Octavia Housing - Leonora House

People’s experience of using this service:

People received personalised care and staff had an excellent understanding of how to meet their needs.

Staff were understanding and supportive when people were at the end of their life. Relatives spoke extremely positively about the difference the support made to them and their whole family at such a sensitive time.

People had access to a wide range of activities and events, which people were encouraged to get involved with to help reduce social isolation and create meaningful friendships.

People and their relatives were positive about the kind and caring attitude of the staff that supported them. One compliment stated, ‘I cannot praise the staff enough. They have so much love for my [family member] it has left me so thankful that they are here.’

People were supported to live independent lives and staff were aware of their needs to help them stay safe. Staff followed best practice guidance and worked closely with a range of health and social care professionals to ensure people received effective care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were supported to a range of healthcare appointments and staff followed up any issues or concerns. Staff contacted health and social care professionals for advice and guidance if there were changes to people’s health and wellbeing.

People were cared for by dedicated staff who felt appreciated and supported in their role. Staff spoke positively about the working environment and the support they received to help improve the quality of care.

Rating at last inspection: At the last inspection the service was rated Good. (Report published 26 October 2016).

Why we inspected: This was a planned comprehensive inspection based on the outcome of the previous inspection.

Follow up: We will continue to monitor information and intelligence we receive about the service until we return to visit as per our re-inspection guidelines. We may inspect sooner if any concerning information is received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Leonora House is a supported living scheme and offers 21 one-bedroom flats, each of which features en-suite facilities and its own kitchen and living area. There is a separate unit which consists of 5 open-plan studio flats which include en-suite facilities and a small kitchenette. Staff are on site 24 hours a day providing support to people.

At the time of the inspection there were 25 people receiving support from the service, although they were not all receiving support with personal care. There were 21 people living in the main building and four in the side unit.

There was a registered manager at the service. 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 using the service said they felt safe and care and support workers were familiar with safeguarding procedures.

People led independent lives and were supported by staff to do so. People were assessed with regards to how well they were able to manage their medicines and were offered the appropriate levels of support.

Care records documented goals and outcomes for people. Staff supported people to achieve these goals and to maintain a level of independence. Each person had a key worker. Care and support workers displayed a good understanding of people’s support needs.

Care records included details of the support that people required to maintain good health. Records were kept of healthcare professional’s involvement in people’s care and people were referred to health professionals when their health deteriorated.

People told us they enjoyed the food at the home and staff helped them to prepare meals if they needed it.

The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA). People were involved in planning their care and their views were taken on board. They had signed their care records, medicine consent forms and also their tenancy agreement. People were free to come and go as they pleased; each person had a key fob for leaving and entering the building.

There was a friendly, relaxed atmosphere at the service. People felt comfortable coming into the staff office and speaking with the registered manager and other members of staff.

The provider carried out pre-employment checks on care and support workers, which included criminal record checks which helped to ensure they were suitable to work with people. There were enough staff employed to meet people’s needs.

A training programme for care and support workers, which included both induction and ongoing training, was available to all staff. Care workers told us they felt supported and records showed that they received regular supervision and annual appraisals. They were asked to demonstrate how they projected the provider’s values and behaviours during these meetings.

Feedback surveys, self-assessment audits, incident reporting and team meetings were used to monitor the quality of service.

Below is a summary of what we found. The summary describes what people using the service and staff told us. It also takes account of the information and records we looked at.

If you would like to see the evidence that supports our summary then please read the full report.

Is the service safe?

Leonora House is an extra care housing scheme for people aged 60 years and over. 24 hour care is available to those who need it and is provided by care staff based at Leonora House. The service also operates an outreach service to those living in their own homes in the local community.

We looked at the support plans for four people living at Leonora House. We saw that these contained assessments covering health needs and medication. We saw that risk assessments had also been completed in areas such as falls and mobility, diet and nutrition and behavioural management. Support plans and risk assessments were updated every three months or earlier if needs changed. We spoke with three people who used the service who told us they had been involved in the care planning process.

There were arrangements in place to deal with foreseeable emergencies. Staff had been trained to deal with emergencies by ensuring people were safe and comfortable and by calling 999 when and if needed. People who used the service told us they felt safe and secure.

Is the service effective?

Staff had been recruited appropriately and been asked to provide two references from previous employers and undergo Disclosure and Barring Service (DBS) checks.

Staff told us they had completed an induction which had covered core subjects such as health and safety, safeguarding and medication handling. The induction had been followed by a period of shadowing more experienced staff. There was a probation period of six months for all new staff.

People who used the service expressed their views and were involved in making decisions about their support needs in collaboration with the staff team. People we spoke with told us 'I try and get involved' and 'staff always ask me what I would like to do.'

Is the service caring?

People who used the service told us "I love it here' and 'staff are so kind and helpful and always willing to help.' We saw that a client satisfaction survey had been carried out in January 2014. From the results we saw that people were satisfied with the support they received and felt the service was sensitive to their social, cultural and/or religious needs.

Is the service responsive?

Staff told us meetings for people who used the service took place on a six monthly basis where issues such as the range of activities, complaints and suggestions were addressed.

There were systems in place to record accidents/incidents and information available to people who used the service about how to make a complaint. We saw from the complaints logging system that the service had received no complaints in the past 12 month period. People who used the service told us they would speak directly to the manager if they had a complaint.

Is the service well-led?

The service had a registered manager in post. Staff we spoke with told us that the manager operated an open door policy. We were told that staff received supervision every six to eight weeks and were appraised annually. We looked at staff records and saw that supervision had taken place for most within the last month. Staff we spoke with told us they felt supported by the management team.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. A manager from the service would meet with the person to assess their needs and suitability for the service. Once accepted to the service a care plan would be drawn up in line with their individual needs.

There were enough qualified, skilled and experienced staff to meet people's needs. All care staff who worked in the service were qualified up to national vocational qualification (NVQ) level two. We saw that staff had received recent appropriate training records.

There were systems in place to measure the quality of the service. Tenant's surveys were conducted every six months to gain people's views about the service. Managers carried out monthly spot checks and periodical observations (focusing on monitoring staff interactions between tenants) to staff visits to measure the quality of service provision.