Archived: Holly Grange Extra Care Housing

At Holly Grange there are 32 one-bedroom flats. There is a communal lounge and a communal kitchen on ground floor that people can use if they wish. Other communal facilities include a lift to each floor, laundry and garden.

At the time of this inspection, there were 26 people living at Holly Grange who were supported with personal care.

People’s experience of using this service:

We found a range of quality monitoring arrangements in place, and we saw these were developing and becoming more effective.

People were supported by staff that were caring, compassionate and treated people with dignity and respect. Any concerns or worries were listened and responded to and used as opportunities to improve.

People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life histories and individual preferences.They used this information to develop positive, meaningful relationships with people.

People and their relatives told us they felt cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible.

The provider ensured people had consistency with staff members, as a result people and staff were able to build positive relationships. People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs.

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

Staff spoke positively about working for the provider. They felt well supported and they could talk to management at any time, feeling confident any concerns would be acted on promptly. Staff felt valued and happy in their role.

Audits were completed by staff and the registered manager to check the quality and safety of the service.

The registered manager and team support manager worked well to lead the staff team in their roles and ensure people received a good service.

More information is in Detailed Findings below

Rating at last inspection: The service was given an overall rating of good.

Why we inspected: This was a planned inspection based on the previous rating.

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

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

At our last inspection of 1 February 2016 although the issues we identified did not warrant a breach of regulation we identified that some improvement was required. The issues included aspects of medicine management and the non-reporting of potential harm. At this inspection we found that improvements had been made.

The provider is registered to provide personal care to adults. People who used the service received their support and care in their own flats within the extra care housing complex. On the day of our inspection 22 people received personal care and support.

The manager was registered with us as is required by law and was present on the day. 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 were supported with their medicines and took them as they had been prescribed by their doctor. Processes were in place to prevent people from the risks of accidents and injuries. The registered manager and staff had taken action to protect people from harm and abuse. There were enough staff available to meet people’s needs and to keep them safe.

Staff felt that the induction training they had received and the support they had on a day to day basis was good. Staff also felt that the supervision sessions offered ensured they did their job safely and in the way that people preferred. Training records confirmed that staff had received, or had secured, the training they required to meet people’s needs and to keep them safe. Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). They knew that regarding extra care services any DoLS referral would have to be made to and approved by the court of protection. Staff supported people to have sufficient diet and fluids to prevent them experiencing ill health due to malnutrition and dehydration. People received assessment and treatment when needed from a range of health care professionals which helped to promote their health and well-being.

People were supported and cared for by staff who were kind and caring. Staff supported people to be as independent as possible. People were encouraged and supported to undertake daily tasks and attend to their own personal hygiene needs.

People were enabled to make decisions about their care and were involved in how their care was planned and delivered. Staff supported people to keep in contact with their family as this was important to them. Complaints processes were in place for people and their relatives to access if they were dissatisfied with any aspect of the service provision.

People told us that they felt that the quality of service was good. Quality monitoring of the service and feedback processes ensured that the service provided was of a good standard and met people’s needs. The provider had informed of recent incidents that they were required by law to report.

At our last inspection of September 2013 the provider was meeting all of the regulations that we assessed.

The service is registered to and managed by Sandwell Council. The provider is registered to provide personal care to adults. People who used the service received their support and care in their own flats within the extra care housing complex. At the time of our inspection 28 people received personal care and support.

The manager was registered with us as is required by law. 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.

Systems did not always confirm that people were given their medicine as they had been prescribed by their doctor.

The provider had not followed processes they are required to. We had not been informed of a recent medicine incident that should have been reported to us as is required by law.

Staff had not reported some issues that required attention so that remedial action could be taken to prevent the issues reoccurring.

Processes were in place to prevent people from the risks of accidents and injuries.

People and their relatives felt that there were enough staff available to meet their [or their family members] individual needs.

Staff felt that the induction training they received the support they had on a day to day basis and the supervision sessions offered ensured they did their job safely and in the way that people preferred.

Staff training records were not up-to-date however; staff confirmed that they had received the training they required to meet people’s needs and to keep them safe.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). They knew that regarding extra care services any DoLS referral would have to be made to and approved by the court of protection.

Staff supported people to have sufficient diet and fluids to prevent them experiencing ill health due to malnutrition and dehydration.

People were enabled to make decisions about their care and they and their families were involved in how their care was planned and delivered.

Staff supported people to keep in contact with their family as this was important to them.

Staff supported people to be as independent as possible. People were encouraged and supported to undertake daily tasks and attend to their own personal hygiene needs.

People received assessment and treatment when needed from a range of health care professionals which helped to promote their health and well-being.

Complaints processes were in place for people and their relatives to access if they were dissatisfied with any aspect of the service provision.

People told us that they felt that the quality of service was good. This was also the view of relatives and staff we spoke with.

All people spoken with were positive about the care they or their relative received. One person said, 'They look after us very well. I am very happy with my care.' One relative told us, 'The staff are excellent. The care they give my mum is the best. I can't speak highly enough about them.' People's needs were assessed and planned to ensure people received care that met their needs. People's needs had been assessed by external health professionals including dieticians and speech and language therapists and community nurses. This meant that people's health care needs had been monitored and met.

People told us that staff asked for their consent before providing care. One person said, 'They always ask me want I want done. They always listen.' The provider had appropriate systems in place to ensure that people's mental capacity to consent to their care was documented.

People received their medicines as prescribed by their doctor to ensure their health needs were met.

Staff training was up to date and included caring for people with dementia so that they had the knowledge to support the people they cared for.

Audit systems were in place to ensure that people received quality care that met their needs.

People that we spoke with said that they and their relatives were involved in agreeing and planning their care. We found that people's views and experiences were taken into account in how the service was delivered.

People told us that their needs were being met. One person told us, 'I feel they are meeting my needs well, the manager and staff are lovely people.' We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that systems were in place to ensure that people were protected from cross infections whilst they were receiving care.

People told us that they were treated well by the staff that supported them. One person told us, 'They are very caring and I can't fault them.' We found that people were cared for by staff that were trained and supported to do their job well.

People told us that they had no concerns about the care that they received. People using the service and their relatives were confident that should they raise a concern it would be listened to and addressed. We found that clear systems were in place to investigate and respond to people's concerns