This inspection took place on 1 August 2017 and was announced.

Patching Lodge Extra Care Scheme is a domiciliary care service and is registered to provide personal care and support for people living in their own home in Patching Lodge Extra Care Scheme, a sheltered housing complex managed by a housing association. This accommodation is for people over 60 years of age and care and support can be provided to people with a physical disability or learning disability, people with a sensory loss, for example hearing or sight loss and people with mental health problems or living with dementia. Twenty four hour care, seven days a week is provided with a dedicated on-site care staff team, and with an emergency call facility. Additional services provided include a restaurant (for main meals), organised social activities, a café, shop, library and a hairdressing salon. There were 33 people receiving a service at the time of the inspection, the majority of which received the regulated activity of personal care.

On the day 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.

Following an inspection which was carried out on 15 February 2015 we found a number of areas which were in need of improvement. This was in relation to care and support plans and risk assessments not having been reviewed, there was a lack of continuity of staff providing the care calls and times the care and support was provided. Quality assurance systems had not been maintained to check the quality of the service provided and to help drive improvement. The provider sent the CQC an action plan stating what they would do to address these issues. We looked at these improvements as part of the last inspection on 27 June 2015. However, despite the improvements identified, we were unable at the inspection to determine whether these practices were fully embedded into the service. They would need to demonstrate appropriate arrangements over a defined period of time to ensure that the sustainability of good care could be achieved for people. At this inspection we found the improvements had been maintained and embedded in the service. However, we did find areas in need of improvement in relation to using feedback received to continue the development of the service. People were supported with their healthcare needs. Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately. However, recording had not always been fully maintained to evidence the administration of medicines. Feedback was varied as to the frequency of staff meetings. Records showed us meetings had been held, but recently some had been cancelled. Staff meeting minutes had not always been completed to inform care staff of agreements made, especially if they had been unable to attend the meeting.

The majority of people and their carers spoke well of the care and support provided. They told us there was now a more consistent dedicated team of care staff working in Patching Lodge Extra Care Scheme. There was now good continuity of care staff providing their care calls. They felt the registered manager had worked hard to address these areas and had listened to their concerns. People told us they always got their care call and they were happy with the care and the care staff that supported them.

Care staff told us there had been a number of changes to the staff team. However, they spoke well of the new management arrangements, and of the changes which had been made to improve the service provided. Staff told us there had been further recruitment of ca

This inspection took place on 26 June 2016 and was announced.

Patching Lodge Extra Care Scheme is a domiciliary care agency and is registered to provide personal care and support for people living in their own home in Patching Lodge Extra Care Scheme, a sheltered housing complex managed by a housing association. This accommodation is for people over 60 years of age and care and support can be provided to people with a physical disability or learning disability, people with a sensory loss, for example hearing or sight loss and people with mental health problems or living with dementia. 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 (for main meals), organised social activities, a café, shop, library and a hairdressing salon.

There have been a number of changes to the service since the last inspection of the service. The registered manager has left and there has been a period of interim management arrangements. Care and support is now only provided to people living in Patching Lodge Extra Care Scheme and not also to people living in the community. About 35 people were being provided with personal care and support with a 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 registered manager from another of the provider’s services had taken over the management of the service. An application had been made to the CQC to add a further location on the manager’s current registration so they can manage this scheme alongside another of the provider’s services.

The last inspection was carried out on 3 and 5 February 2015. We found a number of areas which required improvement. This was in relation to care and support plans and risk assessments not having been reviewed, there was a lack of continuity of staff providing the care calls and times the care and support was provided. Quality assurance systems had not been maintained to check the quality of the service provided and to help drive improvement. The provider sent the CQC an action plan stating what they would do to address these issues. We looked at these improvements as part of this inspection. However, despite the improvements identified, we were unable at this inspection to determine whether these practices were fully embedded into the service. There would need to demonstrate appropriate arrangements over a defined period of time to ensure that the sustainability of good care could be achieved for people.

Systems were in place to audit and quality assure the care provided. However, the changes made had not been fully embedded and it was not possible to evidence these systems were fully up and running and had been maintained. People were able to give their feedback or make suggestions on how to improve the service, through the reviews of their care, and through the completion of quality assurance questionnaires. There was evidence as to how any feedback was acted upon and improvements made to the service provided. People knew who to talk with if they had any concerns. One person told us, “I have not tried to talk to anyone, but I guess if I have to I’d talk to the manager.” One member of staff told us, “We are working to get this place 100 %. (Manager) is really giving this place her all, and is a very hands on manager.”

People spoke well of the care and support provided. However, they told us it had been a difficult time with a number of staff changes, and a high use of agency staff to help cover the care calls. But they felt this had starte

This inspection took place on 3 and 10 February 2015 and was announced. This was the first inspection since the service was re-registered following a change in name of the agency and an office move. We last visited the service on 27 June 2013 and we found the service met the regulations we inspected.

Patching Lodge Extra Care Scheme is a domiciliary care agency and provides personal care and support for people living in their own home in the Brighton and Hove area, or in Patching Lodge Extra Care Scheme, a sheltered housing complex. This accommodation is for people over 60 years of age and managed by a housing association. Twenty four hour care seven days a week is provided with on site care staff and an emergency call facility. Additional services provided included a restaurant (for main meals), organised social activities, a café, shop, library and a hairdressing salon.

Care was provided to adults but predominantly older people, including people with a physical disability or learning disability, people with a sensory loss, for example hearing or sight loss and people with mental health problems or living with dementia. At the time of our inspection around 130 people were receiving a service.

The service had a registered manager, who was present for the inspection. 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.

The registered manager had started working in the agency in October 2014 shortly after the re-registration of the agency. Feedback from staff and people who used the service was that this had been a very busy period, with a number of changes of staff leading to staff vacancies of senior staff and care staff. This had led to care staff undertaking extra work to cover for vacant posts and the two co-ordinators who managed a team of care staff and geographic area each also covering care calls. Procedures such as care plan and risk assessment reviews, telephone quality assurance checks, spot checks of care staff at work, staff supervision, team meetings and staff appraisal, and quality assurance audits had fallen behind and not been fully completed to meet the provider’s timescales. We have asked the provider to make improvements in these areas.

There were systems in place to keep people safe. People we spoke with said they usually got their visit from regular staff, and that staff arrived on time. They were happy with their care worker, or team of care workers who undertook their care call.

Detailed assessments of risks to people had been completed. The service employed enough, qualified and well trained staff, and ensured peoples safety through appropriate recruitment practices. One person told us, “I’m very happy with my carer.” Another person told us, “I’m happy with the way they look after me.”

There were safe procedures in place to help people with their medicines.

People told us they were involved in the planning and review of their care. Where people were unable to do this, the service considered the person’s capacity under the Mental Capacity Act 2005.

Care staff received an induction, essential training and additional specialist training in areas such caring for people living with dementia.

If needed, people were supported with their food and drink and this was monitored regularly.

The needs and choices of people had been clearly documented in their care plans. Where people’s needs changed people’s care and support plans were reviewed to ensure the person received the care and treatment they required.

People and a relative told us they were supported by kind and caring staff. Care staff were able to tell us about the people they supported, for example their likes and dislikes and their interests. People told us they always got their care visit, that they were happy with the care and the care staff that supported them. Care staff encouraged people to be involved in their care.

The registered manager, along with senior staff provided good leadership and support to the care staff. They were involved in day to day monitoring of the standards of care and support that were provided to people using the service.