Background to this inspection
Updated
2 July 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. 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 Care Act 2014.
Inspection team
The first day of the inspection was carried out by two inspectors. The second day of the inspection was carried out by three inspectors including a medicines inspector. Two Expert by Experience made telephone calls to people and their relatives. 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 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 and support service.
There was no registered manager in post during our inspection. The new manager completed their registration during the inspection. This means that they and the provider will be legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service a short period notice of the inspection. This was because we needed to be sure that the management team would be in the office to support the inspection. The Inspection activity started on 4 May 2021 and ended 18 May 2021. We visited the office location on 4 and 5 May 2021.
What we did before the inspection
We reviewed information we held about the service since our last inspection, including records of events the provider was required to tell us about. We sought feedback from the local authority that commissioned the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
During the inspection we spoke with 14 people who used the service and 10 relatives to gather their views about the care and support provided. We spoke with 21 members of staff including a senior quality business partner, the manager, the deputy manager, an administrative officer and 17 care workers to gather their views about the service.
We reviewed a range of records including 10 care plans, risk assessment and medicines records. We reviewed four staff files including staff recruitment, training supervision and appraisals. We also looked at records used in managing the service which included policies and procedures, complaint logs, accident and incident logs, missed visits, staff rotas, daily care logs, surveys and minutes of meetings.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
2 July 2021
About the service
Carewatch (Colebrook House) is an extra care housing scheme providing support to people living in their own flats and houses across two schemes. Carewatch (Colebrook House) provides care and support to 57 flats at Colebrook House and 43 flats and two bungalows at Richard Neve. At the time of this inspection, 68 people were using the service.
Not everyone who used the service received 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
Records were not always complete, consistent, updated when required and personalised to individual needs. There were systems and processes in place for assessing and monitoring the quality and safety of the service. The improvements made had not been fully embedded across both schemes and sustained over a period of time to consistently achieve best outcomes for people.
We have made a recommendation about the infection prevention and control and supporting people with their communication needs.
People and their relatives told us they felt safe using the service and that improvements were being made to the quality of care and support received. Risk to people were identified and assessed but risk management plans were not always personalised to meet individual needs. Despite this staff knew people well and the management team was in the process of reviewing and updating all care and risk management plans to be in line with their current standards. People received care and support from staff that were supported through training, supervision and appraisal.
People were supported by staff that were kind and caring towards them. Staff supported people with activities, however, this was limited due to COVID19 restrictions.
Staff understood their responsibility to protect people from the risk of abuse and to report any concerns of abuse. There were enough staff available to support people’s needs and appropriate recruitment procedures were followed before staff started working at the service. People were supported to manage their medicines safely. Lessons were learnt from accidents and incidents.
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.
Before people began using the service their needs were assessed to ensure they could be met. People were supported to maintain good health; eat healthily and access healthcare services when required. Staff respected people’s privacy, dignity and promoted their independence. Staff understood people's diverse needs and supported them in a caring way. People were involved in making decisions about their care and support needs and knew how to complain if they were unhappy about the service.
Care and support was planned and delivered to meet people’s needs and people were encouraged to build relationships with those that were important to them.
The manager understood their responsibility for meeting regulatory requirements. We received mixed views from staff about the culture and the way the service was managed. The provider gathered the views of people, their relatives and staff to improve on the quality of service. The service worked in partnership with key organisations to deliver an effective service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 10 December 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
The inspection was carried out to monitor for improvements following our last inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led key question sections of this full report. We found no evidence during this inspection that people were at risk of harm from this concern.
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.