Archived: Housing & Care 21 - Cranbrook

Updated 21 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 27 July and 3 August 2016 and was announced. We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available for the inspection.

The inspection team consisted of one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Before our inspection we looked at and reviewed all the current information we held about the service. This included notifications that we received. Notifications are events that the provider is required by law to inform us of. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with two people who use the service, a relative and a visiting social worker on the day of the inspection and two people, and four friends or relatives by telephone after the inspection visit. We also spoke with three members of staff, the manager, the operations manager and the nominated individual. We talked to the local authority safeguarding and service commissioning teams. We reviewed the care records and risk assessments for five people who use the service, recruitment records for four staff, training records for all staff and supervision and appraisal records for three staff. We reviewed quality monitoring records, policies and other documentation relating to the management of the service.

Updated 21 September 2016

Housing & Care 21 - Cranbrook is a domiciliary care agency. The service provides personal care for people residing in supported living properties in a purpose built block of flats. The people the service supported had a wide range of needs including dementia, older people and people with a learning disability. At the time of the inspection 41 people were being supported by the service.

The service did not have a registered manager, although the current manager told us they intended become registered with us. 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.

People who use the service were not always safe. Risk assessments were inconsistent, and had not always been completed. People were supported to take their medicines safely when needed. People who used the service told us they felt safe and staff knew how to recognise the signs of abuse and what to do if they thought someone was at risk.

Although there were enough staff to meet people’s care needs the provider was using a lot of agency staff to provide care. Feedback about the agency staff was mixed, with most people commenting that agency staff did not know their care needs as well as permanent staff. Staff did not have regular training, but supervisions and appraisal was up to date. All of the appropriate pre-employment checks had been completed before staff began working for the provider. Comments from people about staff included “they’re so good”, “Most of the staff know what they are doing”, and a relative said, “I can’t fault the carers. They know their job”.

People’s care needs were not always regularly assessed. The manager was working to ensure that people and those important to them were involved in making decisions about their care. People knew how to make a complaint or raise concerns with the manager and told us these were acted on when they did so. There was an appropriate complaints system in place and any complaints had been thoroughly investigated.

People were asked for their consent appropriately and the manager and staff had a basic understanding of the Mental Capacity Act 2005 (MCA). This legislation provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make decisions for themselves. People were treated with respect and their privacy was protected and the manager and permanent staff knew the people they cared for well and spoke about them in a kind and caring way.

Incidents and accidents were reported and investigated, but not always fully analysed to assess if there was any action that could be taken to prevent the incident from happening again.

The provider had carried out audits to ensure they were meeting the requirements of the regulations. However, concerns that had been identified were not addressed due to a lack of senior manager oversight. This had now been addressed and plans were in place to make sure the improvements made by the manager were continued. People were asked for their feedback about the quality of the service, and told us where areas for improvement were identified appropriate action was taken.

The manager knew the people who use the service well and was aware of the attitudes and behaviours of staff.