About the service:

Bowling Green Court (Chester) Limited is an Extra Care Housing Scheme that was providing personal care to five adults at the time of the inspection.

People’s experience of using this service:

The provider had made a number of positive improvements to the service since our last inspection.

A review had been undertaken of medicines management and improvements made. This ensured that people received their medicines safely and as prescribed.

Steps had been taken to improve the governance of the service with better checks and audits being in place to determine the quality of the care.

The provider and registered manager had made improvements to achieve compliance with the regulations and to ensure that they provided a safe and reliable service.

People who used the service were positive about the impact it had on their lives: enabling them to remain as independent as possible within their own homes. They said that staff were kind, considerate and competent.

There was a range of activities on offer and staff encouraged people to participate in things of interest to them

Clear care records ensured that staff had the information they needed to provide a personal and effective service to people. A regular review of people’s care was undertaken to ensure all of their support needs were met in line with the person’s wishes.

The registered manager worked in partnership with health and care professionals and the local community to ensure support was sufficient and coordinated.

Staff received a robust induction, on-going training and support so that they could be effective in their roles.

The service met the characteristics for a rating of ‘good’ in all of the key questions and therefore our overall rating for the service has improved to ‘good’.

More information is in our full report.

Rating at last inspection:

At our last inspection, the service was rated as ‘requires improvement’ overall. Our last report was published on the 22 March 2018.

Why we inspected:

All services rated “requires improvement” are re-inspected within one year of our last inspection. This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Following the last inspection, we asked the provider to complete an action plan to identify the action they intended to take to ensure the service met all of its legal requirements and to improve the key questions Safe and Well Led to at least a rating of good. This inspection checked whether they had made the required improvements.

Follow up:

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Bowling Green Court Limited (Chester) is a domiciliary care service. A domiciliary care service provides people with support with personal care in their own homes.

This service provides personal care and support to some of the people who live in their own apartments in a purpose built complex called Bowling Green Court. This inspection was undertaken on the 02 February 2018 and was announced. At the time of our inspection, eight people used the service.

At the last inspection the service was rated good. At this inspection we found that some improvements to the service were needed. We identified a breach of regulation 12 of the health and social care act with regards to the management of people’s medications and the way in which the provided monitored the quality and safety of the service required further development. This meant that the domains of safe and well-led were rated requires improvement.

In the domains of effective, caring and responsive we found the service to be good. People we spoke with were more than happy with the support provided. They told us staff were kind and caring and supported them with the things that they needed help with. They said that staff members turned up on time, supported them for the length of time agreed and that they felt safe and confident with the staff members who supported them. People were equally as complimentary about the registered manager and it was clear that they were highly thought of.

People’s care plans and risk assessments were in the majority satisfactory. One person’s skin integrity and moving and handling risks had not been properly assessed but the registered manager took action to rectify this both during and after our inspection.

We saw that people’s care plans were person centred. This meant they contained information about people’s individual needs, their support requirements and their preferences with regards to how their support was provided. It was clear that people had been actively involved in discussing and planning their own support package.

None of the people who used the service lacked capacity to make decisions. People who lived with signs of dementia were supported appropriately and their consent obtained in the day to day delivery of support.

People who needed support with meal preparation had this support provided and the staff we spoke with were aware of people’s dietary likes and dislikes.

Staff recruitment was safe and staff had received appropriate support in their job role. Staff training was satisfactory and we saw that additional training had been booked for staff over the next few weeks. Staff we spoke with felt well trained and told us that the registered manager was supportive and approachable.

The number of staff supporting people at any one time was sufficient and the registered manager had a clear rota that ensured each person’s support was delivered in accordance with what had been agreed with them.

The registered manager told us no accidents or incidents had occurred during the delivery of the service and said that no safeguarding concerns had been reported by any of the people in receipt of support. People we spoke with told us they had no concerns or complaints about the service.

We saw that a satisfaction survey was completed by people who used the service to enable the provider to come to an informed view of people’s experience of support. The surveys we looked at showed that people were pleased with the support they received and that the staff team were highly thought of.

The range of checks in place to monitor the quality and safety of the service required further development to ensure that the risks to people’s health, safety and welfare were properly managed. However during our visit, it was clear that people felt the service was well-led. We found the registered manager to be passionate and committed to providing a good service and they were open and receptive to our feedback.

We visited this service on 25 February 2015 and we gave short notice to the service that we were visiting. This was to ensure that people were available at the office.

Bowling Green Court is a domiciliary care service that provides care and support to people living in the complex known as Bowling Green Court. At the time of this report they were supporting twelve people in the apartments.

The service has a registered manager in place. 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 told us that they were happy with the staff at Bowling Green Court and they felt that the staff understood their care needs. People commented “The staff are pleasant” and “Staff are very friendly and caring.” People confirmed that staff stayed for the length of time allocated and arrived on time. People also confirmed that calls had never been missed and that a duty manager was always available. All the people we spoke to had no complaints about the service.

We found that people were involved in decisions about their care and support. Staff made appropriate referrals on behalf of people who used the service, to others such as the GP, where it had been identified that there were changes in someone’s health needs. During discussions with the staff we saw that they understood people’s care and support needs, and the staff members we observed were kind, thoughtful and respectful towards the people they were supporting. We saw there was a friendly and warm atmosphere between people who used the service and staff.

The care records contained information about the support people required and were written in a way that recognised people’s needs. This meant that the person was put at the centre of what was being described. The records we saw were completed and up to date.

The provider had systems in place to ensure that people were protected from the risk of potential harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults.

We found that good recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service. Therefore people who used Bowling Green Court could be confident that they were protected from staff that were known to be unsuitable.

We looked at three care records and all had an assessment of their health and social needs. There were individual support plans and risk assessments in place. This meant that the service could demonstrate they could meet the people’s needs.

We spoke with three people who used the agency and three staff together with observations during the lunchtime period. Comments included “The staff are very good”, “Its lovely here. I’m well looked after” and “The food is very good.” Observations during lunchtime saw people being treated in a dignified manner and with good responses to requests. There was lively banter and friendly exchanges made between service users and the staff on duty.

We looked at four staff files and found that all appropriate employment checks had been carried out and the files were well presented. Staff had regular supervision sessions and annual appraisals. Staff had also undertaken a range of training in line with the specific needs of their role. Staff confirmed that the training was good, interesting and helpful to their role. They said that the staff team were very good and supportive to each other. They also said “The duty managers are supportive and that they are strict sometimes but fair.” They also said the registered manager was professional and encouraged a good and happy atmosphere.

We saw that the agency had not received any formal complaints in the last year and the Commission had not received any complaints about Bowling Green Court.

We spoke with three of the ten people who used the agency. They told us that the staff were kind and caring and that they were given support to be as independent as possible. People said "The staff are very good", "The staff always arrive on time", "The staff are excellent" and "The staff always stay for the allocated amount of time."

We spoke with six staff members on duty and the registered manager. The staff commented "If I had any concerns I would speak to the manager", "The staff team get on well together", "The manager is good and you can approach her with any problems", "I like caring for people and the mix of tasks I do" and "I have just completed my NVQ level 2 in care."

The people who use the service are supported by staff who are employed by Bowling Green Court Domiciliary Care Agency. The service primarily supports people who live in the apartments at Bowling Green Court but can also support people living in the local community.

We spoke to seven people who use the service and they said:

“The care staff are very good”

“They were very happy with the system of support they were receiving”

“Generally the staff kept to the times that had been pre-agreed”

“The carers are very nice and I have no complaints. They do everything I ask them to do”

“The staff and good and friendly and she has no complaints”

“They usually arrive at the same time each morning and they were asked beforehand at what time they would like the visit each day”

“The carers are fine, you couldn’t ask for better”

“They will do anything for you and my carer is a great girl”

“They help me with everything I need”

“The staff are very good and they keep an eye on me.”

We spoke with staff and they commented:

We also spoke with the manager, the staff team working in the office and other staff.

They commented:

‘My line manager is supportive’

“I like my work here”

“The manager is very good and approachable”

“I like working at Bowling Green Court”

“I get good support from the duty managers and they respond to owners needs as necessary”

“The training is good here.”