Inspection summary

About the service: Housing & Care 21 Ash Lea Court is an extra care housing scheme for older people, comprising of 48 flats with some communal areas. People who lived at the service had a separate care and tenancy agreement. At the time of our inspection, the service supported 19 people with personal care. Some people who lived at the service received care and support from another provider. Other people required social and domestic visits or welfare calls only.

People’s experience of using this service:

The safety of people who used the service was taken seriously and the registered manager and staff were aware of their responsibility to protect people's health and wellbeing. People were confident to raise any concerns they had with staff and the registered manager.

Risk assessments had been developed to minimise the potential risk of harm to people. Risk assessments had been kept under review and were relevant to the care provided.

Staff's suitability to work with vulnerable adults at the service had been checked prior to employment. For instance, previous employer references had been sought and a criminal conviction check undertaken.

People received their medicines as required, from trained and competent staff.

Staff ensured people were protected from the risk of infection.

Staffing levels were sufficient to meet people’s needs and protected them from harm. Plans were in place to recruit more staff and to increase staffing levels.

Staff had received training to meet the needs of people using the service. They had also received regular supervision and an appraisal of their work performance. The registered manager and staff demonstrated a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were supported to maintain good health, and staff liaised with external healthcare providers where appropriate to ensure that care was provided in a way that met people's needs.

People's nutritional needs were met, and people were assisted to prepare meals if they required this level of support.

People received information about the service in a way they could understand and chose how to live their lives in the least restrictive way possible.

Peoples care, and support was planned in a person-centred way and people chose how they liked their care to be delivered. People were supported by staff who were aware of people's life history and preferences and staff used this information to develop positive relationships.

Staff treated people with dignity and respect and helped to maintain people's independence by encouraging them to care for themselves where possible.

Lessons were learnt when things went wrong and systems were improved if needed. The registered manager had a clear understanding of their role and responsibilities.

The service was well-led by a dedicated management team who demonstrated compassion and commitment to the needs of the people who used the service as well as the staff who worked for them.

There were effective processes in place to monitor the quality and safety of the service.

Rating at last inspection: Good (report published 08 December 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until the next inspection. 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

This inspection took place on 30 September 2016 and was announced. The provider was given 48 hour notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office.

Housing and Care 21 Ash Lea Court is registered to provide personal care. At the time of inspection 35 people were using the service, living in their own flats and receiving support with their personal care needs from Housing and Care 21.

The care service at Ash Lea Court is provided by Housing and Care 21. People have a rental agreement with Hanover who own the flats. They also provide cleaning services, lunch time meals and entertainment for people living in the service.

At the last inspection of the service in 16 May 2014 we found the service was meeting the regulations.

The service had 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 and associated Regulations about how the service is run.

People who used the service and those who supported them knew who to report any concerns if they felt they or others had been the victim of abuse. Risks to people's health and safety were managed and detailed plans were in place to enable staff to support people safely. Accidents and incidents were investigated and action taken to prevent recurrence.

There were enough staff with the right skills and experience to meet people's needs. Staff provided people with the support they needed to ensure that they received their medicines as prescribed safely. People were supported by staff who had received the appropriate training to support people effectively.

Staff received supervision of their work. Staff ensured that people had sufficient to eat and drink independently. People had regular access to their GP and other health care professionals.

People were supported by staff that were caring and treated them with kindness, respect and dignity.

People and their relatives were involved in the planning and reviewing of their care to ensure that they received the care they wanted. People could have privacy when needed.

Care plans were written in a way that focused on people's choices and preferences. A complaints procedure was in place and people felt comfortable in making a complaint if needed.

The culture of the service was open. People were supported by staff that were clear about what was expected of them. Staff had confidence that they would get the support they needed from the registered manager. People and staff were asked for their opinions about the quality of the service.

The registered manager undertook audits and observed practice to ensure that the care provided met people's needs.

We carried out an inspection at Ash Lea Court. 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?

People we spoke with told us; "I am very happy here I just came back from hospital. Staff are doing everything they can to help me. I feel safe here. They are helping me to get back on my feet”.

People we spoke with said that they had no complaints or concerns about the care and support provided. People said they felt confident about their safety. One person told us "I feel safe here. If I am not happy I will tell my relatives or the staff but I have no complaints" and "I feel really safe here and I look forward to the staff coming to support me."

Staff were able to explain the purpose of 'whistleblowing' and how to report their concerns. One member of staff told us; "If I had any concerns I would go directly to the manager." Another member of staff told us that they felt the culture within the service was open and stated "I will report any incidents or suspected abuse regardless of who is involved. I will also contact the care direct and the care Quality Commission (CQC) if necessary”.

We saw records of a number of specific assessments for each person. These ensured care could be safely provided to people in their flats. This included falls risk assessments, moving and handling assessments and medication as necessary. There was also an assessment of any health and safety hazards. The records showed what action should be taken as a result of those assessments. This meant that systems were in place to minimise risk to people's health and safety.

All records were accurate and well maintained. We saw relevant policies and guidance were available to staff to ensure maintenance and security of all records. The service held two sets of care files, both in the office and in people’s flats. These were both detailed and up to date with the involvement of the person.

Is the service effective?

As part of the assessment process detailed information had been collated with regards to each person's identified support needs and associated areas of risk.

We saw this information had been used to develop a support plan. This ensured that staff delivered care and support relevant to the person. The risk assessments undertaken also ensured risks to the person were managed effectively to keep the person safe without undermining their independence.

We saw the current training records for staff which was maintained in staff files and on the service computer. This demonstrated that staff had attended training to enable them to keep up to date with their roles to meet people’s needs.

Is the service caring?

Care plans were person centred and updated annually or as required. People had been asked to sign to agree their care plans this ensured they were fully aware of their care. We saw that relevant information was readily available If a person was to be admitted to hospital. The information would assist staff to plan care for the person in a consistent way in the hospital concerned.

People we spoke with were satisfied and positive about the care and support they received and one person told us, "I am happy with the standard of care here, the staff are very friendly and caring."

Is the service responsive?

All care records were held at the office in files, on the computer and in the person's own flat. We saw records were regularly reviewed and amended where necessary to reflect the current and changing needs of the person.

Is the service well-led?

The manager told us the provider carried out regular contract monitoring visit. The last visit was in June 2013. Action plan was put in place to address any concerns or issues identified at the visit. We saw that the next visit had been scheduled for 21 and 22 May 2014.

Management meetings were held monthly for the managers of all four locations to share good practice and provide an update on issues within the service they needed to be aware of. This allowed managers to discuss and deal with any problems that may be common to all the locations.

Staff meetings were held every three months and when we spoke with staff we were told that they felt they were given opportunities to raise any issues. No one raised any concerns with us. This meant that staff felt able to raise concerns with the manager if they had any.

Four people who used the service agreed to meet us and kindly invited us to their flats to speak with us. People spoke positively about the service, staff and management and felt that they were fully supported with their needs. People said their care workers spoke with them in a respectful manner.

People confirmed that members of staff came at the agreed time and provided care and support for the agreed period of time. Some comments included, "Staff are lovely", "brilliant, I trust them" and "the help and support I receive is good."

We found that people's care and welfare needs were assessed and each person had a written care plan that set out their identified needs and support. The plan also set out the actions required of staff to meet these needs.

The service had a policy and procedure for safeguarding adults from abuse. Staff were aware of the procedures to follow to ensure people were protected. All of the people spoken with said that they felt safe with the care staff. This meant that staff were able to report any issues affecting people's safety.

We found that relevant training and support was provided to staff so that people's welfare and safety was promoted.

We found evidence that prescribed medicines were given to people safely.

The service carried out audits of various aspects of the service. This meant that they could be assured of the quality and safety of their service delivered to the people who used the service.

We visited the agency on 3 August 2012 as a part of this compliance review. We visited eight people in their flats. We also spoke with five staff members and four relatives

People told us they liked living in the Ashlea Court. People with told us that they were happy with the care and support they were receiving. They said that staff were respectful, supportive and friendly and they were treated with dignity.

People told us that they could choose who supported them with their care. People told us they had tenancy agreements and this had been discussed with them and where relevant their families. People told us that they had regular meetings about the care and running of the home.

People told us their care files were kept in their flats and they were involved in decisions about their care. One person said “Staff talk to me about how they will help me everyday and afterwards I see them writing on my care file sometimes I read it to find out what was written”.

People described good relationships with each other and staff and said their views on the service were listened too and acted upon.

One person told us that staff would ask for their permission before giving information to anyone and that they had the choice to accept or not. One person told us that staff gave them all information before they received any treatment. The individual told us that the doctor arranged it if they had to go to the hospital for treatment. We observed that people who used services looked happy and content.

We observed staff interacting with people who used services in a respectful and dignified manner We saw that people were participating in activities of their choice with support from staff. We observed five people participating in different activities on the day. People told us that they were enjoying their activities

People told us that staff were good and that they felt safe in their flats. They told us that they would talk to the care staff if they were not happy. People told us that they were supported to take their medication and on time.