Highbury Court Flats is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates six people, with mental health issues and/or learning disabilities in their own flats. Highbury Court Flats is based in Prestwich, Greater Manchester and provides accommodation for up to six people who require personal care and support.

The inspection took place on 30 October 2018 and was unannounced. At our last inspection on 26 July 2016 we rated the service good in all domains and overall. At this inspection we found the evidence continued to support the rating of good and 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.

There was a registered manager at the service. 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.

Appropriate safeguarding systems were in place to keep people safe. Recruitment procedures were robust and staffing levels were appropriate.

Health and safety measures were in place. There was an infection control file in place with guidance for staff to follow. Accidents and incidents were recorded appropriately, and medicines systems were safe.

Care files included all relevant health and personal information and there was evidence that referrals were made to other agencies as required.

Induction for new staff was comprehensive, all mandatory training was up to date and service specific training was delivered as required.

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

Staff interactions throughout the day were respectful and friendly. People’s privacy and dignity was respected, and service had a policy and training in place regarding equality and diversity.

Care plans demonstrated that people who used the service were fully involved with their care and support planning. People were encouraged to be independent and pursue their own interests and hobbies.

There were monthly residents’ meetings where people could put forward their views and suggestions for the service. Policies were in place with regard to confidentiality and data protection.

Care files were person-centred and included information about what was important to the individual, their daily routines, strengths and gifts. People were supported to access activities, work and interests and to maintain relationships with family and friends.

People who used the service were aware of how to make a complaint and there were regular house meetings as well as annual surveys, providing opportunities for people to voice their opinions and raise concerns.

The registered manager was supported by a service manager and was accountable to a management committee. The service had good links with the community and we saw evidence of good partnership working with other agencies.

Further information is in the detailed findings below.

This was an announced inspection, which took place on 26 July 2016. We had previously carried out an inspection on 6 August 2014 when we found the service to be compliant with all the regulations that were in force at the time.

Highbury Court is a care home registered to provide accommodation and personal care for up to six people who have a learning disability or mental health needs within a complex of six individual flats. At the time of this inspection, six people were using the service.

The service had a registered manager in place. 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. The registered manager for this service was also the registered manager for four other residential services run by the provider.

People who lived at the service who we spoke with us told us they felt safe at the home. They said they could approach the registered manager, the staff or a relative if they had any worries or concerns. They were confident they would be listened to and that any problems would be sorted out.

Recruitment processes were sufficiently robust and should help protect people who used the service from the risk of staff who were unsuitable to work with vulnerable adults.

There were sufficient staff available to meet people’s needs. No outside agency staff were used by the service. This meant that people who used the service received consistent support from a staff team who knew them well.

There were systems in place to ensure the safe administration of medicines and effective infection control practices. Staff had received the training they needed to support people safely and effectively.

People had the access they needed to health and social care professionals.

People we spoke with told us that their Jewish faith and culture was observed, for example, celebrating Shabbos and buying kosher food.

The atmosphere in the service was relaxed and friendly and there was a good rapport between people who used the service and the staff supporting them.

We saw that those who used the service had person centred care records, which included easy read formats and photographs that helped people to be involved in decisions about their care and support.

People had access to a range of activities that met their individual needs and were encouraged to be as an independent as possible.

Wherever possible people who lived at the home were encouraged to maintain contact with their family and friends.

We saw records that showed that the registered manager carried out regular audits of the home’s records and health and safety checks.

All the people we spoke with told us the registered manager and the project manager were approachable and would always listen and respond if they raised any concerns.

During this inspection, we contacted the commissioner and safeguarding teams at the local authority. They raised no concerns about the service with us.

We saw that people were asked for feedback about the quality of the service they received.

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: Is the service safe? Is the service caring? Is the service effective? Is the service responsive to people’s needs? Is the service well led?

Below is a summary of what we found. The summary is based on speaking with two people who used the service and three staff members who supported them, observation and looking at records.

Is the service safe?

People who lived independently in the flats were able to maintained contact with the staffed flat via an intercom. The person we spent time with said that if they had any worries or concerns it was reassuring to know that a staff member was there. The person said they also let the staff know if they were going out and when they came back so that staff knew they were safe.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Is the service effective?

People told us or we saw that their individual needs, choices and preferences were acted upon and were respected by the staff supporting them.

People were supported by a stable staff team who knew them and their support needs well. The deputy manager told us that members of the staff team were “Very reliable.”

Is the service caring?

Interactions between people and the staff supporting them were seen to be frequent, friendly and the atmosphere was calm and relaxed.

One of the support workers we spoke with was employee of the month for July 2014. The deputy manager told us the support worker had been nominated for the award by a person who used the service. They said they had nominated the support worker for “Going the extra mile” in relation to a specific set of changing circumstances.

Is the service responsive to people’s needs?

Wherever possible people who lived at the home were encouraged to maintain contact with their family and friends. We were told that some people visited their family on a Friday evening for the Shabbos meal.

We were told that where the health needs for one person were about to temporarily change, additional staffing had been obtained to ensure they had the support they needed during their recovery.

Is the service well-led?

The manager of the home was registered with the Care Quality Commission (CQC). We saw records that showed that the registered manager carried out regular audits of the home’s records and health and safety checks.

People who used the service who we spoke with and the support workers said that they felt comfortable to raise any concerns that they had with the registered manager. The deputy manager told us that the registered manager was “very approachable and supportive.” The deputy manager received supervision from the registered manager every two months.

During the inspection, we spoke with two people who use the service. They told us they were very happy with the care they received. They told us they could choose what they wanted to do and they could take part in a number of activities.

We found that people were asked for consent and the provider acted in accordance with people’s wishes. People who use the service received care in a way that met their needs and preferences.

We found that the provider had processes in place to ensure people who use the service were protected from the risk of abuse. The people we spoke with told us that they had no concerns about the care they received. They told us they felt safe and secure.

One person told us that some staff were not always polite and talked down to them sometimes. The other person told us that a member of staff had shouted at them for showering. We spoke with the registered manager, who confirmed they were aware of the concerns raised by the people using the service and the involved member of staff no longer worked at the home.

People were cared for by staff that had been through the appropriate recruitment checks. There was an effective complaints system available, in case anyone wished to raise a complaint.

During the visit, we spoke with one person who used the service. They told us they were kept involved in their care and the staff discussed their care and support with them on a daily basis.

The person we spoke with told us they were very happy with the service they received. They told us they had no concerns around medication and told us they always received their medication on time. They also told us the staff were very friendly and supportive and were available when they needed them.

One person who lived at the flats said that they liked living there and being able to do what they wanted to, when they wanted.

A person told us that they liked the staff and that they “all the staff are very nice and very pleasant.”

We spoke with one person who told us that they did their own shopping and they were aware of the need to eat healthy. They liked fish and fruit and had plenty of food stocks in their flat. They liked their flat and told us that they had recently had a new kitchen and bathroom fitted.

We contacted the local commissioning and safeguarding teams about the home. They told us that there were no concerns about the home at the time of this review.