We carried out a review of the data available to us about Housing 21 - Holm Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Housing 21 - Holm Court, you can give feedback on this service.
At the time of our inspection there were 33 people using the service.
At the last inspection of 01 April 2015, the service was rated Good. At this inspection we found the service remained Good.
The service has a registered manager. A registered manager is a person who has registered with the 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.
People using the service felt safe. There were systems in place to safeguard people from the risk of possible harm. Personalised risk assessments were completed and updated as required.
The service continued to have robust recruitment procedures in place. There were sufficient staff on duty to meet the assessed support needs of the people. Staff had received training in the administration of prescribed medicines.
Staff were knowledgeable and competent in their roles and were supported by way of supervision and appraisals. These were consistently completed for all staff and were used to provide feedback on performance and plan future personal development.
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 support this practice.
People continued to be supported to maintain their health and well-being and accessed the services of health care professionals.
Staff were kind, helpful and maintained people's dignity when support was provided. Positive
relationships existed between people and staff. The staff were knowledgeable about the people they supported.
People were involved in planning their support and deciding in which way their support was provided. Each person had a detailed care plan which was reflective of their needs and had been reviewed at regular intervals and after significant events.
People and staff knew whom to raise concerns to and information regarding the complaints procedure was available in the reception area of the service. The service had a consistent process for receiving and recording complaints, concerns and compliments.
Quality assurance processes were in place. Feedback on the service was encouraged and people were provided with frequent opportunities to express their views on the care and support they received.
There was an open culture. People and staff found the registered manager supportive and approachable. The service sought the advice of other organisations upon management and quality assurance.
Further information is in the detailed findings below.
The inspection took place on the 31 March and 1 April 2015. This was an announced inspection. The provider was given 24 hours’ notice because the location provides a domiciliary care service.
Housing & Care 21 - Holm Court is providing personal care to people living in very sheltered accommodation [Holm Court] and the local community. When we inspected on 31 March and 1 April 2015, the service was providing care and support to 33 people in Holm Court, some of these people are living with dementia, and to six people living in the community.
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.
There were systems in place which provided guidance for care workers on how to safeguard the people who used the service from the potential risk of abuse. Care workers understood the various types of abuse and knew who to report any concerns to.
There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.
Where people required assistance to take their medicines there were arrangements in place to provide this support safely.
There were sufficient numbers of care workers who were trained and supported to meet the needs of the people who used the service. Care workers had good relationships with people who used the service.
Where people required assistance with their dietary needs there were systems in place to provide this support safely. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.
People or their representatives, where appropriate, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions.
A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.
Care workers understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system and shortfalls were addressed. As a result the quality of the service continued to improve.
This is a summary of what we found;
Is the service safe?
People living in the sheltered housing complex told us they felt safe in the knowledge, if an emergency occurred, that staff would be able to offer prompt assistance.
We found further improvements were needed to ensure that all staff were following the provider's management of medication guidance. This was to reduce the potential risk of people not receiving their medication as prescribed.
The staff rotas and discussions with people using and working for the service showed that the service had enough staff to cover people's visits, as agreed in their care plans.
Is the service effective?
People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good insight into people's individual needs to support person centred care.
People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.
Is the service caring?
People were supported by kind, respectful and attentive staff. One person who used the service told us that staff were, 'Very polite and always speak to you.' Three people described staff as, 'Nice.' One person told us that staff gave them, 'All the support I need.'
People had been consulted about their preferences, choices, aspirations and diverse needs and we saw staff supported people in accordance with their wishes.
Is the service responsive?
One person told us when they had raised a concern with management, it had been dealt with promptly.
People's preferences and choices were taken into account and listened to. We saw staff involved people in making decisions and acted on the information they received.
People's care records showed that where concerns about their health and wellbeing had been identified that staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from healthcare professionals which included a doctor and community dietician.
Is the service well-led?
The service had quality assurance systems in place and records seen by us showed that identified shortfalls were addressed promptly. We found the provider had listened to feedback they had received from people who used, or had contact with the service. As a result the quality of the service was continually improving.
We did not speak with anyone using the service about this standard when we carried out our follow up inspection. However, we did meet two people who used the service when they visited a communal lounge. They both told us that they were happy with the service provided and liked the staff.
We arrived at the service towards the end of their staff meeting, which the registered manager told us were held monthly. The registered manager told us that the staff meetings were always well attended. This was our observation. We saw that the meeting provided staff with a positive two-way forum where they could openly discuss practice related issues.
Discussions with staff and records we were shown, confirmed that there were effective systems in place to ensure that all staff received appropriate supervision and appraisal. This meant that staff were given an opportunity, at regular interviews, to talk through any practice issues and receive support on an individual basis from their line manager.
People told us that they felt the service was well led, that their views were listened to and acted on. One person told us that the, 'Care management team here are very good.' Another person told us that the registered manager, 'Is very, very committed, attends most of the functions, knows everyone.'
People told us that staff were caring, responded to their changing needs and treated them in a respectful and kind manner. They told us that staff supported them to retain their independence. One person said, 'I just like being here, I like my independence, if you want the help they (staff) help, if you don't want help they let you get on with it.'
People who lived in Holm Court told us they felt safe in the knowledge that although they lived in their own home, if they fell or became ill they could summon staff quickly. One person commented that when they fell, "Staff immediately came," and provided support.
We found issues around staff not being given regular one to one support to enable them to discuss practice and development issues.
People we spoke with were well informed about the service they received. They told us staff worked with them to identify the level of care and support they wanted. Staff had then written this information into a care plan for people to keep as a record of their discussion.
People told us staff gave them the agreed level of support and care. That staff mostly visited them when they said they would. One person told us that sometimes staff were delayed, but they felt confident that a care worker would also arrive. We were told if there was a delay, it was normally due to an unforeseen emergency.
People told us they had confidence in the staff's abilities to support their individual needs. Three people described many of the staff as being 'Very experienced.' We observed staff interact well when they supported a person living with dementia. They ensured they had eye contact when speaking with the person and asked their permission before undertaking a task. This showed they understood their needs and how to provide their care.
People said that they found staff to be approachable and treated them in a respectful manner. One person felt staff were 'Very kind', another person told us they felt staff were 'Very polite.'
People knew who they could talk to if they had any concerns about the service provided.
We were given several examples of how staff supported people to maintain their independence. One person told us that 'Staff definitely let them do what they could for themselves.' They felt it was important to stop them losing daily life skills.