Archived: Saxon House

Updated 3 September 2021

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service provides care 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 service. The service offered support as a small domiciliary care agency and provided personal care to people living in their own houses and flats in the wider community.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced. Inspection site visit activity started on 12 November and ended on 13 November 2019. We visited the office located in the housing complex on both days.

What we did before the inspection

We reviewed any notifications we had received from the service. A notification is information about important events which the service is required to tell us about by law. We had not asked the service to complete a Provider Information Return since their last inspection on 11 March 2019, but we reviewed the last one they sent us. 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. We also reviewed any information about the service that we had received from members of the public and external agencies. We used all of this information to plan our inspection.

During the inspection

We looked at records relating to seven people’s care from within the housing complex and from the wider community. We also looked at four staff recruitment records, training records and complaints. We also looked at what audits and systems they had in place to check on the quality of service provided. We spoke with the registered manager, community care manger and acting care coordinator, office administrator and the area manager. We also talked with five people using the service who lived within the housing complex, one person who lived in the wider community, and one person’s relative.

Updated 3 September 2021

About the service

Saxon House is a domiciliary care service that supports people with their personal care needs in their own homes or flats both in the community and in an extra care housing unit where the service was based. Extra care housing is purpose built or adapted single household accommodation in a shared site or building. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care provided by the service. Not everyone being supported by Saxon House received the regulated activity of personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. On the day of our inspection 35 people were being supported with their personal care in the extra care housing unit and 21 people in the wider community.

In May 2018 Hales Group Limited registered Saxon House to provide the regulated activity of personal care. The previous organisation continued to manage the extra care housing accommodation and are responsible for the upkeep of people’s flats and the communal areas. This meant Hales Group Limited only provided personal care to the people living in the extra care complex, within their contracted hours and are not responsible for who moved into the flats or providing care or supervision outside people’s contracted care times. The previous organisation had provided activities and other services, without charge, that were outside their remit as a registered domiciliary care agency. This has led to misunderstandings and expectations from the service that are outside their remit. Hales Group Limited are not obliged, under their registration with the Care Quality Commission (CQC), to offer or arrange activities within the housing complex or out in the local community.

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

People’s care plans were person centred and gave staff the information they needed to be able to meet people’s needs. However, people told us they did not know which staff member was going to work with them and sometimes staff they had not met before arrived to support them with their personal care needs. Nor did people have consistency in the staff that attended to them. One person told us in the previous nine days they had received care from nine different staff members.

The registered manager was supported by the organisation and staff told us they were open and supportive. There were quality assurance systems in place to monitor the quality of service the organisation offered people. However, the governance systems in place had not yet ensured people received their visits when they needed them and from consistent staff.

People who used the service were protected from bullying, harassment, avoidable harm and abuse by staff that were trained to recognise abusive situations and knew how to report any incidents they witnessed or suspected. People were protected by staff that had been safely recruited.

Risks were assessed, and steps have been put in place to safeguard people from abuse. Risks to individual people had been identified and action had been taken to protect people from harm.

Staffing levels were rotated at sufficient levels. However, staff absences, short notice sickness for example, meant people’s care visits were sometimes late and on occasion missed without notice. People were supported with their medicines in a way that ensured that people received them safely.

People received care from staff that had the knowledge and skills they needed to carry out their roles. People were asked for their consent by staff before supporting them. People were supported to eat and drink enough to maintain a balanced diet. People were also supported to maintain good health and access healthcare services.

We saw examples of positive and caring interaction between the staff and people using the service. People told us they were able to express their views, staff listened to what they said and took action to ensure their decisions were acted on. Staff protected people’s privacy and dignity.

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 requires improvement (published 11 March 2019).

Why we inspected

The inspection was prompted in part due to concerns received about people’s safety. A decision was made for us to inspect and examine those risks. Prior to the end of the inspection it was confirmed to us that the concerns were not all substantiated, and the provider had investigated those area of concerns raised with us.

Follow up

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