About the service: St Augustine’s Place 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 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 and support service. The service comprised of 20 flats and 14 bungalows. At the time of visit there were 34 people receiving support with personal care from the service.

What life is like for people using this service:

• There were sufficient numbers of suitably trained staff to meet the needs of people living at St Augustine’s Place. People told us the staff were kind and caring.

• St Augustine’s Place provided people with opportunities to engage in meaningful activities and supported people with this where it was part of their agreed care plan. This reduced the risk of social isolation.

• People who required support to maintain good nutrition and hydration told us they received the support they needed.

• Information about people’s preferences in coming to the end of their life were documented. The service worked well with other agencies to ensure people had a comfortable, pain free death.

• People told us staff were respectful, asked for their consent and gave them the privacy they wished for.

• Where required, people were supported to make appointments with other healthcare professionals and attend appointments.

• People were actively involved in the planning of their care and had access to several ways to give feedback on the service they received. People’s feedback was acted on.

See more information in Detailed Findings below.

Rating at last inspection: At the last inspection on 1 September 2016 the service was rated Good.

Why we inspected: This was a planned inspection following the service’s registration with the Commission.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Good.

This inspection took place on 1 September and was announced. We gave 48 hours’ notice, as the service is registered as a domiciliary care agency and we wanted to be sure that people would be available to speak with us.

St Augustine’s Place provides support and personal care to the people who live in the 20 flats and 14 bungalows, which are part of the St Augustine’s Place Housing with Care Scheme. Each person lives in their own home under a tenancy agreement with a housing association. At the time of our inspection 37 people were using the service.

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 safe because staff knew how to recognise signs of possible abuse and knew the correct procedures for reporting concerns. There were sufficient numbers of staff to support people and appropriate recruitment checks were carried out, so that only staff, who were suitable to work in care, were employed.

Identified risks to people’s safety were recorded on an individual basis and there was clear guidance for staff to be able to know how to support people safely and effectively.

Medicines were managed and administered safely and people received their medicines as prescribed. Some people managed their own medicines but all staff who administered people’s medicines had completed appropriate training. There were also clear policies and procedures in place for staff to follow, with regard to the recording and administration of medicines for people.

People were supported effectively by staff who were skilled and knowledgeable in their work. All new members of staff completed an induction. Staff received regular support and supervision and suitable training that was relevant to their role. Formal staff meetings were held and staff communicated regularly with each other and the management team.

CQC is required to monitor the Mental Capacity Act (MCA) 2005 and report on what we find. The management team ensured the service operated in accordance with the MCA and staff demonstrated a clear understanding of the MCA capacity and consent.

Staff supported people, where required, to ensure they had enough to eat and drink. People were also supported to access relevant healthcare professionals as and when needed.

Staff employed by the service were caring and attentive. People were treated with respect and staff preserved people’s dignity. People were encouraged and supported to be as independent as possible and were also supported to follow pastimes or hobbies of their choice.

People planned and agreed their own care with staff who were reliable and consistent. Detailed assessments were completed with people before they started using the service, to ensure the service could meet their needs. Each person’s care package was completely individual and specific for that person. People’s care records were regularly reviewed, to ensure they remained up to date and accurate.

People were able to voice their concerns or make a complaint if needed and were listened to with appropriate responses and action taken where possible. Regular meetings were held for people who used the service and a liaison officer also helped people to express their views.

The service was well run and people’s needs were being met appropriately. Communication between the management team, staff and people using the service was frequent and effective.

There were a number of systems in place in order to ensure the quality of the service provided was regularly monitored. Audits were carried out by the management team in order to identify any areas that needed improvement. Record keeping and management systems were in good order, with effective fo

We met eight people who used the service and one person's relatives. All the people we spoke with told us that they were happy with the service that they were provided with and that the support they received met their needs. One person said, “Lovely I like it here…very good staff.” Another person said they had got, “My independence back.” Another said, "Staff are very good, we have a laugh with all of them, it is like one big happy family."

When we asked people if they would recommend the service to others, they told us they would. One person replied, “Oh, yes definitely, I love being here it is my home now and all the staff are very nice.”

People told us that the staff treated them with respect, and always asked for their consent before carrying out a care task. This was our observation. One person who told us that staff always asked for their consent to carry out a task first, said, “If I don’t want something done, I wouldn’t let them (staff) do it.”

We looked at the care records of four people who used the service, and found that people experience care, treatment and support that met their needs and protected their rights.

Where staff supported people with their medication, we saw that safe systems were in place to ensure people received their medication as prescribed. One person told us, “They (staff) know what I take; I get muddled and can forget.”

People told us that the service was well led, and felt assured that if they did have any concerns that they would be listened to and acted on. One person told us if they did have a concern, “I’ll just go straight in and see the manager.” Another person told us that the, "Manager cares.”

We found that the premises were suitable for running a domiciliary care service.

Recruitment checks were made on new staff to ensure that they were suitable to work with vulnerable people.

We had the opportunity to talk with five of the people who used the service. All of the people we spoke with were happy with the care they received. They told us that they were supported how they wanted to be and were able to make their own decisions regarding their care. They were complimentary about the staff who supported them.

One person we spoke with told us that, “I can’t complain about anything.” Another person said, “The carers are so good, they even sent me a birthday card.”