity rooms, therapy room, laundry, lounge and landscaped garden. The communal facilities, including the restaurant can be accessed by the general public. At the time of our inspection 36 people were receiving personal care from the service.

There was a registered manager in post. 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. At the time of our inspection, the registered manager was currently receiving training, support and guidance at one of the providers other local locations.However, a registered manager from a different service run by Housing and Care 21 was overseeing the management of Lincoln Gardens.

There had been a lack of leadership within the service which the provider addressed by appointing an interim manager. The service needed to develop more robust quality assurance systems. Although some processes were in place, effective monitoring and auditing systems at service level were required to provide consistent, good quality, safe and effective care for the people who used the service. This would also help drive improvement.

Care records in respect of people’s health and specific management of a health condithin did not adequately reflect people’s needs. Care plans were not audited regularly to ensure they contained accurate information to support people effectively. Accidents and incidents were not effectively monitored to reduce the risk of reoccurrence.

The management of medicines was not always safe and improvements were required to the service’s practices with regard to the recording of medications given to people.

Staff members were not supported regularly through formal supervisions and appraisals in accordance with the provider’s policy. Competency checks were also not carried out to ensure people were receiving care and support from adequately skilled and competent staff members. Required training and refresher courses were not monitored effectively to ensure they were up to date with current guidance. Concerns were responded to immediately by the service.

People’s nutritional needs were supported adequately and staff members were mindful of people’s wellbeing. People and their relatives knew how to make a complaint; complaints had been resolved and documented appropriately. The high level of comments reported staff members were respectful and caring towards people. Care was provided in a way that intended to promote people’s independence and wellbeing.

People felt safe and staff members had an understanding of how to keep people safe and avoid harm. Management and the provider had taken steps to ensure that sufficient members of staff would meet people’s individual needs consistently and within reasonable time frames. There was a robust recruitment process in place and staff were only employed upon completion of required checks. Staff had attended training on safeguarding people from abuse or harm.

Staff supported people to ensure they received access to healthcare services when required. Management and staff understood their responsibilities and the framework of the Mental Capacity Act 2005 (MCA) and demonstrate they had received adequate training. Staff members supported people to maintain their independence and make their own choices.