Housing 21 - Deighton Court

Updated 9 October 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service 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 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.

The service had a manager registered with the Care Quality Commission. This means that they 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. This was because we needed to be sure the provider or registered manager would be in the office to support the inspection and that people would be available to speak with us.

Inspection activity started on 06 September 2019 and ended on 10 September 2019. We visited the office location on 09 and 10 September 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and 16 relatives about their experience of the care provided. We spoke with seven care staff, three assistant care managers and the registered manager.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the quality and safety of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found and received updates related to medicines management at the service.

Updated 9 October 2019

About the service

Housing 21 – Deighton Court is an Extra Care Housing provision and domiciliary care service providing personal care for people aged 55 years and over. 23 people were supported at the time of the inspection.

People using the service lived in their own flats within one adapted building. 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

We rated the ‘Safe’ key question as Requires Improvement and identified a breach of the regulations related to safe care and treatment. This was because systems had not ensured people always received safe medicines support. The registered manager took action shortly following our inspection to address these concerns. We have made a recommendation about medicines management that the provider continues with those improvements to ensure consistently safe ordering and medicines support. People and relatives did not raise concerns about the medicines support provided and told us errors had been appropriately responded to.

People and relatives told us they felt the service was safe. Systems helped to ensure suspicions of abuse would be appropriately responded to. People’s risks were monitored, incidents learned from and staff knew how to help keep people safe. Recruitment processes were safe and people we spoke with told us they got their calls on time and for the planned length of time.

People and relatives all spoke positively about the care provided. People were supported to access healthcare services and with their meals if needed. Staff felt supported and that they had enough training and guidance for their roles. 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.

All feedback we received showed the service was caring. People were involved in reviews about their care. People were treated with respect and their privacy, independence and dignity was promoted.

People’s care plans showed how they wished to be supported. We received consistently positive feedback about how people’s needs were met. The registered manager told us end of life care plans would be developed if people wished. People and relatives felt comfortable complaining and confident that complaints would be addressed.

People were encouraged to make community links and get involved in activities. People and staff told us the registered manager was approachable and they would recommend the service to loved ones. Improvements were underway to ensure audits were robust and we shared some records inconsistencies with the registered manager. The provider met their responsibilities to the Commission, to display ratings and notify us of specific events when needed.

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 05 April 2016).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Housing 21 – Deighton Court on our website at www.cqc.org.uk.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led key questions of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified a breach in relation to safe care and treatment in relation to medicines management. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.