The inspection took place on the 23 and 25 November 2016. We gave 48 hours’ notice in line with our methodology for domiciliary care services. This is to give people notice that we wish to visit them in their own home. The service was last inspected on the 8 January 2014 and the service was meeting all the required standards. Since then there has been a recent change in the management of the service and a new manager and deputy manager have come into post.

The service provides Housing with care. People have their own tenancies with Broadland Housing and Norse care provides care according to people’s individual needs. There is a dedicated extra care unit for people living with dementia and a separate unit for older people.

The manager is registered with the Care Quality Commission.

‘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.’

During our inspection we received mostly positive feedback from people using the service. The service supports and enables people to live independently and have their own tenancies whilst also providing variable support around their individually assessed needs.

Staffing levels were based on the assessed level of support people required with higher staffing ratios on the Extra Care Unit. Some people using the service and a number of staff told us that at times the levels of staffing were not sufficient to meet people’s needs. They gave us examples of when people’s needs had rapidly declined and they had needed additional support. Staff said the service was sometimes stretched really thinly. However within the staffing structure the team leaders, deputy manager and manager were not directly rostered on shift to provide care which meant they were able to help staff at busier times. Reassessments of people’s needs meant gaps in provision and funding could be identified and decisions made if this was the right service to continue to meet a person’s needs or if additional funding could be made available to continue to support the person.

We have made a recommendation about staffing.

Risks to people’s safety were managed as far as possible and risk assessments identified what actions staff should take to mitigate risk. Joint meetings between care and housing providers meant environmental and risks associated with care were discussed and addressed by the right service, (housing or care) with clear lines of accountability and responsibility.

People received support as required with their medicines by staff who were trained to administer medicines. Audits were in place to ensure people got their medicines as required and mistakes could be quickly rectified.

We have made a recommendation about medicines.

Staff received sufficient training to help them support people with their care needs and to assess risks to people’s health and safety. Additional training in specific health care conditions could be accessed as required and more training would benefit some of the less experienced staff.

Staff spoken with knew how to safeguard people in their care and felt comfortable in raising concerns through their internal procedures or through external agencies when this might be necessary. Staff had received training in protecting adults from abuse and said they had policies they could follow.

Robust staff recruitment processes helped to ensure that only suitable staff were employed. Once staff were employed they were supported through an adequate, induction and training programme to ensure they had the necessary skills and competencies. Supervisions had recently taken place and there were direct observations of practice linked to staff supervision and annual appraisal of staff performance.

People were supported to re

There were 39 people living at Robert Kett Court on the day of this visit. We spoke with five people and they all stated that they were happy there and felt they received good care. One person said, “I have settled in very nicely. Everyone is friendly and nice”. Another person said, “I have no complaints, the food is excellent, everything is excellent”.

People told us that staff asked for their consent before providing care and support. The provider had systems in place to ensure people’s consent was documented.

Care records were detailed and accurate. People had completed risk assessments appropriate to their needs. We noted that the care plans and risk assessments were audited and reviewed on a regular basis.

We observed the different activities available to people during this visit. Care staff spent time with people who chose to stay in their room and undertook reading, talking and reminiscing activities with them.

The people we spoke said that they felt safe in Robert Kett Court and did not have any concerns. We noted that staff had received appropriate training in relation to safeguarding and could recognise the signs of actual and potential abuse. However, the provider’s policies and procedures were out of date and referred to the previous service provider.

Staff were well supported and there was an effective training and education schedule in place to ensure they were able to meet the needs of the people who used the service.

The provider had a complaints policy and procedure and we noted that this was readily available to people who used the service, their relatives and the staff. We saw evidence that staff supported people if they wished to complain.

People told us that they felt the staff treated them with respect. They said staff knocked on their doors and waited before entering. The felt that staff were kind and did what they expected to support them. One person said that staff were getting to know how they liked things done.

One person said that staff "come and talk to me about it every so often, make sure everything is OK."

Although most people and a visitor could not confirm that they had any guidance about raising concerns, they said they would feel able to speak to the manager if they had any worries about how they were supported.