About the service: Housing and Care 21 – Westhall Court provides personal care and support to people who live in their own homes within a shared building of flats. This can be older people who may have mental or physical health needs, or people living with dementia. At the time of our visit there were 32 people who received personal care support.

People’s experience of using this service:

• People felt safe living at the service and with the staff that supported them with care.

• The provider’s recruitment procedures had ensured staff were safely recruited.

• Risks related to people’s health were identified and acted upon.

• Staff knew how to protect people from potential abuse and avoidable harm to keep them safe.

• Medicines were managed safely, and people received them as prescribed.

• There were enough staff to support people’s needs including any emergency care needs.

• People's needs were assessed before they lived at the service and staff completed training to ensure these needs could be met safely and effectively.

• People said staff were caring and kind in their approach.

• Staff knew people well, so they could provide them with care and support in ways they preferred.

• People were provided with support to access healthcare professionals when needed.

• People's right to make their own decisions about their care were respected and supported by staff who understood the principles of the Mental Capacity Act 2005.

• People’s care plans contained detailed information for staff to ensure people received the personalised care and support they had agreed.

• Staff understood the importance of respecting people’s privacy and dignity.

• People were supported to be as independent as possible.

• The provider had various quality monitoring systems to check people received safe care and support in accordance with the providers policies and procedures.

• Overall, people were happy living at Housing and Care 21 – Westhall Court. People knew of the complaints process should they have any concerns about the service.

• At the time of our visit there was a registered manager in post. They were being supported by a new manager who intended to register with us.

We found the service met the characteristics of a “Good” rating in all five areas; For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good, with ‘Requires Improvement’ in Well - led. At this inspection we found the issues we previously identified in relation to quality assurance systems, and detail within care and medicines records, had been addressed. The last report for Housing and Care 21 – Westhall Court was published on 29 December 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The previous ‘good’ service provided to people had remained consistent.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

The inspection took place on 10 and 14 November 2016 and was announced. At the last inspection completed June 2013 the provider was meeting all of the legal requirements we looked at.

Westhall Court is an extra care housing scheme that provides accommodation and care for up to 87 people. As part of the scheme the service is registered with CQC to provide personal care to people living at the scheme. At the time of the inspection there were 34 people using the service for support with personal care.

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.

Quality assurance checks had not always identified the areas where improvements were needed. Care records in relation to medicine management and health needs required more detail so staff had all the information they needed to ensure people’s needs were consistently met. The provider had not always notified us about changes in the service, for example change of registered manager and they had not kept their statement of purpose up to date to reflect these changes.

People were protected by a staff and management team who knew how to recognise and report potential signs of abuse. Staff understood the potential risks to people’s safety and knew how to reduce the risk of harm to people. People were supported by sufficient numbers of staff who had been recruited safely for their roles. People received their medicines as prescribed by their GP.

People were enabled to consent to their care and support. People were cared for by staff who had the skills to support them effectively. People were supported to meet their nutritional and day to day health needs.

People were supported by a staff team who were caring in their approach and understood people’s needs. People were enabled to make day to day choices about their care. People’s privacy, dignity and independence were promoted and they were treated with respect.

People were involved in planning and reviewing their care. The care people received met their needs and preferences. People told us that they knew how to complain and felt confident their concerns would be addressed by management.

When we inspected Westhall Court was offering personal care to 40 people.

We spoke with seven people who used the service, five staff, the care coordinator and the operations manager. Following the inspection we carried out two telephone interviews with people who used the service.

All the people we spoke with told us that they were happy with the staff. One person told us, “I can’t fault any of them they really do their very best”. Another person told us, “I don’t always know which member of staff is coming to help me, but they are all good staff”.

All the staff we spoke with knew people’s care needs and had read people’s care records so they knew how to meet their needs.

Appropriate staff recruitment checks were in place so people were protected from unsuitable staff providing care.

Systems were in place so that people received support to take their medication safely.

The provider had some systems in place for making improvements to the service.

The purpose of the review was to check that improvements had been made to people’s records for their prescribed medications. As the focus of the visit was to check records, we did not request or receive any comments from the people who were using the service. We found that improvements had been made.

Most people we spoke with who received personal care from the agency were happy with the quality of care received.

People told us that the agency had carried out an assessment before the service started and that they had a copy of the care and support plan in their home. People we spoke with were confident that they could raise concerns if they were not happy with the care being received and that they would be listened to.

People told us they were happy with the support they received and that it made a difference to their everyday living. People told us that they were treated with respect and that care staff maintained their privacy and dignity. They told us that care staff completed the care and support required. Care staff were available at all times, within the building, to make the necessary calls to people.

Westhall Court was an extra care and housing provision for people aged 55 years and over who had care needs. The accommodation comprised of 87 flats. Housing 21 were offering support to about 30 people who live at Westhall court.

As an extra care housing provision Westhall Court was not required to be registered for the accommodation, this was because people were living in their own homes. They were however registered to deliver personal care to people, this is the area we looked at during the inspection.

During our visit we spoke with seven people who used the service, four relatives, the team leader and the operations director.

We had received information from the service about medication errors, so we asked that a pharmacist inspector visited to look at medication management. We found that where people required support to take their medication the systems in place did not ensure that people received their medication safely.

People told us that staff were helpful and friendly. One person said "The staff are good they do not rush you" and another person told us "The staff are usually on time and they ask you how you want things done".

Staff we spoke with knew people's needs. Information about people's care needs was not always completed in detail and some risks to people were not identified and planned for which meant that people's needs may not be met safely.