Comfort Call - Astley Court

Updated 4 September 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and two Expert by Experiences carried out the inspection. 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 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.

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 24 hours’ notice of the inspection. This was because we needed to ensure the registered manager was available to support the inspection process and inform people of our planned visit.

What we did before 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 17 people who used the service and 19 relatives about their experience of the care provided. We spoke with twelve members of staff including the registered manager, regional manager, care manager, care co-ordinators and care workers.

We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at and quality assurance records.

Updated 4 September 2021

About the service

Astley Court is an extra care scheme, which has an additional scheme (Amblecote Gardens) attached to its registration. Both schemes operate in purpose-built properties, which provide support and housing for older people who are unable to live completely independently. Each person lives in their own flat but has access to a communal room and dining area. The service can support up to 124 people in total, and 72 people were receiving support with their personal care at the time of the inspection.

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 did not always receive support in line with their care needs. Moving and handling risk assessments were not always robust. People received their medicines, however people and relatives told us about the lack of organisation for reordering medicines when people were coming to the end of their prescribed cycle. People’s medicine records were not always maintained.

Incidents that involved contacting the housing provider to report faults were not always clearly recorded. We have made a recommendation about the provider reviewing their documentation processes in relation to reporting faults.

Staff told us about the pressures they had experienced and the need for more staff to support their workload. We have made a recommendation about the provider reviewing their staffing structures.

Governance systems required improvement. Staff told us there was a lack of presence form the registered manager and support from the wider management team in the care co-ordinator’s absence. Robust monitoring and auditing systems were not in place. We received mixed feedback from people and their relatives about the service and care.

Staff received appropriate safeguarding training and had a good understanding of how to safeguard people. Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. We were assured that the provider was working with the housing provider in relation infection prevention and control.

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 06 October 2017).

Why we inspected

We received concerns in relation to the management of medicines, staffing and management structures. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all extra care scheme inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to assessing risk and governance systems at this inspection.

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 for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.