Grays Fair Court

Updated 1 June 2022

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 Health and Social Care Act 2008.

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

Consisted of two CQC inspectors, with an Expert by Experience completing telephone calls with people living in the housing with care flats. 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 reablement unit operated like a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The reablement unit is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there were two registered managers in post, in a job sharing arrangement. They are referred to as the management team for the purposes of the report.

Notice of inspection

We gave a short period notice of the inspection to ensure permission and consent was sourced from people living in the extra care housing, for home visits to be completed by an inspector. We needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 12 May 2022 and ended on 17 May 2022. We visited the services on 16 May 2022

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sourced feedback from the local authority who work with the service. We reviewed information we held about the service. We used all this information to plan our inspection.

During the inspection

We spoke with the two registered managers, three care co-ordinators, and two members of care staff. We reviewed eight people’s care records and eight people’s medicine administration records, as well as other people’s records relating to the administration of topical medicines for the care of their skin. We looked at staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures. We spoke with eight people who use the service and one relative. We spoke with a further two people by telephone.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 1 June 2022

About the service

Grays Fair Court consists of 24 extra care housing flats, and 20 reablement beds in a separate unit. The reablement unit usually supported people discharged from hospital, requiring further rehabilitation for approximately six weeks, before returning home. The service provides the regulated activity of personal care at the extra care housing, and regulated activity of accommodation, personal and /or nursing care for the reablement beds. At the time of our inspection there were 39 people using the service.

Not everyone who lived in the housing with care flats received the regulated activity of 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 were supported to live meaningful lives, and /or develop the skills and abilities needed to enable them to return to living independently. People worked collaboratively with staff to set personal goals, and to ensure they continued to maintain their independence.

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.

The care environment was visibly clean, with arrangements in place to maintain the cleanliness and condition of the whole service 7-days a week. Some people received support with aspects of housekeeping to keep them safe while living independently.

We received consistently positive feedback on the staff skills, quality of care and responsiveness to people’s needs, including when using their call bells. The service had an active recruitment programme in place to reduce the use of agency staff and ensure consistency and familiarity within the staff team.

Staff and the management team took pride in their work and were clear that caring for people was a privilege, and valued, responsible position. Staff recognised their own accountability and were comfortable to challenge or question any concerns relating to colleagues practices.

Where incidents or accidents occurred, there was evidence of analysis being completed to determine what measures could be put in place to improve people’s safety and reduce the risk of reoccurrence.

We identified some examples of notifiable incidents that should have been referred to CQC, but had not been, we have made a recommendation about this in the report. However, we could see the actual situations had been dealt with appropriately. We received timely assurances from the management team on changes to practice being implemented to prevent this happening again, and were open to our feedback to ensure safe service provision for people.

We identified environmental risks in relation to unrestricted windows, increasing the risk of people falling from a height, with no individualised risk assessments in place. We received timely assurances from the management team that changes were being made to the environment, and risk assessments were being implemented.

We identified some aspects of medicines management that would benefit from changes to documentation, to ensure greater levels of monitoring and oversight. The management team were responsive to our feedback, and implemented timely changes to practice.

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

Rating at last inspection

This service was registered with us on 12 May 2021 and this is the first inspection. The last rating for the service under the previous provider was Good, published on 31 October 2018.

Why we inspected

We inspected as part of our routine monitoring of services. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home 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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.