Archived: Patching Lodge Extra Care Scheme

Updated 18 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The last inspection was on 1 June 2016 where the service was rated as Requires Improvement.

This inspection took place on 1 August 2017 and was announced. We told the registered manager 48 hours before our inspection that we would be coming. This was because we wanted to make sure that the registered manager and other appropriate care staff were available to speak with us on the day of our inspection. Two inspectors undertook the inspection, with 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. They helped us with the telephone calls to get feedback from six people and one relative being supported on 31 July 2017.

We asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before the inspection, we reviewed information we held about the service. This included previous inspection reports, complaints and any notifications. A notification is information about important events which the service is required to send us by law. We contacted the local authority commissioning team to ask them about their experiences of the service provided. We also received feedback from a social care professional.

During the inspection we went to the service’s office and spoke with the registered manager, a senior member of care staff and four care staff. We spoke with the manager of the housing complex. We spent time reviewing the records of the service, including policies and procedures, five people’s care and support plans, the recruitment records for two care staff, training records for six care staff, complaints recording, accident/incident and safeguarding recording, and staff rotas. We also looked at the provider’s quality assurance audits.

Updated 18 October 2017

This inspection took place on 1 August 2017 and was announced.

Patching Lodge Extra Care Scheme is a domiciliary care service and is registered to provide personal care and support for people living in their own home in Patching Lodge Extra Care Scheme, a sheltered housing complex managed by a housing association. This accommodation is for people over 60 years of age and care and support can be provided to people with a physical disability or learning disability, people with a sensory loss, for example hearing or sight loss and people with mental health problems or living with dementia. Twenty four hour care, seven days a week is provided with a dedicated on-site care staff team, and with an emergency call facility. Additional services provided include a restaurant (for main meals), organised social activities, a café, shop, library and a hairdressing salon. There were 33 people receiving a service at the time of the inspection, the majority of which received the regulated activity of personal care.

On the day of our inspection, 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.

Following an inspection which was carried out on 15 February 2015 we found a number of areas which were in need of improvement. This was in relation to care and support plans and risk assessments not having been reviewed, there was a lack of continuity of staff providing the care calls and times the care and support was provided. Quality assurance systems had not been maintained to check the quality of the service provided and to help drive improvement. The provider sent the CQC an action plan stating what they would do to address these issues. We looked at these improvements as part of the last inspection on 27 June 2015. However, despite the improvements identified, we were unable at the inspection to determine whether these practices were fully embedded into the service. They would need to demonstrate appropriate arrangements over a defined period of time to ensure that the sustainability of good care could be achieved for people. At this inspection we found the improvements had been maintained and embedded in the service. However, we did find areas in need of improvement in relation to using feedback received to continue the development of the service. People were supported with their healthcare needs. Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately. However, recording had not always been fully maintained to evidence the administration of medicines. Feedback was varied as to the frequency of staff meetings. Records showed us meetings had been held, but recently some had been cancelled. Staff meeting minutes had not always been completed to inform care staff of agreements made, especially if they had been unable to attend the meeting.

The majority of people and their carers spoke well of the care and support provided. They told us there was now a more consistent dedicated team of care staff working in Patching Lodge Extra Care Scheme. There was now good continuity of care staff providing their care calls. They felt the registered manager had worked hard to address these areas and had listened to their concerns. People told us they always got their care call and they were happy with the care and the care staff that supported them.

Care staff told us there had been a number of changes to the staff team. However, they spoke well of the new management arrangements, and of the changes which had been made to improve the service provided. Staff told us there had been further recruitment of care staff to help cover staff vacancies and they had not now needed to use agency staff. They felt the team was working well together and there was good communication between the team members. One member of staff told us, “I love it here. I like working in the one building. We are fully staffed and the team are brilliant. If cover is needed people work extra.” A system was in place to ensure priority in the times care calls had been made to people receiving personal care, or assistance with medicines. Senior staff were working to ensure people were notified when call times had been changed.

There were 16 care staff who worked in the scheme. Care staff had been recruited through safe recruitment procedures. People told us they were supported by kind and caring staff who understood their care needs. Care staff received a five day induction, basic training and additional specialist training where required. Care staff had supervision in one to one meetings in order for them to discuss their role, training needs and share any information or concerns. One member of staff told us, “We are fully staffed. We work really well together.”

The needs and choices of people had been clearly documented in their care and support plans. People told us that they felt safe with the staff that supported them. Detailed risk assessments were in place to ensure people were safe within their own home and when they received care and support. Where people’s needs changed, people’s care and support plans had been reviewed to ensure the person received the care and treatment they required. Care and support plans had been reviewed and updated. People and care staff were aware reviews were happening and could tell us where reviews were planned and booked to take place.

Consent was sought from people with regard to the care that was delivered. All staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. One member of staff told us, “We always ask if they are happy to proceed and we record.” Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.

Where required, care staff supported people to eat and drink and maintain a healthy diet.