Archived: Grays Fair Court

We inspected the service on 17 October 2018. The inspection was unannounced. At the time of our inspection visit, there were 15 people staying in the respite service, and there were 34 people who were tenants in housing with care. 27 of these people received personal care from the housing with care team.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with CQC 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. The registered manager had been registered on 19 June 2018, and they were not in attendance when we inspected the service because they were on leave.

At our last inspection we rated the service, ‘Good’. At this inspection, we found the evidence continued to support the rating of, ‘Good’, and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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The service was safe as risks to people were identified and mitigated. Where there were additional risks to people associated with their health conditions, there was not always detailed guidance in place for staff. However, further care plans were put in place for these immediately.

Staff were aware of their safeguarding responsibilities and had training in this area. There were enough staff to keep people safe, and they were recruited safely. Staff administered medicines as they had been prescribed. Where areas for learning and improvement were identified through incidents or errors, these were acted upon.

Preassessments established people’s care needs and preferences, and these were used to build a care plan with guidance for staff on how to meet people’s needs. People were supported to eat and drink enough, and to access healthcare when they needed. Staff worked closely with healthcare professionals to ensure people received comprehensive, consistent care.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. 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. Staff asked people for consent before delivering care.

Staff supported people to maintain and increase their independence, and treated people with respect and dignity. Staff respected people’s privacy and carried out support in a kind and caring way.

There were detailed care plans in place with guidance for staff, and they met people’s needs in line with these plans. People were supported to received care when, and how, they wished. People felt confident to raise any concerns with staff should they have any.

There were robust systems in place for monitoring the quality of the service and ensuring the service kept improving. These included systems for gaining feedback on the service, audits and action plans.

Further information is in the detailed findings below.

We inspected the service on 13 April 2016. The inspection was unannounced. At the time of our inspection 18 people were receiving respite and 23 people were receiving personal care in their own homes.

There was a registered manager in post at the time of our inspection. A registered manager (‘the manager’) is a person who has registered with CQC to manage the service. Like registered providers (‘the provider’), 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.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. Staff had received training in this area and demonstrated their understanding of how to support people who lacked the capacity to make some decisions for themselves.

People were at the heart of the service. Staff understood what was important to each person and worked closely with each other and other professionals to promote people’s well-being and happiness.

Systems were in place to meet people’s needs effectively and safely. Staff were aware of the procedures for reporting concerns and protecting people from harm. Staff were only employed after the provider had carried out satisfactory pre-employment checks. Staff were trained and were well supported by their managers. There were sufficient staff to meet people’s assessed needs.

The CQC monitors the operations of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. We found people’s rights to make decisions about their care were respected. Where people were assessed as not having the mental capacity to make decisions, they had been supported in the decision making process. DoLS applications were in progress and had been submitted to the authorising body.

People received care and support from staff who were kind, caring and respectful. Staff respected people’s privacy and dignity. People, their relatives, staff and other professionals were encouraged to express their views on the service provided.

People’s health, care and nutritional needs were effectively met. People were provided with a varied, balanced diet and staff were aware of people’s dietary needs. Staff referred people appropriately to healthcare professionals. People received their prescribed medicines appropriately.

Care plans contained all of the relevant information that staff required to meet people’s needs and therefore people could be confident that they always received the care and support that they needed. Changes to people’s care was kept under review to ensure that the care and support provided was effective. The registered manager assessed any potential risks to people and staff and put preventive measures in place, where required, to manage identified risks.

Staff supported people to take part in hobbies, interests and activities of their choice. There was a varied programme of activities available to people. People were given lots of opportunities to meet each other socially and encouraged people to retain an active presence in their local community and to maintain personal interests and hobbies.

The registered manager was supported by senior staff and support workers. There was a good management structure in place and staff were clear on reporting procedures. People, relatives and staff told us the service was very well run and that the staff and the registered manager, were approachable. People’s views were listened to and acted on.

The registered manager was known personally to everyone who used the service and provided staff with strong, values-led leadership. Staff worked together in a friendly and supportive way. They were proud to work for the service and felt listened to by the registered manager and provider.

The provider was committed to the continuous improvement of the service and maintained a range of auditing and monitoring systems to ensure the care provided reflected people’s needs and preferences. The provider sought people’s opinions on the quality of the service.

Grays Fair Court provides respite care to guests, domiciliary care services to tenants living in flats on the same site and also day care services. We spent time speaking with guests and tenants and they told us they were very pleased with the care they received.

We looked at care records and saw they were up to date and gave staff the information they needed to care effectively. People had been involved in planning their care and support and had signed to show this was the case.

People also spoke positively about the food. A guest said, "I like the food. There are always alternatives and there's plenty of it." We saw that a varied menu was available that offered choice. All food was prepared on the premises, using locally sourced meat and vegetables. Special diets were catered for.

Medicines were stored and administered safely. Staff were trained and demonstrated good practice when administering and supporting people with their medicines.

Staff had been subject to a rigorous recruitment process that ensured they were safe to look after vulnerable people. Staff received regular training, supervision and appraisal. A tenant told us, "Staff are very good. They visit me when they are due."

Processes were in place to monitor the quality of the service provided. People were asked for their views about the service and action plans developed where improvements could be made.

The environment was well maintained and safe. One guest said, "The room is lovely and there's lots of space."

We saw evidence of individualised care being provided that was based on the informed consent of the person themselves. This showed us that people were asked for their consent and the provider acted in accordance with their wishes. People we spoke with told us that they received the care and support that they needed. This showed us that people experienced care, treatment and support that met their needs and protected their rights.

We found evidence which demonstrated to us that there were enough staff to meet people's needs. For example, we saw that people were not kept waiting for assistance. We saw that where there had been changes to people's needs, staffing levels had been amended to ensure these needs could be met. We reviewed a complaint received in March 2012 and noted that this had been investigated and that everyone involved had been kept fully informed of the outcome. This showed us that the comments and complaints people made were responded to appropriately. We saw that people's care and welfare needs were recorded in detail. This demonstrated to us that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.