Emily Bray House 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.

Emily Bray House consists of 45 self-contained one and two bedroom apartments over two floors. At the time of this announced inspection of 6 and 7 December 2017 there were 34 people who used the service. The provider was given up to 48 hours’ notice because we wanted to be certain the registered manager and key staff would be available on the day of our inspection. We also wanted to give them sufficient time to make agreements with people so we could visit them in their homes to find out their experience of the service. This service was registered with CQC on 10 June 2011.

At the last inspection of 29 October 2015 the service was rated Good. At this inspection we found that the service remained Good.

A registered manager was 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.

The service continued to provide a safe service to people. This included systems intended to minimise the risks to people, including from abuse, mobility, accessing the community, nutrition and with their medicines. Care workers understood their roles and responsibilities in keeping people safe.

Recruitment checks were carried out with sufficient numbers of care workers employed who had the knowledge and skills through regular supervision and training to meet people’s needs.

People told us that they felt safe and well cared for and had developed good relationships with the care workers and the registered manager.

People were able to express their views and care workers listened to what they said and took action to ensure their decisions were acted on. Care workers consistently protected people’s privacy and dignity.

People were supported to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services. Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

People received care that was personalised and responsive to their needs. People’s care records were comprehensive and accurate. This ensured they received care and support which was planned and delivered to meet their specific needs in accordance with their wishes.

People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service listened to people’s experiences, concerns and complaints and took action where needed. People, relatives and staff told us the registered manager was accessible, supportive and had good leadership skills. The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to progress.

Emily Bray House provides personal care to people living in their own flats within a very sheltered accommodation scheme. When we inspected on 29 October 2015 there were 32 people using the service. This was an announced inspection. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available.

There was no registered manager at Emily Bray House. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. Since our last inspection a manager had been appointed by the provider to run the service and was in the process of registering with the CQC.

People we spoke with including their relatives were complimentary about the care provided. They told us they received safe and effective care by care workers who were compassionate, attentive and kind.

Systems were in place which safeguarded the people who used the service from the potential risk of abuse. Care workers understood the various types of abuse and knew who to report any concerns to. They understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

People were treated with kindness by the care workers. We observed care workers respect people’s privacy and dignity and interact with them in a caring and compassionate manner. There were sufficient numbers of care workers who had been recruited safely and who had the skills and knowledge to provide care and support to people in the way they preferred.

People or their representatives, where appropriate, were involved in making decisions about their care and support. People received care and support which was planned and delivered to meet their specific needs.

Where people required assistance with their dietary needs there were systems in place to provide this support safely. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

The atmosphere in the service was friendly and welcoming. People received care that was personalised to them and met their needs and wishes. Care workers listened to people and acted on what they said.

There was an open and transparent culture in the service. All the staff we spoke with were passionate about their work and understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The management team demonstrated good leadership skills and care workers said they felt valued and supported.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. The service had a quality assurance system with identified shortfalls addressed promptly; this helped the service to continually improve.

Four people we spoke with told us that staff always included them in the delivery of their care. They told us that staff always respected their privacy and listened to and responded to their wishes. One person said that staff were, "Very good to me." Another person said they were, "Very helpful."

People told us that they were always given choices for their meals and staff told us that they would report any concerns regarding people's nutrition for further investigation.

People said they felt safe and had no concerns about the care provided. They told us that they felt confident to express any concerns they might have.

We spoke with three staff members who said they received regular training, supervision and felt well supported.

The premises were in a good state of repair and the provider had a robust auditing system in place to ensure the safety of the people who used the service.

We found shortfalls in the provider's record keeping. This meant that there was insufficient evidence to show that people were being cared for safely and appropriately.

We visited four people in their flats and spoke with them about their views of the service that they were provided with. They told us that they were consulted about the care and support that they were provided with and the care workers listened and acted on what they said. One person said that they were "Fully consulted" when we asked them if they felt that they were consulted about their care.

People were provided with a copy of their care plans and the care workers supported them with the care that they had agreed with in their care plans. They told us that they felt that their needs were met and comments made by people included "Everything is fine, could not be better cared for," "They do look after me" and "They look after me well."

We asked people if they felt that the care workers treated them with respect. One person said "Definitely." Another said "They (care workers) are very nice indeed." Another person said "They (care workers) are wonderful."

During our inspection on 3 April 2013 we found shortfalls in the care records of people who used the service. We completed a follow up inspection to determine whether improvements had been made. We found that the provider had taken appropriate action to update the records of people who used the service.