We carried out a review of the data available to us about Housing 21 - Limestone View 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 - Limestone View, you can give feedback on this service.
The provider was given 24 hours’ notice because the location provides an extra care service and we needed to be sure that someone would be in. At the time of the inspection the service was supporting 21 people with personal care.
Housing & Care 21 – Limestone View provides personal care and support to older people who live in their own apartments. There are 50 apartments altogether. Some of the people who use the service are living with dementia. Apartments are located on one site in Settle around an office and communal areas. There is a café on site which can be used by the public, as well as the local library. There is also a hair salon based on the premises which is open to people using the service and the public. The aim of the service is to support people to live independently.
On the day of the inspection, we visited two people who used the service in their own apartments, spoke with one person's relative and a visitor of another person using the service. We also spoke with four people in communal areas of the housing complex. We spoke with the manager, the care team leader, five support workers and a visiting GP. We looked at five people's care records, medication records, five staff files, training records, call schedules and other records related to the management of the service. Following the inspection, on 1 September 2017, we contacted the relatives of three people by telephone to speak with them about their experience of the service. We also spoke with a member of social care staff from the local authority and a community staff nurse from the district nursing team.
The service had a registered manager. However, they were not on site on the day of the inspection. 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 was a manager on site who assisted us with the inspection.
People told us they felt safe and could speak to any of the staff if they were worried about anything. The manager understood their responsibilities for safeguarding people and staff were trained to understand and recognise abuse. They knew who to report concerns about people's safety and welfare within the organisation and knew where to access contact numbers to external agencies if necessary. Staff confirmed safeguarding was regularly discussed in supervision sessions with management to support their knowledge.
Systems were in place to ensure medicines were managed safely. Observational checks on staff competencies were carried out as well as weekly medication audits.
Risks to people's safety and welfare were identified and managed. Risk assessments clearly identified the risks to people and what could be done to mitigate the risks and keep them safe whilst promoting independence.
People received a service that was based on their personal needs and wishes. Care plans were personalised. Staff felt they had enough information to meet people's needs, including receiving regular up to date information. Changes in people's needs were identified and their care packages were amended to meet their changing needs. The service was flexible and responded positively to people's requests where possible. People who used the service felt able to make requests and express their opinions and views. Health and social care professionals were regularly involved in people's care to ensure they received the right care and treatment.
Without exception, all of the people we spoke with and their relatives provided positive feedback about the service. People said they would recommend the service to anyone who needed extra support. They described the service as a community where they felt included. People we spoke with told us staff were kind, caring and compassionate. We observed genuine warmth between people and the staff who supported them. Relatives we spoke with informed us the staff showed a high level of compassion and sensitivity towards their family members. They also said that staff went out of their way to promote the independence of the people they provided care for. All the people we spoke with explained how staff went over and above what they expected from them and they couldn't ask for anything more. People told us the support they received improved their well-being and sense of inclusion. Staff were positive about the people they supported and the service provided.
People were supported to prepare meals. We saw people's nutritional needs and preferences were taken into account.
We found the service was working in accordance with the Mental Capacity Act 2005 and this helped to make sure people's rights were protected. Where there was any concern regarding a person's capacity to understand a particular decision the correct process was followed to make sure any actions taken were in their best interests.
There was a complaints procedure. The people we spoke with said they would speak with one of the staff or the manager if they had any concerns.
The management team were committed to continuous improvement. Feedback from people, whether positive or negative, was used as an opportunity for improvement. The manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.
This inspection was focussed to review the progress made by the registered provider in making sure people were kept safe from the risks associated with medicines management. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Housing & Care 21 – Limestone View on our website at www.cqc.org.uk.
This focussed inspection took place on 6 December 2016 and was unannounced.
Housing & Care 21 – Limestone View provides personal care and support to older people who live in their own apartments. Some of the people who use the service are living with dementia. Apartments are located on one site in Settle around an office and communal areas. There are 50 apartments currently in use. The aim of the service is to support people to live independently.
At the time of our inspection there was no 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. The current manager had applied to be registered with the CQC and their application had been accepted. However, they were advised by CQC registration to seek management training in care before they could be registered. The manager was aiming to complete this training by March 2017. In the interim, the registered provider has made arrangements for the regional manager to register as temporary manager.
The system for administering medicines had been improved to make sure that people received their medicines safely. Medicine records were clearly written and we found no unexplained gaps in recording. There were systems in place to identify any errors promptly. We found that appropriate action was taken where any errors had occurred. This meant that the previous breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had now been met.
Staff were confident about how to protect people from harm and understood how to identify if anyone was at risk of harm. Staff had received training in medicine administration and were kept aware of any changes or updates to procedure. Risks to people had been assessed and plans put in place to keep risks to a minimum.
This inspection took place on 17 July 2015 and was announced. This was the first inspection of the service which has been open for nine months.
Housing & Care 21 – Limestone View provides personal care and support to older people who live in their own apartments. Some of the people who use the service are living with dementia. Apartments are located on one site in Settle around an office and communal areas. There is a café on site which can be used by the public, as well as the local library. The aim of the service is to support people to live independently. The service provides personal care to ten people and there are fifty apartments altogether.
At the time of our inspection there was no registered manager in post. The current manager has been in post for two months and has applied for registration with the CQC. 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.
The system for administering medicines was not effective at keeping people safe from potential risks. The administration records did not ensure that people received their medicines safely and as prescribed. We also identified errors with the proper ordering of medicines. The risks associated with medicine administration identified during our inspection meant that there was not proper and safe management of medicines. This was in breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and you can see what action we told the provider to take at the back of the full version of the report.
People told us they felt safe. Staff had a good understanding of safeguarding procedures and how to protect people from harm. There were plans in place to identify risks due to people’s health or mobility and to make sure these were minimised without intruding on people’s privacy and independence.
Staff told us they liked working at the service and that there was good team work. Staff were supported through training, regular supervisions and team meetings.
The manager and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are safeguards put in place to protect people where their freedom of movement is restricted. There were no restrictions at the time of our inspection and we saw that appropriate action was taken if any concerns about this were identified.
People were supported to maintain their health and had access to services such as a GP or dentist when needed. Where people needed support with eating and drinking appropriate professionals were involved.
There was a caring and friendly atmosphere in the service. People told us that staff were kind and that their privacy and dignity were respected. Care plans were person centred and showed that individual preferences were taken into account. Care plans gave clear directions for staff about the support people needed to have their needs met.
People’s needs were regularly reviewed and appropriate changes were made to the support people received. People had opportunities to make comments about the service and how it could be improved.
The manager was new in post and had a clear vision about how they wanted the service to develop. Staff told us that there was a culture of respect and their priority was to deliver person centred care. The provider had systems in place to monitor the quality of care and to review if improvements had been made.