We carried out an announced inspection at Housing and Care 21 – Belsize Court on the 2 and 7 August 2018. At our last comprehensive inspection on 21 April 2017 we found the service was breaching regulations relating to medicines management and assessing risks to people, caring for people in line with the Mental Capacity Act 2005 (MCA) and also good governance. We issued the provider with two warning notices in relation to the repeated breaches of safe care and treatment and good governance. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective and well led to at least good. At our next focussed inspection in August 2017 we found the provider had met the requirements and was no longer in breach of the regulations. However, we did not improve the rating for these questions from requires improvement because to do so requires consistent good practice over time.At this inspection we found the provider had embedded the required changes into practice and sustained the necessary improvements. We have therefore improved the overall rating to Good.
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 bought or 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.
People using the service lived in their own private flats in a large purpose-built building within the town of Sutton. Belsize Court has a total of 63 flats for people aged 55 years and older.
Not everyone using Housing and Care 21 – Belsize Court 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. At the time of our inspection the service was providing personal care to 58 people
The 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. 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. The manager had started at the service in April 2018. At the time of our inspection visit the manager had made an application to become registered.
The provider had sustained improvements to the way they managed medicines. We found medicines continued to be administered safely and people received them as prescribed.
People felt safe and well cared for. Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse. Risks were managed so that people were protected from avoidable harm and were not unnecessarily restricted.
Themes and trends in relation to accidents and incidents were reviewed and followed up with action where necessary.
The provider followed safe recruitment practice to check staff were of good character and suitable for their roles. Staffing was managed flexibly so that people received their care and support when they needed it.
People were supported by regular staff who were appropriately trained and supervised. Management observed how staff cared for people in their home to ensure their practice was safe and people received the support they needed.
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.
The care plans evidenced people's involvement in the planning of their care and support. People's strengths and abilities were recorded and the importance of empowering people and encouraging independence was recognised.
People were treated equally, without discrimination. Staff encouraged them to live as full a life as possible, maintaining their independence where they could.
People were supported with their dietary and health needs. Staff took prompt action when people became unwell or were at risk from poor nutrition. They consulted other healthcare professionals to ensure that people received the additional support they needed.
Staff took steps to ensure people enjoyed meaningful activities and stayed connected to their local community.
There were regular checks on the quality of the care provided and the management team had good oversight of the service. The provider had effective links with external organisations and health professionals to make sure people received the care and support they needed.
People, their families and staff were encouraged to share their views and contribute to developing the service. Any concerns or complaints were acted on and the provider used learning from complaints to make improvements.
The provider used information from feedback and mistakes in a positive way to improve the care provided.