About the service:

St David’s House 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.

Not everyone living at St David’s House receives the regulated activity of personal care. CQC only inspects the service being received by people provided with personal care. There were 20 people receiving the regulated activity of personal care from St David’s House at the time of the inspection. People supported included older people and people living with dementia.

For more details, please see the full report which is on the Care Quality Commission website at

www.cqc.org.uk

People's experience using the service:

• People felt safe. There were systems in place to protect people from the risk of abuse and harm. Medicines were managed safely.

• Staff had sufficient training and knowledge to effectively meet people’s healthcare needs.

• People were treated with dignity and respect and were encouraged to maintain their independence. Staff showed warm and caring attitudes to the people that they supported.

• The care and support people received reflected their personal needs and preferences.

• Processes were in place to monitor and improve the quality of the service, there was a culture of openness and of reflection and learning from any incidents identified.

Rating at last inspection:

• The last inspection took place on 16 December 2015 and was rated good in all areas.

Why we inspected:

• This was a planned inspection to check that this service was meeting the regulations.

Follow up:

• We did not identify any concerns at this inspection. We will therefore re-inspect this service within our published timeframe for services rated good. We will continue to monitor the service through the information we receive.

This inspection took place on 16 December 2015 and was announced. Staff at St David’s House provide supported housing for people living in their own homes. There were 25 people receiving services for which CQC registration was required at the time we inspected.

A registered manager was in post at the time of our 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 and associated Regulations about how the service is run.

People were protected from the risk of potential abuse and told us they felt safe because of the way staff cared for them and made sure they had the right equipment to stay safe. Plans to manage people’s individual risks were in place, and staff knew what to do if they had any concerns about people’s safety. Staff took action to care for people in a way which promoted their safety. There were enough staff employed to care for people and chat to them so they did not become isolated. Some people liked the independence looking after their own medicines gave them. Other people valued the support staff gave them by administering their medicines.

Staff received regular training based on the needs of people using the service. Staff had the skills and knowledge to care for people effectively.

People and their relatives were involved in making decision about how care was delivered on a daily basis. People and their relatives also told us they felt listened to when they regularly reviewed their care plans with staff. Staff knew the histories and preferences of the people they were supporting and provided care in a way which meet individual people’s needs. People were encouraged to make choices about the food they ate and where they wanted to eat. Staff knew if people had any dietary requirements, and what support they required to eat so they remained well. People were supported by staff to maintain their health.

People’s consent was appropriately obtained by staff when caring for them. If people’s ability to make specific decisions changed, senior staff involved people’s relatives and other professionals, so care would continue to be delivered in the best way for people.

People and their relatives had developed good relationships with staff who were caring. People received care from staff who took time to get to know them. Staff supported people to maintain their dignity and privacy.

People’s changing care needs were recognised by staff, who worked with other agencies to make sure people were getting the right care for them.

The registered manager and senior staff checked people were receiving the care they needed in the best way for them. Staff knew what was expected of them, and implemented the implemented the values demonstrated by registered manager and senior staff. People were encouraged to give feedback on the quality of the service. We saw the registered manger also took action to develop the service when external agencies had suggested how the service could be further developed.

People who used this service all live in a shared complex of flats known as St David's House. During our inspection, we spoke with five people about the care and support that was provided by the care staff that went into their homes. We also looked at some records and spoke with three care staff, one senior care staff and the manager.

People told us that care staff always asked them about their preferences in how they would like assistance with their daily routines when they arrived at their homes. One person told us: “I am happy with my care, it’s all I need.” Another person told us: “They (care staff) help me when I need them to, I have no complaints.”

We looked at the information in the records that staff used every day when doing their call rounds to people who used the service. We saw that these records provided a good overview of the day to day care and support required to meet people’s health and care needs.

People who used the service were protected from the risk of abuse because the service made sure all staff recruited were suitable to work with vulnerable people. People told us they felt safe when care staff visited them in their homes and that care staff were helpful and kind.

We found that the manager had systems in place to monitor the quality of the care and support provided. For example, people’s views about their care were continually monitored so that these influenced improvements and kept people safe from any identified risks.

We spoke with four people who lived at St. David's House. They told us they were provided with support when they needed it and they valued the security that living at St. David’s House provided them. People told us that moving to St. David’s House had made a difference to their everyday living as they did not feel isolated. People also said that there were always people around should they need any support which was reassuring.

People told us that they were treated with respect and that staff maintained their privacy and dignity. Several people described how they were supported where needed or checked on by a group of regular support staff. They told us that staff had got to know them well and understood their routines. We were also told by people that staff knocked and used their door bells before entering their homes and people had their own keys.

We looked at the care records for three people that used the service. We saw that an assessment of people’s needs was carried out before the service started and reviewed when people’s needs had changed. When speaking with people they told us that they held information about how their care needs would be met and that they had been involved in deciding their support.

People we spoke with were confident that they could raise concerns if they were not happy with the support being received and that they would be listened to. Improvements were made as a result of listening to the views of people.