Background to this inspection
Updated
21 December 2018
The inspection: 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.
Inspection team: One inspector and an expert by experience carried out this 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. The expert had personal experience of supporting older people living with dementia who used community services.
Service and service type: This in an extra care housing scheme which provides housing and personal care. CQC only reviews the ‘personal care’ people receive in these services and does not inspect the ‘housing’ provided.
There was not a registered manager at the time of this inspection. The acting manager was in the process of recruiting to this post.
Notice of inspection: We gave the service 48 hours’ notice of the inspection visit because it is small, and the acting manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
What we did when preparing for and carrying out this inspection: We reviewed information we had received about the service. This included details about incidents the provider must notify us about and we sought feedback from the local authority and health professionals who worked with the service. Due to technical problems on our part, the provider was not able to complete a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. Due to the recently identified concerns, the provider had put together an action plan that they had worked through with social services. We reviewed this and took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection we also reviewed and spoke to;
• Four people’s care records and risk assessments
• Records of accidents, incidents, complaints and compliments
• Audits and quality assurance reports
• Observed the lunchtime meal experience for people
• Spoke to; the acting manager, one field care supervisor, five care support workers
• Thirteen people using the service and one relative
• An occupational therapist [OT], a social services extra care contract coordinator, social services moving and handling advisor, a social services team manager and local authority commissioner, one social services rehabilitation officer for the visually impaired [ROVI] and one GP.
Updated
21 December 2018
What life is like for people using this service:
Before this inspection we had received concerns from social services, staff, people who used the service and their relatives about the services received at Osmund Court. We found at this inspection that improvements had been made and concerns previously raised had been reduced under new management and a more stable staffing team. People told us that the service had greatly improved over recent months, although noted that this was in progress and that some aspects of the service were “not quite there yet” and were “getting there.” People felt able to raise any concerns they may have openly with the staff and management team. Concerns were acted on and addressed promptly by the management.
People received their medicines safely and newly introduced monitoring systems and procedures had reduced medicines errors that had previously been reported at the service. However, we found that for some incidents, systems weren’t always consistently followed. We made a recommendation about this.
People said they felt safe and reported that the care they received had improved. Staff were trained and understood how to report any safeguarding or other concerns they may have. People were supported to feel safe by caring staff that they knew well. Staff understood the individual preferences of people and were able to provide care for them that met their identified needs. One person told us, “They [staff] understand here and make sure someone comes in early to see me and we have a cup of tea and that makes me less anxious and makes me feel safe.”
Systems and processes for monitoring aspects of the service had improved which provided further safety measures for people who used the service. Accidents and incidents were closely monitored and analysed by the management. Risks to people were assessed and actions taken to reduce these when possible.
People had enough to eat and drink. The landlord at this extra care scheme provided lunch time meals for people as part of their tenancy agreement. People often came together at lunch time and shared their meal in the communal dining area. The on-site care team helped people who needed support to eat their meals. This was done sensitively and was not rushed. People who had any specialist nutritional needs were supported with supplements. Care staff provided support with breakfast and tea time meals in people’s individual flats when this assistance was required.
Staff had received appropriate training and the acting manager planned to source additional condition specific training to enable staff to better understand these and the impact different conditions may have on a person’s daily life. Staff felt supported by the management and received supervision and were observed in practice to monitor their competence in their roles.
People had access to health and social care services. Routine appointments were arranged for people to receive at the service or they were supported to access these in the community with staff assistance. The acting manager and staff team had worked closely with occupational therapy and other professionals including sensory loss specialists to encourage and promote people’s independence.
The Mental Capacity Act 2005 was understood by the management and staff team. Where people did not have capacity to make decisions, they were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Activities were provided and staff had come into the service in their free time to play games with people who lived there. The care staff and management team were caring, compassionate and dedicated in their roles.
The service was managed well by a passionate and dedicated acting manager. At the time of this inspection the acting manager was in the process of recruiting a new manager for the service. We were told that the acting manager would maintain their involvement at the service with scheduled monthly quality monitoring visits to ensure that the quality and safety of the service was not compromised with further changes to the management structure.
Rating at last inspection: This was the first inspection for this location.
More information can be seen in the main body of the report for each Key Question below.
About the service: Caremark [Osmund Court] provides care and support to up to 40 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 service. At the time of this inspection 30 people were being supported with their personal care needs.
Why we inspected: This was the first inspection for the service which was brought forward. This was due to recent concerns and complaints that had been received from staff, people who used the service, and their relatives. There had also been safeguarding concerns raised by social services. At the time of this inspection we found that these concerns had been addressed and people’s experience of the service had improved.