This inspection took place on 4 and 5 July 2017 and was announced. At the last inspection completed in July 2016 we found the provider was meeting all of the legal requirements we looked at. However, we found some improvements were required under the key questions of ‘safe’ and ‘effective’. At this inspection we found that the provider had not only made the necessary improvements in these areas but had made vast improvements to the service over all.

Housing and Care 21-Winehala Court is an extra care service that contains 60 self contained flats. The service is registered with the Care Quality Commission to provide personal care to people living in these flats. At the time of the inspection there were 30 people using the service who required support with their personal care needs. People who required this care had a range of support needs, including older people living with dementia, people with disabilities and people with medical conditions such as Parkinson’s Disease.

A registered manager was 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.

People were supported by a care staff team who went over and above the call of duty to ensure they felt valued and important. Care staff were kind and caring towards people and demonstrated a high level of passion and commitment in their roles. People were enabled to be as independent as possible in all areas of their lives, including in ways they had not necessarily considered possible before moving to the service. People’s privacy and dignity were respected and promoted. People were enabled to maintain relationships that were important to them. People were supported to remain at home where possible at the end of their lives and were cared for in a kind and dignified way.

People felt the management of the service was excellent. They felt their voices were heard and that they were actively involved, consulted and contributed to the development of the service. It was evident that the provider was committed to working in partnership with people to ensure they felt consulted, empowered. People were supported by a care staff team who felt supported and motivated in their roles.

People were supported by a management team who were open, transparent and committed to a culture of continuous learning and improvement. The provider and management team had effective systems in place to ensure the quality of service provided to people was good and was continually improved.

People were supported by a staff team who knew how to protect them from potential abuse. Staff understood the risks to people they supported and how to keep them safe in an enabling way without limiting their opportunities for enjoyment and quality of life. People were supported by sufficient numbers of care staff who had been recruited safely for their roles. People received their medicines safely and as prescribed.

People were supported by care staff who had the skills they needed to care for them effectively. Care staff were led by a management team who were also well supported and had access to training and development opportunities. This originated from the provider’s dedication to endorse a culture of excellence through consultation with other leading organisations, research and reflective practice; this enabled them to continuously improve and develop. The provider had systems in place to enable them to monitor the safety and effectiveness of the service, proactively identify further areas and opportunities for development as well as sustain the improvements made. People were enabled to consent to the care and support they received. People’s rights were upheld by the effective use of the Mental Capacity Act 2005.

People

This inspection took place on 20, 21 and 22 July and was announced. At the last inspection completed on 17 March 2014 the provider was meeting all of the legal requirements we looked at.

Winehala Court is a extra care housing scheme that provides accommodation and care for up to 60 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 38 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.

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 care staff who had been recruited safely for their roles.

People were protected by medicines management systems that had recently been improved. However, some improvements were still required to ensure people received their medicines as prescribed.

Where people lacked the capacity to make decisions about, or consent to their care, decisions were not always made in line with the Mental Capacity Act 2005 (MCA) and in people’s best interests. People were supported by staff who had the skills to support them effectively in most areas of their care. Training in the MCA was not sufficient to give staff or managers the knowledge required to protect people’s rights. People were supported to meet their nutritional needs effectively. People were supported to meet their day to day health needs.

People were supported by a staff team who were caring in their approach and understood their 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 supported to maintain important relationships with friends and relatives.

People and their representatives were involved in planning and reviewing their care. The care people received met their needs and preferences and this was reflected in their care plan. People were supported to take part in leisure opportunities. People told us they knew how to complain and felt confident their concerns would be addressed by management.

People spoke highly of the management of the service and felt well supported and listened to. People were supported by a committed, motivated staff team who felt supported by the registered manager. Quality assurance checks were completed across the service to identify areas for improvement and further develop the service provided to people.

We visited Winehala Court on a unannounced follow up inspection. We had inspected in October 2013 and had concerns that people's care and welfare needs were not always met as staff had insufficient information to be able to care for people appropriately.

The manager had sent us an action plan telling us how they planned to make the required improvements. We used their action plan as the basis of our inspection. We looked at care records and spoke to staff as part of the inspection. The care coordinater sent us information to support the improvements following our inspection.

At this inspection we found the service had made improvements and people's care and welfare needs were being met through clear, effective communication.

We carried out this inspection to check on the care and welfare of people using this service. We visited Winehala Court in order to update the information we hold about the service and to establish that the needs of people using the service were being met.

Winehala Court is an Extra Care Housing provision for people aged 55 years and over. Some of the people living at the Court had care requirements; staff were available 24 hours a day to provide care and support. Winehala Court were not required to be registered with CQC for accommodation, as people were living in their own homes. They were registered to deliver personal care to people; this is the area we looked at during the inspection.

We discussed care delivery with five staff members; generally the staff were knowledgeable regarding the care requirements of people living at the court. The care plans we viewed did not hold all the necessary assessments and care plans to ensure care was delivered in a consistent manner. Systems were in place for managing and recording medication. A reporting system was in use to identify errors or concerns.

Prior to commencing work at Winehala Court staff undertook an induction. Mandatory training was available throughout the year. Staff had the opportunity for one to one discussions and meetings with the manager or a member of the management team.

We carried out this review to check on the care and welfare of people using this service. We visited Winehala Court in order to up date the information we hold about the service and to establish that the needs of people using the service were being met. The visit was unannounced which meant the provider and the staff did not know we were coming

Winehala Court was an Extra Care Housing provision for people aged 55 years and over who had care needs. Accommodation comprised of 60 flats including two respite flats. Staff were available 24 hours a day. In house facilities consisted of a shop, restaurant, hairdressing salon and a well being suite. As an extra care housing provision Winehala Court were not required to be registered with CQC for 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 used a number of different methods to help us understand the experiences of people using the service. This is because some people had complex needs which meant they were not able to tell us their experiences. We observed interactions between staff and people using the service, spoke with seven people who lived at Winehala Court, four staff members and the manager. Through a process called 'pathway tracking' we looked at care plans, spoke with people about the care they received and asked staff about how they provided support. This helps us establish whether people were getting appropriate care that met their needs and supported their rights.

During the visit we observed some good interactions from staff with people living at Winehala Court. Staff greeted people entering communal areas in a manner which was friendly, engaging and polite. We saw staff sat with people in the communal areas for a chat and sat in the restaurant enjoying their lunch together.

We viewed training records and spoke to staff about training that was available to them. The staff we spoke with told us that training was available and they were supported by the manager regarding their learning and development needs. Training records were not up to date to confirm training had been delivered.

During the inspection we looked at the process the service had in place to monitor the quality of the service provided at Winehala Court. We found systems were in place for auditing documentation within the service and saw that a satisfaction survey had been undertaken, although the results for this survey were not available at the time of the visit.