The inspection took place on 12 December 2017 and was unannounced. The last comprehensive inspection took place in September 2016, when the service was rated requires improvement. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Housing & Care 21- Charles Court’ on our website at www.cqc.org.uk.

At our inspection in September 2016 we found that the registered provider did not have effective systems in place to monitor and improve the quality of the service. We also found that the registered provider did not ensure that all administration of medicines were accurately recorded. The registered provider sent us an action plan indicating what action they would take to address these breaches. This inspection took place to check if improvements had been made.

At this inspection we found the registered provider had taken appropriate actions to meet the requirements of the breaches. The registered provider had put monitoring systems in place to ensure policies and procedures were being adhered to.

Housing and Care 21 – Charles Court is an extra care support scheme which provides personal care for up to 40 people who live on the premises in their own flats. The service has communal areas which include a fitness suite, restaurant, lounge and hair salon. The service is situated in the Armthorpe area near Doncaster. At the time of our inspection there were 26 people receiving personal care.

At the time of our inspection 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.

Risks associated with people’s care and support had been identified and methods were in place to minimise the risk occurring. Systems were in place to ensure people were safeguarded from the risk of abuse. Staff had received training in this subject and knew what types of abuse there were and how to recognise and report abuse. We found the service had a safe recruitment system in place which ensured pre-employment checks were completed prior to staff commencing their employment. The service ensured people’s medicines were administered in a safe way.

Staff were training to ensure they had the skills to carry out the roles and responsibilities of their job. Staff felt supported by the management team. Healthcare professionals were involved in people’s support as required. People who required support with eating and drinking, received this in an appropriate way. This ensured people received adequate nutrition and hydration. Consent to care was sought in line with legislation and guidance.

We observed staff interacting with people in a caring and supportive manner. People we spoke with were complimentary about the staff and the care they received.

People received personal care that was responsive to their needs and respected their choices. People knew how to make a complaint if they needed to and felt it would be appropriately dealt with.

Audits were in place to monitor the service delivery. People felt they had a voice and were involved in decisions about the service. People who used the service had the opportunity to attend meetings and discuss events and any concerns.

This inspection took place on 12 and 15 September 2016 and was unannounced.

Housing and Care 21 - Charles Court is a domiciliary care agency and is registered to provide personal care and support for people living in their own home within an extra care scheme. An extra care scheme is, a sheltered housing complex managed by a housing association. Twenty four hour care, seven days a week is provided with on-site care staff and with an emergency call facility. Additional services provided include a restaurant, organised social activities and a hairdressing salon.

There had been a number of changes to the service since the last inspection of the service in October 2013. The registered manager had left and there had been a period of interim management arrangements. On the day of our inspection 26 people were being provided with personal care and support by dedicated team of care staff who worked in the scheme.

On the day of our inspection, there was not 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. However, the manager in post had made an application to the CQC for registration.

During our inspection, staff demonstrated knowledge of how to recognise signs of potential abuse and there were systems in place to report concerns. The manager thoroughly investigated any safeguarding matters and acted upon them in a timely manner. There were systems in place to ensure medication was administered safely. However, these were not carried out with the efficiency required to identify issues.

There were sufficient staff to support people safely according to their needs. Recruitment processes were in place to ensure staff were suitable to care for people within their own homes.

Staff received an induction. We found that staff training to ensure they had the knowledge and skills to effectively carry out their role was not always up to date. Staff told us they felt supported by the manager, yet there was an absence of documented supervision and appraisal.

People were positive about the care they received. Care was provided by regular staff who knew people well, and with whom they had developed a good rapport. People's dignity and privacy was respected.

People's care plans were personalised and met their individual needs. People were involved in their care planning, which was reviewed regularly and care was delivered according to the person's preferences and wishes.

People knew how to make a complaint about the service and records showed that they were recorded in line with the complaints policy.

Notifications concerning safeguarding had not been sent to the CQC, the manager had notified the local authority. However, they had not informed the CQC as required by the regulations.

We found two breaches of the regulations. You can see what action we told the provider to take at the back of the full version of the report.

People who used the service told us they received a good standard of care. They said staff encouraged them to make choices in all aspects of their care, treatment and support. One person told us, "I'm looked after well." Another person said staff attended for the allocated time and provided the care and support which they required.

We found care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were arrangements in place to deal with foreseeable emergencies. Staff we spoke with were knowledgeable about the procedures to follow if a person required immediate medical attention.

People were protected from the risks of inadequate nutrition and dehydration. People said they could choose what they wanted from the menus and that alternative meals were available if they preferred. One person said, "Food is good, there's a good choice, I also cook myself."

There were effective systems in place to reduce the risk and spread of infection. People who used the service confirmed staff followed appropriate standards of hygiene. We found staff had a good understanding of their roles and responsibilites in infection prevention and control and were up to date with their training.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks were undertaken before staff began work. There were effective recruitment and selection processes in place.

There was an effective complaints system available. People were given support by the provider to make a comment or complaint where they needed assistance. People we spoke with confirmed they could raise any concerns with staff and these would be acted on.

During our inspection we spoke with five people who used the service. The people we spoke with were positive about the care and support they received. They told us they were happy with the service and staff were caring. We received comments such as: "Couldn't be better, the staff are caring and look after me", "I am happy with the care I receive, the staff are polite and respectful" and "Care is great."

We found people who used the service or their representative had been involved in planning their care. Care and treatment was planned and delivered in a way that ensured people’s safety and welfare. We observed how staff interacted with people who used the service. We found staff promoted and respected people's privacy, dignity and independence.

The provider had systems in place to ensure people who used the service were protected from the risk of abuse. Staff we spoke with understood the aspects of safeguarding processes and had received appropriate training.

We found arrangements were in place to ensure staff received appropriate training, supervision and appraisal. Staff were supported to provide care to people who used the service.

Evidence showed the provider had a system in place to assess and monitor the quality of the service. There was evidence that learning from incidents and accidents took place and appropriate changes were implemented. The service also took account of complaints and comments to improve the service.