Archived: Housing & Care 21 - Bentley Grange

Updated 14 January 2017

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.

This inspection was carried out on 05 December 2016 and was announced. We gave short notice of our inspection to ensure tenants were prepared by staff who explained the purpose of our visit. The inspection team consisted of one inspector.

The manager had not received a Provider Information Return (PIR) at the time of our visit. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We gathered this information during our inspection. Before our inspection we looked at records that were sent to us by the manager or the local authority to inform us of significant changes and events.

We spoke with eight people who received support from the service and two of their relatives to gather their feedback. We also spoke with the manager, and five members of care staff. We consulted a local authority quality monitoring officer, and a district nurse who oversaw people’s care in the community. We obtained their feedback about their experience of the service.

We looked at ten people’s care plans and records relevant to staff management, staff recruitment and to the quality of the service. We looked at people’s assessments of needs and care plans and talked with people to check that the support provided was delivered consistently with these records. We looked at the satisfaction surveys that had been carried out. We sampled the services’ policies and procedures.

Updated 14 January 2017

This inspection was carried out on 05 December 2016 by one inspector. Housing and Care 21 – Bentley Grange provide ‘extra care’ to older people who are tenants in Bentley Grange. This includes support with personal care and independent living. Bentley Grange is a four storey building containing 45 purpose-built apartments in a community setting, that can be bought or rented by tenants. The Care Quality Commission inspects the care and support the service provides to people but does not inspect the accommodation they live in. There were 41 tenants living in Bentley Grange apartments at the time of our inspection. All of the people we spoke with in the communal areas were able to express themselves verbally.

There was a manager in post since September 2016 who was in the process of registering with the CQC. 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. The new manager had been in post for eleven weeks and had achieved a remarkable amount of improvement in the service in that short time.

Staff were trained in how to protect people from abuse and harm. They were aware of the procedures to follow in case of abuse or suspicion of abuse and whistle blowing.

Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of re-occurrence could be reduced.

There were enough qualified, skilled and experienced staff to meet people's needs. Staffing levels were calculated according to people’s changing needs and ensured continuity of one to one support. Recruitment was underway to ensure agency staff were seldom used. Thorough recruitment practice was followed to ensure staff were suitable for their role.

Staff were trained in the safe administration of medicines. Records relevant to the administration of medicines or the supervision of medicines were monitored. This ensured they were accurately kept and medicines were administered to people and taken by people safely according to their individual needs.

Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed before care was provided and were continually reviewed. This ensured that the staff could provide care in a way that met people’s particular needs and wishes.

Staff had received essential training and had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff were in the process of receiving one to one supervision sessions to ensure they were supported while they carried out their role. They received an annual appraisal of their performance and training needs.

All care staff had received training in the principles of the Mental Capacity Act 2005 (MCA) however they were not knowledgeable about how these should be applied in practice. Processes relevant to mental capacity were not appropriately carried out and/or documented. Although staff had completed the training they needed to support people in a safe way, they needed a refresher course in mental capacity and on how to implement the relevant processes. We have made a recommendation about this.

Staff sought and obtained people’s consent before they provided support. When people declined or changed their mind, their wishes were respected.

The staff practised inclusive methods of communication. People told us that staff communicated effectively with them, responded to their needs promptly and treated them with kindness and respect. People were satisfied with how their support was delivered. Clear information about the service, the management, the facilities, and how to complain was provided to people. Information was available in a format that met people’s needs.

People were helped with referrals to health care professionals when needed and in a timely way. Personal records were person-centred and paid attention to what was important to people. They included their likes, dislikes, a summary of their life history and interests. Staff promoted people’s independence, encouraged them to do as much as possible for themselves and people made their own decisions.

People’s privacy was respected and people were assisted in a way that respected their dignity and individuality. Staff took account of people’s psychological wellbeing.

People’s individual assessments and support plans were reviewed regularly with their participation. A relative told us, “We are definitely involved and kept well informed.” People’s support plans were updated when their needs changed to make sure they received the support they needed.

People’s views were sought and acted upon. The provider sent satisfaction survey questionnaires to people to identify how the service could improve. The results were analysed and action was taken in response to people’s views.

Staff told us they felt valued and supported under the new manager’s leadership. The manager notified the Care Quality Commission of any significant events that affected people or the service. Comprehensive quality assurance audits were carried out to identify how the service could improve and action was taken to implement improvements.