We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection. The inspection took place on 6 December 2018 and was unannounced. We gave the service 48 hours notice. This is because the service provides care to people in their own extra care housing, and we needed to be sure there would be someone available to support the inspection.

The inspection was carried out by two Inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Prior to the inspection we reviewed the Provider Information Return (PIR). This is a form that the provider completes to describe the service, what they are doing well and any areas they intend to improve. We also looked at notifications. Notifications are information about specific events the provider is required to tell us by law.

As part of the inspection we spoke with 15 people who use the service, five of these were in their flats and the others were contacted by telephone. One relative was also present when we spoke with a person in their flat. We reviewed four people’s care records and looked at other documentation relating to the running of the home such as audits, MAR sheets and staff records. We also spoke with the registered manager and three care staff.

The inspection took place on 20 September 2016. The provider was given 48 hour notice. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.

Waverley Gardens Extra Care provides personal care and support to older people who occupy or own their own flats located within the premises at Waverley Gardens. There are 66 flats in total and at the time of our visit 60 people were receiving support with personal care.

At the last inspection of the service on 24 April 2014 we found the service was meeting the regulations.

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’s care and support needs were assessed and care and support plans identified how care and support should be delivered. People we spoke with told us they were happy with the service they received and staff were kind and caring, treated them with dignity and respected their choices. People who used the service told us they felt safe with the staff and the care and support they were provided with.

There were systems in place to protect people from risk of harm and appropriate recruitment procedures were in place. There were policies and procedures in place in relation to the Mental Capacity Act 2005. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves.

People were cared for, or supported by, properly trained staff. Staff received support to help them understand how to deliver appropriate care. People told us they got the support they needed with meals and how to access healthcare. We saw arrangements for medication administration were safe.

Quality assurance systems were robust. We found that there were systems in place to monitor the quality and safety of service provided and there were appropriate systems in place for the management of complaints.

We carried out an inspection at Waverley Gardens Extra Care to help us to answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with five people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe

People told us that they felt safe with staff that supported them. One person told us “the carers are respectful. We trust them and have confidence in what they do. When we didn’t get on with some carer we asked for them not to come again and the agency did not send them again”.

The provider had ensured that there were safeguarding guidelines and policies in place for vulnerable adults, which were in line with the local authority safeguarding procedures. We saw that these policies had been updated to ensure that current information was available in relation to protecting vulnerable people from abuse.

There was a risk assessment process in place to ensure that care could be safely provided to people in their flats. We saw completed assessments of people's mobility, medication and an assessment of any health and safety hazards. This meant that people could be cared for safely.

Is the service effective?

People who used the service understood the care choices available to them. We saw that people's care plans were detailed and personalised in relation to their care needs. People we spoke with told us that their care plans reflected their own choices about how they wanted their care delivered. We saw from the care records that any changes in the person's choice were documented and implemented. We saw that, where appropriate, people had signed their care plans. This demonstrated people had knowledge and agreed of what appeared in their care plans.

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Assessments had been undertaken prior to the commencement of the care package to ensure that a person's needs could be safely met. The person receiving care, or their representative, had signed agreements to confirm the care arrangements.

Care staff were regularly supervised to monitor their work performance and development needs. This was confirmed by staff we spoke with during the visit. Regular 'spot checks' were made by the agency's management staff to ensure that staff's care practices were regularly monitored.

Is the service caring?

People's dignity was respected at all times. People told us that care was delivered in a respectful and dignified manner. One person told us that the carers were, "kind, polite and always made sure that everything was done before they left the flat." Observations made during our visit showed that there was a friendly and respectful rapport between the care staff and the people who used the agency. All staff we spoke with gave good examples of how they carried out personal care, such as bathing, whilst maintaining the person's dignity. Staff also highlighted the need to ensure curtain and doors were closed to preserve people's dignity during intimate care.

We saw that staff had received equality and diversity training and person centred support. This course is now known as ‘Knowing You Matter’ training to promote people’s choices and preferences.

Is the service responsive?

There were guidelines in place for each visit made to a person to ensure that staff knew how care and support should be delivered. Care plans showed that individual preferences were taken into account and were written in a 'person centred' way. Care and support included assistance with; personal care, medication and household chores. This meant that people were involved with their care planning to ensure that their needs were fully met.

The provider took account of complaints and comments to improve the service. The manager told us that people who used the service were encouraged to make a complaint and information was easily accessible about how to do this. We looked at the complaints records for the service. These showed people's complaints were fully investigated and resolved to their satisfaction. This showed the provider listened to and acted on people's concerns.

A variety of activities was being offered to people which were advertised around the communal areas. Many of these activities took place in a large, well presented communal room. Activities offered included music therapy, coffee mornings and gardening club and film show.

Is the service well-led?

Families and representatives we spoke with during the visit told us they were satisfied in relation to the care and services provided for their family members. Some of the comments included “We are very happy with the agency. The staff are good, they are always on time. The senior staff always comes to make sure everything is ok”. Another person said “the care is excellent”.

People who use the service, their representatives and staff were asked for their views about their care and treatment and these were acted upon. The manager told us that they sent out questionnaires every six months to ask people using their service what they thought about the care they received.

Surveys were analysed and an action report was collated. A recent report in 2013 indicated that people were satisfied with the care and support the agency was providing. One comment was “at the moment I am happy with the care I receive”.

We spoke with 10 people who used the service two relatives, four staff members and the manager. People who used the service told us staff did things in the way they liked things done. One person told us "I am happy with my care. I like the girls they are always good to me. They do things I want them to do and the way I like it done".

People told us staff always respected their privacy and treated them with respect. They told us they felt able to raise any issues with the manager or staff should they have any concerns.

People's relatives told us that staff were always friendly and professional. One person said "they understand my relative’s sense of humour they are brilliant”. Another person told us "my relative is perfectly happy".

We saw the provider had a policy on safeguarding people from abuse. Staff had attended training to help ensure that people who used the agency were protected from the risk of abuse.

We found evidence that prescribed medicines were given to people safely.

We found there were sufficient numbers of suitably qualified, skilled and experienced staff at all times to support the people who used the service.

We saw the provider had effective systems in place to regularly monitor the quality of service that people received.

We spoke with seven people receiving a service, four members of staff, the manager and six relatives during our visit.

People told us they liked the care and support the received from Waverley Gardens Extra Care. They told us that the staff were supportive and helpful.

People told us that they could choose when to get up and retire. People said us they had tenancy agreements and this had been discussed with them and where relevant their families. People told us that they had the choice to eat at the restaurant or supported by staff to prepare their own meals

People told us their care files were kept in their bedroom and they were involved in decisions about their care.

People said they had good relationships with each other and staff and said their views on the service were listened to and acted upon.

People told us they felt safe and enabled by the staff to be independent.

One person described the service as 'excellent'