Pitches View is a domiciliary care agency. It provides personal care to people living in their own flats in a sheltered housing complex. It provides a service to adults. At the time of this announced inspection of 1 August 2018 there were 31 people who used the personal care service. We gave the service 48 hours’ notice of our inspection to make sure that someone was available.

At our last inspection of 21 January 2016, the service was rated Good overall. We found the evidence continued to support the rating of Good overall and improvements had been made in the key question for Safe. There was no evidence or information from our inspection and ongoing 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 continued to provide people with safe care. There were systems in place which were intended to minimise the risks to people, including from abuse and in their daily lives. There were enough care workers to cover people’s planned care visits. Recruitment of care workers was done safely. Where people required support with their medicines, these were administered as prescribed. There were infection control systems in place to reduce the risks of cross infection.

People continued to receive an effective service. People were supported by care workers who were trained to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people required support with their dietary needs, systems were in place to deliver this. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

People continued to receive a caring service. People had positive relationships with the care workers, team leaders and manager. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued.

People continued to receive a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place and complaints were acted upon and used to improve the service.

People continued to receive a well-led service. There was a new manager in post and they were building links with the local community to improve people’s lives. The service used comments from people and incidents in the service to learn from and to drive improvement. The service had a quality assurance system and shortfalls were identified and addressed. As a result, the quality of the service continued to improve.

Further information is in the detailed findings below.

Pitches View is extra care sheltered accommodation providing personal care to people living in their own flats. When we inspected on 21 January 2016 there were 24 people using the service.

This was an announced inspection. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available.

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 we spoke with including their relatives were complimentary about the care provided. They told us they received safe and effective care by care workers who were kind and compassionate.

Systems were in place which safeguarded the people who used the service from the potential risk of abuse. Care workers knew how to recognise and report any suspicions of abuse. They understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

There were sufficient numbers of care workers who had been recruited safely and who had the skills and knowledge to provide care and support to people in the way they preferred. People were treated with kindness by the care workers. Care workers respected people’s privacy and dignity and interacted with them in a caring and compassionate manner.

People received care and support which was planned and delivered to meet their specific needs. People and/or their representatives, where appropriate, were involved in making decisions about their care and support arrangements.

Where required people were safely supported with their dietary needs. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

There was an open and transparent culture in the service. The management team demonstrated good leadership skills and care workers said they felt valued and supported. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. The service had a quality assurance system with identified shortfalls addressed promptly; this helped the service to continually improve.

We spoke with eight people during our inspection. Three people we visited in their homes, four people we spoke with in the communal areas of Pitches View and one person by telephone. All eight people told us that they were very happy with the service they were provided with. One person said, “I am very happy here thank you. I have no complaints. I have settled in nicely and they (staff) are helping me to maintain my independence to do what I want, when I want.” Another person told us, “Coming here has given me a new lease of life. I can sleep easy at night as help is on hand if I need it.”

People who used the service told us that they were consulted about the care and support that they were provided with and understood the care and treatment choices available to them. One person told us that they had been involved in a review of their care with relatives, the service and other healthcare professionals and felt they had been listened to. They said, “I spoke with lots of people involved in my care and told them I was very happy with what was in place and had no complaints or changes to make. All is in order”.

We looked at five people’s care records which provided information for staff on how to meet individual’s health and care needs. We saw that people’s choices and preferences were reflected in the care records and written in a way that promoted independence.

People we spoke with told us they felt safe at Pitches View and trusted the staff. They confirmed they felt well looked after by staff and their needs were met.

We saw that the service provided enough qualified, skilled and experienced staff to meet people’s needs. We looked at staff records and spoke with two members of staff who told us they were being appropriately supervised and supported. They told us how they were able to meet people’s needs and were knowledgeable about the people they supported.

We saw that the provider had systems and procedures in place to regularly monitor and assess the quality of the service provided.

During our inspection we observed that the interaction between staff and people using the service was friendly, respectful and professional. Staff respected people’s privacy and dignity and sought their agreement before providing any support or assistance.

We visited four people who used the service to hear their views. We also spoke with visiting health and social care professionals. People told us they would be happy to recommend the service to others. One person told us they would “Absolutely” recommend the service as “They couldn’t fault it.”

People we spoke with were well informed about the service they received. They told us staff worked with them to identify the level of care and support they wanted. Staff had then written this information into a care plan for people to keep as a record of their discussion. We saw that people were involved in reviews of their care. This meant that people could raise any issues or changes they would like made to their plan of care.

People told us staff gave them the agreed level of support and care. They told us staff acted in accordance to their wishes. Three out of the four people said that they found staff to be approachable and treated them in a respectful manner. One person said they found staff to be “Always very polite.” Another person gave us an example where they felt that staff could have been more respectful. The registered manager said the issue would be addressed through further staff training.

People told us they had confidence in the staff’s abilities to support their individual needs. They gave us examples where staff had advocated on their behalf to obtain equipment or supported them to retain their independence.

People knew who they could talk to if they had any concerns. When we visited people we saw that people had been given a copy of the formal complaints procedure. One person felt that all the staff were nice which was the reason they “Hadn’t needed to make a complaint.”

We were given several examples of how staff supported people to maintain their independence and ensure their rights were upheld. We observed how staff worked with health and social care professionals to ensure this. This included supporting people to access entitled benefits and specialists to meet their needs.

Our inspection of 11 October 2011 found that staff did not receive sufficient training to support people with their increasing dementia and mental health needs. The provider wrote to us to say they had taken action and arranged for staff to attend further training in dementia care.

The focus of this visit was to check what action had been taken. Records and discussions with staff confirmed that relevant training was now in place. We spoke with a social care professional. They felt that staff were managing a person’s dementia needs quite well. They felt the person was being supported to improve their wellbeing.

One person using the service told us they had observed staff “To be very understanding, incredibly patient and tolerant” when supporting people living with dementia.

We observed good interaction between a member of staff and a person living with dementia. We heard them instigate meaningful conversation which the person could relate to. This showed they had a good insight into the person’s family life to be able to do this.

We visited two people in their own homes to hear their views of the service. We also met people who used the service at a tenants meeting to gain their feedback. Visiting health and social care professionals also gave us feedback. People using the service told us they were well informed about the service they received. They told us staff worked with them to identify the level of care and support they wanted. Staff had then written this information into a care plan for people to keep as a record of their discussion.

People told us staff gave them the agreed level of support and care and that staff mostly visited them when they said they would. We were told that if there was a delay, it was normally due to an unforeseen emergency. One person told us that it gave them comfort to know that if they ever required help in an emergency, staff would be around to give it.

People told us they had confidence in the staff’s abilities to support their individual needs. The majority of people found staff to be approachable and treated them in a respectful manner. Where they had not, they said they had reported the incident so it could be looked into. People knew who their support carers were, who was in-charge, and who they could talk to if they had any concerns.

We were given several examples of how staff supported people to maintain their independence and have a say in how the service is run. This included completion of annual survey and monthly attendance at the tenant’s meeting.