This inspection took place on 15 and 17 November 2016. The service was last inspected in May 2013 and met the regulations we inspected against at that time.

Housing & Care 21 – Cambrian Green Court provides an 'extra care' service to people living in their own flats. There were 60 flats in the main building and 10 cottages set behind the flats. Extra care housing supports people to live as independently as possible, with the reassurance of onsite care support when needed. At the time of the inspection the service was supporting 37 people with personal care. Not everyone living at Cambrian Green Court required assistance with personal care, some had support with domestic duties such as cleaning and shopping. This did not fall within the scope of registration with the Care Quality Commission.

The building was owned by Housing & Care 21.The accommodation did not fall within the scope of registration with the Care Quality Commission.

A new manager had been appointed and was available during the inspection. The registered manager left in July 2016, and a new manager had been appointed. However they had resigned and left in October 2016. 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.

Staff had a good understanding of safeguarding and knew what to do if they were concerned about the welfare of people or an allegation of abuse had been made. Any safeguarding concerns were investigated with the outcomes fed back and practices changed if necessary in order to prevent reoccurrences. People had risk assessments to keep them safe whilst receiving personal care. This included environmental risk assessments. People told us they felt safe whilst being supported by staff. Staff were recruited in a safe and consistent manner.

Medicines were managed safely with people receiving their medicines appropriately. All records were complete and up to date with regular medicine audits being carried out. Where errors had taken place, appropriate action had been taken to protect people, including additional training and observations of staff practice.

There was sufficient staff to meet people’s individual needs. People told us staff turned up on time and stayed for the full duration of the visit.

People had access to a range of health professionals when required. Some people looked after their own health care appointments. People’s nutritional needs were being met. There was a communal dining facility on the premises that operated Monday to Friday which people could use if they wanted.

People had their needs assessed and clear plans of care were in place about how the person wanted to be supported. These were personalised and up to date. People were very much involved in their care. There was an emphasis on encouraging people to be independent as possible enabling them to live independently in their own flats.

Staff were consistently caring and supportive and demonstrated a good understanding of their roles in supporting people. Staff received training and support that was relevant to their roles and the people they supported.

People told us they knew how to make a complaint and would feel comfortable in doing so. They confirmed they had no complaints about the care they received. People’s views were sought periodically through care reviews and surveys. The management team regularly visited people to check if people were happy with the service being provided.

People were provided with a safe, effective, caring and responsive service that was well led. The registered provider was aware of the importance of reviewing the quality of the service and was aware of the improvements that were needed to enhance the service.

People had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint. People told us "If I was unhappy I would go to the office and feel I would be listened to” and “The staff would do their best to ensure my complaint was dealt with”.

People were given support by the provider to make a comment or complaint where they needed assistance. People living in the home told us "I received a copy of the complaints procedure when I first moved here" and "Staff encourage me to talk if I am unhappy".

Records were maintained of 'Resident meetings'. These clearly demonstrated people were supported to make decisions about activities and choices of daily living. We saw evidence that ‘residents meetings’ were planned and minutes from previous meetings were displayed in the main entrance.

We spoke with staff who confirmed that staffing levels were good at the home. They told us "We have a very good staff team and generally staffing levels are good” and “We cover the daily runs very well to ensure service users do not have missed calls”.

Staff we spoke with told us that they regularly reviewed people's care plans, audited daily record sheets and involved the people in the process. We saw evidence of this when we looked at care records.

We spoke with 12 people receiving a service and a visiting relative. Comments were positive about the care and support they received. One person told us "the staff here are wonderful, things have improved so much over the past six months and I wouldn’t want to be anywhere else”.

People told us they had access to their care records and these were present in people’s homes. People told us that the care manager had sat with them to discuss what was recorded. People using the service had signed their care documentation and, where relevant, a family representative had been involved.

People confirmed that the service listened and acted appropriately to most requests. One person said "when I was grieving the staff took time to listen and to support me, both emotionally and physically, they couldn’t do enough for me”, another person told us “there is a mixed range of age and experience amongst the staff team and I believe that this works well in their approach in caring for us”.

Another person told us, “I was ill over the weekend, really low, the care manager came in on their day off to speak to me and to check that I was alright, this was over and above the call of duty and I am very thankful to them”.

People told us how staff had supported them to maintain their independence, one person told us “staff support me to keep mobile and encourage me to do as much as I can for myself, this motivates me and keeps me going”.

People told us the staff treated them with respect and were very caring. We observed staff spoke to people in a polite and respectful manner, asked people for their views and acted appropriately in response.

People using the service had information to enable them to make a decision on whether to move to the service. This included a statement of purpose and a service user guide. This information was available in each of the information packs within people’s homes.

People were registered with a local GP, dentist and opticians. A relative told us "this is an excellent service and would highly recommend it. The staff are really kind and caring and we are always made to feel welcome".

People seen during the visit looked well cared for, we observed staff interacted with individuals in a positive and caring way.

People told us; “I have no worries, I have friends here and we all get along”, another person told us “I have made a formal complaint in the past and this resulted in improvements, things are so much better here now, I have no complaints”. Other people we spoke with assured us that they were happy. People gave us the names of staff they would tell if they had any concerns

People told us the service obtained their views through regular meetings and care

reviews. People also told us that they had been recently consulted by the provider and asked for any ideas or suggestions that would improve the service.