Saffron Court

Not everyone living at Saffron Court receives a service from the domiciliary care service. People receiving care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate the premises. 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. At the time of the inspection, five people were receiving the regulated activity of Personal Care.

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

Risks associated with people’s individual care and support needs had not been sufficiently assessed to ensure people’s safety. Risk assessments had not been regularly reviewed or amended when people’s needs changed.

The provider had an incident management system used to review, monitor and manage incidents that occurred. This included oversight and analysis to enable learning to reduce further risks. However, this was not fully effective.

There was a high use of agency staff to cover staff vacancies. The provider did not have details of agency staff to check their identity, and to assure themselves staff had undergone safe recruitment checks and were sufficiently trained. The provider had failed to provide staff with training and support to meet some people’s specific health, care, and support needs.

The provider’s governance systems and processes used to assess, monitor, and mitigate risks and to develop and make improvements were not fully effective or robust.

Infection prevention and control practice did not fully reflect best practice guidance. This included the monitoring of COVID-19 testing, assessment and risk management for people at high risk, how used personal protective equipment (PPE) was disposed of and was not monitored.

The provider’s safeguarding policy did not reflect the local multi-agency safeguarding procedures. However, staff had details of how to make a safeguarding referral. When safeguarding incidents, concerns or allegations had occurred these had been acted upon and reported correctly to external agencies including CQC.

Relatives who gave feedback, raised concerns about the high use of agency staff and their concern of the impact on continuity and consistency of care. However, they spoke highly of the permanent staff employed.

A person who used the service was positive about the care and support they received. They confirmed staff mostly arrived on time and stayed for the duration of the pre-planned care visit.

At the time of the inspection, people receiving personal care and support managed their prescribed medicines independently. However, the provider’s medicines systems and processes reflected best practice guidance.

The new registered manager and service manager who had day to day responsibility, were aware of improvements required and showed commitment and determination to develop the service. The provider was also making changes within the organisation to further develop and improve.

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 22 May 2019).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about infection prevention and control and staff deployment at the service. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with risk management, staff deployment, training and the provider’s governance systems, so we widened the scope of the inspection to become a focused inspection which included the key questions of Safe and Well-led.

Please see the Safe and Well-led sections of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Saffron 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risk management, staffing, including training, and the provider’s governance systems and processes used to monitor quality and safety and drive improvements.

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.

Adjuvo (Midlands) Support for Living Ltd., Saffron Court is a domiciliary care agency. The service provides care and support to people living in ‘extra care’ housing. Extra care housing is purpose built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupants’ own home. The extra care housing complex was known as Saffron Court and was made up of individual flats. Not everyone living at Saffron Court receives a service from the domiciliary care service. People receiving care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate the premises. This inspection looked at people’s personal care and support. At the time of the inspection 16 people were receiving a service.

People’s experience of using this service:

A registered manager was not in post. The service had been without a registered manager for 27 days at the time of the inspection. We were informed that an application to register as a manager would be submitted to the Care Quality Commission, to register as the manager.

People told us they felt safe. People were kept safe by staff who understood how to safeguard people from abuse and the actions they needed to take to protect people from the risk of harm. There were sufficient numbers of staff to support people and staff were recruited safely. There were appropriate infection control practices in place. Where required staff supported people to clean their home do their laundry. People were supported to take their medicines safely.

People were supported by staff who had completed the relevant training to give them the skills and knowledge they needed to meet people needs. People were supported to have sufficient amounts to eat and drink, which included support with grocery shopping and cooking. Staff supported people to maintain their health and well-being, which included liaising with health care professionals on their behalf. People 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.

People were consistent in their praise of staff for the support they provided. People spoke of the kind and caring approach of staff and their willingness to listen to them. People were involved in decisions about their care and support, and very much viewed themselves as part of a family. People’s privacy and dignity was both promoted and respected.

People were involved in the assessment and care planning process to ensure the services offered were appropriate for them. People were supported to express their wishes and preferences regarding their care and staff were provided with information, within people’s care plans, which enabled them to provide personalised care. People were confident to speak with staff about any issues of concern to them.

The provider had systems in place to monitor the quality of the service to ensure people received good care. People and staff were given the opportunity to comment upon the service. The manager and staff liaised and worked with partner agencies to support people in the best way possible.

Rating at last inspection:

This is the first inspection of this service since its registration with CQC on 30 April 2018.

Why we inspected:

This was a planned comprehensive inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk