Shaw South Coast CL

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.

Not everyone using Shaw South Coast CL receives a regulated activity. CQC only inspects the service being received by people provided with 'personal care': help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

98 people received the service. There were 135 flats across the three sites in Poole, Trinidad Village, Delphis Court and Belmont Court. Each building had communal lounges and an office where the care and supervisory staff who worked in that building were based. The service's registered manager was based at Trinidad Village, but also visited Delphis Court and Belmont Court.

People’s experience of using this service and what we found

The service had improved the arrangements for managing medicines safely. We saw medicines were managed and administered safely by trained staff.

The service had improved staffing to ensure consistency for people. This had resulted in them not needing to use agency staff for the eleven months prior to this inspection.

Staff understood their role in recognising and acting upon any concerns of abuse or poor practice. Recruitment processes were robust and included employment and criminal record checks to ensure staff were suitable to work with older people.

The service was honest and open about any accident or incident that had caused or placed a person at risk of harm. People, their families and the staff team had opportunities through regular meetings to share ideas and be involved in developing the service.

People were supported by staff who had completed an induction and had on-going training and supervision that enabled them to carry out their role. Working with other health and social care professionals ensured people received the best outcomes.

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.

People had care plans that detailed their individual care needs and lifestyle choices. Staff were knowledgeable about people and how they were able to communicate which meant they were able to involve people in decisions about their care.

A range of activities were organised that reflected peoples interests and abilities. A complaints process was in place that people and their families were aware of, felt able to use and were confident they would be listened to. People had an opportunity to be involved in end of life care planning which reflected their cultural and spiritual wishes.

People and their families described the care as good and spoke positively about the staff. We observed people being involved in decisions about their day to day lives with staff enabling people to be as independent as they were able. People had their privacy and dignity respected.

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 requires improvement (published 3 September 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

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.

Not everyone using Shaw South Coast CL receives regulated activity. CQC only inspects the service being received by people provided with ‘personal care’: help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People using the service lived in 134 flats in three buildings in Poole: Trinidad Village, Delphis Court and Belmont Court. Each building had communal lounges and an office where the care and supervisory staff who worked in that building were based. The service’s registered manager was based at Trinidad Village, but also visited Delphis Court and Belmont Court. 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.

Low staff numbers had resulted in a high usage of agency staff to cover care calls. People were often not informed about who would be providing their care or at what time. Staff reported pressures on staffing levels. The provider was taking measures to address this.

There was a shortfall in the service’s processes for ensuring medicines administration records (MAR) were accurate and up to date. MAR were not always complete with an explanation of any gaps in administration. You can see what action we told the provider to take at the back of the full version of the report.

Recruitment checks, such as criminal records checks and taking up references, were made prior to employment. However, full employment histories and explanations of gaps in employment were not available for all staff. We have made a recommendation regarding the implementation of a more robust recruitment system.

People were protected from abuse, infection and unmanaged risks. Information about risks was not always comprehensive or up to date, but this was attended to promptly when we drew it to the attention of the registered manager. We have made a recommendation regarding developing staff awareness and confidence in relation to safeguarding adults.

Lessons were learned when things went wrong and the service worked to bring about improvements.

People’s individual needs and choices were assessed, and care was planned based on these. People received care that was responsive to their individual needs, in line with their care plans. Assessments and care plans flagged up sensory loss or communication difficulties and people had the support they needed with these. Staff followed the requirements of the Mental Capacity Act 2005 (MCA), making sure that people were involved in decisions about their care.

People were supported to eat and drink enough, where this formed part of their care package. They were satisfied with this aspect of their care. Staff liaised with health and social care professionals to ensure people had the care they needed and were supported to maintain their health. They supported people to maintain social links.

The service was taking steps to ensure staff had the skills and knowledge to support people effectively. Staff had one-to-one supervision meetings to review their practice, provide support and discuss any training and development needs. Staff had the training they needed.

People did not always receive care and support from familiar staff. People and their relatives reported that unfamiliar staff did not always know how they or their relative liked things to be done, leading to inconsistent support. We have made a recommendation regarding staff familiarising themselves with people’s care plans.

People were otherwise treated with kindness and compassion, and their privacy and dignity were respected. People were supported to express their views and to be involved in decisions about their or, where appropriate, their relative’s care.

Concerns and complaints were listened and responded to, and where appropriate used to improve the quality of care. Information about how to complain was included in people’s information packs.

There had been challenges when the service started in February 2018, taking over people’s care from an unrelated service that was rated inadequate and placed in special measures. The service continued to experience some challenges. There had been a turnover of staff and a number of staff had just joined or were about to join the service. People and relatives told us they perceived improvements in the service since it started. Quality monitoring and assurance arrangements were in place, but these had not all been as rigorous as they should have been. The service was working closely with the local authority commissioners to develop and improve the service.

The registered manager and operations manager confirmed that staff had equality and human rights training. However, when asked how they would respond to people’s diverse needs and preferences no staff mentioned protected characteristics. The registered manager and operations manager told us they would organise some bite-sized training sessions for staff to raise their awareness.

The service sought to engage and involve people who used the service, their relatives and staff. People and relatives said they could generally speak with the registered manager or with the manager of care services at their complex. However, staff expressed mixed views.