The inspection took place on 25 and 26 April 2017 and was announced. We gave the registered manager 48 hours notice of the inspection to ensure people we needed to meet with were available. This was a return inspection to a service we had rated as overall Good in March 2016. However, the safe area had been rated as Requires Improvement (no breach of regulations) because there were minor discrepancies with the records kept in respect of medicine administration. We followed up on this at this inspection.

The service was provided to people who lived in the Colliers Gardens Extra Care housing complex. There were 50 one and two bedroomed flats within Colliers Gardens and at the time of our inspection a care and support service was provided to 35 people. Other people in Colliers Gardens received domestic or social support from the staff team The service employed 24 staff in the care and support team, which included two team leaders and two seniors. In addition there were five bank staff who supported the service and worked when needed.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People were safe. People were protected from harm and staff and knew what to do if there were concerns about a person’s welfare. They received safeguarding adults training and were aware of what constituted abuse. They also received training in moving and handling people so were able to do this safely following the correct procedures. There were robust recruitment procedures in place which meant unsuitable staff could not be employed by the service. Any risks to people’s health and welfare were well managed and strategies put in place to reduce or eliminate the risk. Where required people were supported to take their medicines safely.

People received an effective service. The assessment and care planning arrangements in place ensured that people received the service they expected and had agreed to. Staff received the appropriate training and support to enable them to undertake their roles effectively. They were able to tell us about the people they looked after and how they supported them. People were supported to eat and drink sufficient amounts where this was an assessed need and care was provided for this purpose. People were supported to access health care services if needed.

People received a caring service. The feedback we received about the staff team was that they were kind and caring and treated people with respect and dignity. The staff spoke professionally about the people they supported and had good working relationships with them. People had the opportunity to have a say about the support they received and how their service was delivered.

People received a service that was responsive to their particular needs. They were provided with care and support that took account of their wishes and specific requirements. Their care plans were regularly reviewed and the plan of care adjusted accordingly. People’s preferences and choices were respected. They were encouraged to express their views about the service they received and were listened to.

People received a service that was well-led. The registered manager, team leaders and seniors provided good leadership and management for the staff team. There were good quality assurance systems in place to measure the quality and safety of the service. The registered manager used feedback from people and outcomes of any audits to look where improvements could be made.

The inspection took place on 15 March 2016. We gave the registered manager 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.

Colliers Garden Extra Care provides personal care and support to older people who occupy or own their own flats located within the premises at Colliers Gardens. There are 50 flats in total and at the time of our visit 39 people were receiving support with personal care.

At the last inspection of the service in 9 May 2014 we found the service was meeting the regulations.

There was a registered manager in post. 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.

We found that some aspects of medicines management were not in line with best practice. People told us they felt safe at Colliers Garden and were supported by a consistent group of staff who were kind, caring and respectful towards them. Staff were trained in safeguarding adults and understood how to protect people from abuse. Checks were carried out prior to staff starting work to ensure they were of good character to work with people who used the service.

We found there were enough suitably trained staff to deliver safe and effective care to people. People told us staff had the right skills and experience to provide the care and support they required and did not rush their care when they supported them. There were procedures for staff to follow to minimise risks to peoples’ safety such as how to manage risks associated with people’s medicines. Information in care files supported staff in managing risks and we found these were being managed so that people’s needs were met. Care plans also contained relevant information to help staff provide the personalised care people required.

Care staff helped people to prepare meals or attend the facility available in the building where a choice of nutritious meals were available. A varied programme of activities and entertainment was organised and regularly provided by the service which people could participate in if they wished. People had an opportunity to say what social activities and entertainment they would like by attending ‘tenants meetings’ where these were discussed. This helped to effectively meet people’s social care needs.

The registered manager and staff understood the principles of the Mental Capacity Act 2005 (MCA) and supported people in line with these principles. People were involved in their care and their opinions were sought about the service they received to make sure this met their preferences. The complaints about the service were investigated according to the provider’s policy. People felt confident to raise any concerns or issues with the registered manager if they needed to.

The provider and registered manager ensured people received the quality of care and services they would expect. There were processes to monitor the quality of the service people who used the service received and experienced. This was through regular communication with people and staff, checks on records, ‘Tenants meetings’ and a programme of checks and audits.

We carried out an inspection at Colliers Gardens Extra Care. This helped us to answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

All of the care plans reviewed contained an initial assessment which showed that people's needs were assessed before they started to receive support from care staff in the agency. People's assessment and care plans were person centred, and identified their current needs and choices. One person told us “everything I want is what they do for me, that makes me feel confident and safe with the staff. I am happy”.

We saw the organisations medication policy and this had been reviewed and updated regularly. All staff spoken with had received medication training and had access to the medication policy. We were told that staff were subject to competency checks, where they would be observed to ensure they administrated medication correctly.

Is the service effective?

People told us that staff asked for their consent before providing care. One person said, "staff will always ask me the things I want done. They always listen to what I have to say." The provider had appropriate systems in place to ensure information about people's mental capacity to consent to their care was documented.

Staff training was up to date and included caring for people with dementia so that they had the knowledge to support the people they cared for. Staff also told us they attended relevant training courses to inform and direct their work. We saw that they had received regular supervision and annual appraisal.

Is the service caring?

Relatives of people who used the service felt their relatives were treated with respect, their dignity was promoted and they were supported to meet their care needs, whilst being enabled to maintain and develop their independence. One relative told us “staff are kind and caring. We never have to go to anywhere else” another person told us “they are very good staff. Mum cannot do anything but they know their needs”.

Is the service responsive?

All people spoken with told us that staff took account of their personal preferences such as how they wished to have their personal care carried out. This meant that staff knew how people liked to be cared for and what their interests were. It also so enabled staff to make sure that people’s needs were met in the way that they wanted and needed in accordance with their assessed plan of care.

Is the service well-led?

We saw that people who used the service, their representatives had been asked for their views about the quality of the service and these were acted upon. Records we reviewed confirmed that service user questionnaires had been given regularly to the people who used the service and their relatives. We saw recent analysis of the questionnaire and found that these were all positive.

All of the people we spoke with confirmed that they were asked about the running of the service and any changes that they thought were needed. We reviewed recent comments and found that these were all positive. This meant that systems were in place to obtain the views of people who used the service and their relatives to ensure that the service was run and delivered in the best interests of the people who used it.

Peoples' needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at the records of five people in order to see how they were supported with their care, health and emotional needs. People had a detailed care plan which explained what their needs were and the assistance they needed.

There were enough qualified, skilled and experienced staff to meet people's needs. We spoke with the registered manager who told us staffing levels were good. We were told by the registered manager they were in the process of recruiting bank staff in order to offer a consistent service.

People were given support by the provider to make a comment or complaint where they needed assistance. People who used the service told us "I was given information on what to do if I was unhappy" and "I have details of how to make a complaint in my flat".

There was evidence that learning from incidents / investigations took place and appropriate changes were implemented. We saw evidence of a monthly fall audits which included the name of the person, how many accidents or incidents there had been and if any trends had occurred.

Records were kept for the appropriate period of time and then destroyed securely. We spoke with the manager who told us that the staff files were stored in a locked file cabinet in the office. These records were disposed of in accordance with the company's policy.

We spoke with four staff members who confirmed they had received this supervision. Staff told us "I now have more supervision with my manager and recently had my appraisal” and “I had supervision with my manager last week and find this a positive experience”.

We asked to look at supervision records for five staff. We saw evidence that staff had received regular supervision since the last inspection. One member of staff had received three supervisions since October 2012. Records were signed by the staff member and their supervisor.

We asked people who live at the service what they would do if they were worried about something, or if they were unhappy. One person said "I am happy here, I would talk to the staff or manager if I was not happy about something".

We saw that people had personalised their flats with their own furniture, televisions and computers. One person told us they were learning how to use the computer.

People expressed their views and were involved in making decisions about their care and treatment. They told us “We have lived her since the opening and we absolutely love it” and “Staff are brilliant, they are the best, always trying to promote our independence”.

We looked at other records to ensure that people’s safety was being maintained. These included cleaning schedules, fire log, and health and safety management audits. These records were up to date and in order.

We looked at supervision records for two senior staff members and one care staff and saw evidence that supervision was not being undertaken regularly. One member of staffs file did not have any supervision records in place since Oct 2011.

We spoke to people about how staff assisted them and what the care staff were like. Comments were positive about the care and the support they received. One person told us "The staff here are brilliant we couldn’t be happier”.