Housing and Care 21 Mere View provides care and support to people living in an ‘extra care’ housing scheme and people in living in the wider community. The scheme is referred to as Mere View by people, relatives, staff and the provider. We have also referred to the scheme as Mere View in our report. Extra care housing is purpose built or adapted single household accommodation in a shared site or building. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and service. Not everyone living at Mere View received the regulated activity. On the day of our inspection 17 people were receiving a personal care service.

At our last inspection we rated the service good. 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 on going 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.

The service had a registered manager. 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.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected.

There were sufficient staff to meet people’s needs. Recruitment processes were robust and ensured that staff were of suitable character to work with vulnerable people. All staff had been subject to a check by the disclosure and baring service (DBS) and had also been required to provide references prior to commencing employment.

Medicines were administered safely to people when they needed this support. Staff were aware of the infection control measures in place to reduce the risk of the spread of infection.

Staff had received the training they required to carry out their roles effectively and new staff had also been supported to undertake a period of induction. This helped ensure that staff had the skills they needed to support people. Staff skills were regularly assessed through spot checks to ensure they knew how to support people in a safe, respectful and effective way.

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 understood the principles of mental capacity.

People were supported to access healthcare professionals when required and the service worked with a number of external agencies to ensure that people received joined up, consistent care.

Staff provided a service which was caring, respectful and promoted people's privacy and dignity.

The provider had a system in place for responding to people's concerns and complaints. People were regularly asked for their views. There were effective systems in place to monitor and improve the quality of the service provided.

Further information is in the detailed findings below

This was an announced inspection that took place on 26 August 2015.

The service comprises of 32 flats and provides a supported living service to people. Mere View is a block of sheltered living apartments on two floors with various communal areas. The building can only be accessed through the front-door by a key pad system and each flat has its own separate doorbell.

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 and associated Regulations about how the service is run.

At our last inspection of this service 24 January 2014. We found that the service was not meeting expectations in relation to complaints. Some complaints were dealt with in supervision, but for reasons of confidentiality, did not get logged on the electronic system. This meant that the provider did not receive information about all complaints that were made in the service. There was no other log kept of complaints which meant that an audit of complaints within the service was not accurately kept. The service had supplied an action plan and undertaken corrective action to resolve this situation.

People told us they were very content and happy with the service provided by caring and supportive staff. The support requirements as stated in the support plans were carried out to people’s satisfaction, they felt safe and the staff team really cared. However, people were still awaiting over six months after the events for compensation to be paid to them regarding problems with the heating system.

Records were maintained daily and were up to date and covered all aspects of the support people received. They contained clearly recorded, fully completed and regularly reviewed information that enabled staff to know the support required.

The staff we spoke with where knowledgeable about the people they supported, the way they liked to be supported and worked well as a team. Staff had appropriate skills and provided assistance in a professional, friendly and supportive way that was focussed on the individual’s choices and needs.

People and their relatives were encouraged to discuss health and other needs with staff and had agreed to information being passed onto GP’s and other community based health professionals, as required. A detailed assessment was completed prior to people moving to the service to ensure their needs could be meet.

People were protected from nutrition and hydration associated risks with balanced diets that also met their likes, dislikes and preferences. People were positive about the choice and quality of the service provided.

The staff were well trained, knowledgeable, professional and made themselves accessible to people using the service and their relatives. Staff said they had access to good training, supervision and appraisals. They felt supported and there were opportunities for career advancement. The service had a robust recruitment process.

People said the management team were approachable, responsive and encouraged feedback from them. The quality of the service provided was consistently monitored and assessed. People spoke highly of the previous manager and also of the current manager and their team. The manager worked with the local authority regarding safeguarding people and with the local hospital to ensure that people were accurately assessed prior to discharge from hospital back to their own home in this supported living service.

The service was currently without a registered manager. We spoke with the team leader, a senior manager, a care coordinator, six staff and nine people who used the service.

The care plans we looked at were detailed and up to date and staff were aware of the contents. People confirmed that staff knew their needs well, although six people told us that the quality of support could be variable. All of the people we spoke with said that staff sought their consent before giving care. One person told us, “They do things how I like them done, they don’t force their way on you.” This was confirmed by our discussions with staff. This meant that people were supported by staff that understood their needs and respected their rights to make decisions about their own care.

Some people who lived at Mere View felt that they were not asked for their views about the care they received. We found that the senior team had taken steps to improve consultation with people. However, we found that, although the service took action in relation to complaints, they had not always responded to the people concerned appropriately. This meant that people did not always feel that their complaints were listened to.

Training in safeguarding was not up to date for nine out of 16 staff but the senior team had taken steps to ensure staff were aware of their responsibilities. All staff we spoke with had an understanding of what abuse is and what action they must take if they suspected abuse was happening.

People told us that they liked living at Mere View and that staff were supportive and caring. People told us they could get help when they needed it. One person said "Staff come when I call, they always ring first before coming in." We found that care was provided according to people's assessed needs and people could make comments about the service. We found that staff were recruited and trained appropriately, and had the skills required to provide safe care. The provider had effective systems to monitor the quality of the service.