About the service:

Sanctuary Home Care Ltd – Stoke provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care. At the time of the inspection there were ten people being supported with personal care living in the scheme. People had a range of support needs such as people living with dementia, people with mental health needs, older and younger adults and people with a physical and/or sensory impairment.

The service was also registered for domiciliary care for people living in their own homes in the community; however, the service was not currently supporting anyone with this.

People’s experience of using this service:

People felt safe and risks were mitigated. There were enough staff to ensure people received timely support. People received their medicines. Lessons were learned when things went wrong. People were protected from cross infection as appropriate measures were in place.

People had their needs assessed and had access to other healthcare professionals when needed. People were supported to have food and drinks appropriate for their needs. The principles of the Mental Capacity Act (2005) were being followed.

People were treated with dignity and respect by staff. People had a choice and were able to make decisions about their care whilst being supported to remain independent.

People received personalised care that met their needs. People knew they could make a complaint if they needed to and these were responded to. No one was nearing the end of their life at the time of the inspection, however the provider had considered the plans people may need and had developed templates in readiness.

People, relatives and staff found the registered manager and head of care approachable and supportive. The service worked in partnership with organisations and sought feedback from people who used the service to make improvements.

Systems were in place to monitor the care people received and improvements were made when necessary. People were asked for their opinion about their care. The service worked in partnership with other organisations. The previous inspection rating was displayed and notifications were submitted as necessary.

Rating at last inspection:

Requires Improvement (report published February 2017)

Why we inspected:

We planned the inspection based on the previous rating.

Follow up:

We will continue to monitor the service through the information we receive.

We completed an announced inspection at Sanctuary Care Home Limited on 5 and 6 January 2017. This was our first inspection since the provider registered with us in January 2016.

Sanctuary Care Home Limited are registered to provide personal care to people living in their own apartments within an extra care scheme in Stoke on Trent. At the time of our inspection, the service supported 13 people 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.

At the time of our inspection there had been some unrest at the service due to disputes going on within the scheme between some of the people living there. This had resulted in some allegations of anti-social behaviour and the Police attending the service on four occasions. When we arrived at the service this situation was on-going and we found that it was having an impact on both people using the service and staff delivering care.

We found that there was no risk assessment in place in relation to the on-going situation at the service, although one was written during the course of our inspection.

Staff reported that they felt unsafe working alone within the scheme and people using the service reported that they felt staffing levels were too low during the afternoon and evening shift. Staff felt supported, however, regular supervisions were not taking place to assess and monitor staff performance.

People felt safe with the staff who supported them, however, not all risks to people's safety had been assessed and planned for.

People's consent to their care was sought and documented, however, staff lacked an understanding of the Mental Capacity Act 2005 (MCA).

People were happy with the support they received to eat and drink, and were supported to maintain good health and had access to healthcare when required.

People were supported by staff who treated them with kindness. People were involved in making decisions about how their care and support was provided, and staff supported people in a way that maintained their privacy and dignity. However, some people using the service had become isolated due to the on-going issues at the service.

People and their relatives felt involved in the assessment, planning and review of their care and support needs. People and their relatives knew how to raise a concern or complaint and the provider took action to address and resolve complaints.

People and staff were encouraged to give feedback on the service. Some systems were in place for monitoring and checking the quality of the service but improvement was needed in order to assess and monitor staff performance and to effectively address risks posed to people through the delivery of their care and support.

Relevant agencies were notified of incidents which took place at the service and staff were safely recruited.