Blackbourne View is a domiciliary care agency. It provides personal care to people living in their own flats in a sheltered housing complex. It provides a service to adults. At the time of this announced inspection of 19 June 2018 there were 29 people who used the personal care service. We gave the service 24 hours’ notice of our inspection to make sure that someone was available.

At our last inspection of 9 December 2015, the service was rated Good overall. However, the key question for Safe was rated Requires Improvement, this was because improvements were needed in the service’s medicines procedures and processes for monitoring the management of medicines. We found the evidence continued to support the rating of Good overall and improvements had been made in the key question for Safe. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service provides a safe service to people. Improvements had been made in the medicines procedures and monitoring medicines. Where people required support with their medicines, this was done safely. There were systems in place which were intended to minimise the risks to people, including from abuse and in their daily lives. There were enough care workers to cover people’s planned care visits. Recruitment of care workers was done safely. There were infection control procedures in place to guide care workers in how to minimise the risks of cross infection.

The service continued to provide an effective service. People were supported by care workers who were trained and supported to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people required support with their dietary needs, systems were in place to support them. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

The service continued to provide a caring service. People had positive relationships with the care workers, team leaders and registered manager. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued.

The service continued to provide a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place and complaints were acted upon and used to improve the service.

The service continued to provide a well-led service. The service used comments from people and incidents in the service to learn from and to drive improvement. The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.

This inspection took place on the 9 December 2015 and was unannounced.

Blackbourne View is a housing with care complex run by Orwell Housing and is registered to provide personal care to people living within their own flats. The scheme has 34 flats. On the day of our inspection the manager told us there were 33 living at the scheme.

There was 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.

People’s safety had been considered and were at a reduced risk of harm as staff understood their roles and responsibilities. Staff had the required knowledge and knew what action to take to protect people from harm and what action to take if they had concerns.

There was a system in place to audit medication errors and determining the roles and responsibilities of staff. The provider’s policy was in the process of being updated as it did not currently provide staff with the guidance they needed in the ordering and obtaining of people’s medicines. Staff also required guidance in understanding the difference between prompting people to take their medicines and actual administration.

There were enough qualified, skilled and experienced staff to meet people’s needs. The manager followed safe recruitment practices.

Staff were provided with regular supervision, annual appraisals. This enabled staff to be supported and provided with opportunities to discuss their work performance and plan their training and development needs.

People were satisfied with the care provided. Everyone we spoke with expressed their satisfaction with the way the service was managed and the support provided by staff. People told us they felt safe and were treated with kindness and compassion. They also told us their dignity had been respected when staff supported them with personal care.

The care needs of people had been assessed prior to their moving into the service. Risks to people’s health and wellbeing were clearly identified and actions in place to minimise these.

People were provided with opportunities to express their views regarding the quality of the service they were provided with. People were knowledgeable of the provider’s system for receiving and responding to complaints.

The culture of the service was open, transparent and focused on the needs of people who live at Blackbourne View. Staff were supported by the manager who they described as supportive and approachable.

The manager had systems in place to carry out spot checks on staff performance and medicines audits. However, further work was needed to ensure the provider evidenced regular, quality and safety monitoring of the service. The manager told us the provider had recognised the need to improve their quality monitoring systems of their services and were in the process of developing audit tools to enable them to do this effectively. This would provide a focus more on the quality and safety of care provided in addition to the monitoring of the housing and financial side of the business.

We found that people living at Blackbourne View were happy with the care provided. One person said, “I wear my alarm all the time. Staff come to me within minutes”. Another said, “Staff talk to me about my care. I am involved”. Families we talked with also spoke positively. One relative told us, “We are kept informed. Mum has improved mentally and physically”.

Staff told us they were well trained and felt supported. One member of staff commented, “I have everything I need to do my job”. Although training records were up to date, it was not clear that supervision meetings were regularly recorded. The provider told us that improvements would be made.

Care plans we reviewed were person centred, relevant and up to date. We found that people were asked for consent. However, the provider may want to note that it was not clear from records how often people were involved in reviewing their care. During our inspection we found that systems were in place to monitor the quality of care provided.

We spoke with eight people during this inspection. Six people who used the service and two relatives. One relative was able to confirm that they had seen the plan of care and had signed this on their relative's behalf.

Both relatives spoken with confirmed that the plan of care reflected their wishes and preferences with regard to the way their relative received their care. The majority of people told us that the carers were reliable and that they appreciated the continuity of staff. We were told by six people that generally the staff arrived on time, although one person told us that there had been one occasion recently when they had to wait an unacceptably long time for someone to respond to their call alarm. This was fedback to the senior on duty at the end of this inspection for their attention.

People told us that generally staff took their time, that they did not feel rushed and they were given the opportunity to do things for themselves. They said that staff treated them with respect and consideration was given to their privacy and dignity at all times.

We met and spoke with four people who use the service. People were able to confirm they had personal care plans that covered the support and assistance they required.

One person told us “This is a nice place. I like it here. A girl comes and helps me out with what I need. I like my own flat and bedroom.”

Two people told us that staff always knocked on the door before entering their flats. One person told us that they thought the staff were generally kind and were helpful when she required or asked for assistance. One person had a bird table outside her patio door window and told us that staff had sometimes helped her feed the birds.