Archived: Nichols Court Extra Care Scheme

Nichols Court Extra Care Housing Scheme is a domiciliary care agency that provides personal care to people living in their own flats at Nichols Court. It provides a service to older adults. At the time of our visit 26 people were using the service.

Not everyone using Nichols Court Extra Care Housing Scheme received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager at this agency who was supported by Customer Care Officers and the organisation’s senior management. 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.

At our previous inspection on 15 April 2016 we rated this service as 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.

Staff knew how to keep people safe, how to respond to possible harm and how to reduce risks to people. There were enough staff who had been recruited properly to make sure they were suitable to work with people. Medicines were administered safely. Staff had enough equipment, such as gloves and aprons, to make sure that infection control was maintained. Lessons were learnt from accidents and incidents and these were shared with staff members to ensure changes were made to staff practice.

People’s care was planned and delivered in line with good practice guidance. People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff helped people to eat and drink and to do so in a way that also supported their health needs. Staff had information if they needed to refer people to health care professionals and they followed the advice professionals gave them.

Staff understood and complied with the principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the agency supported this practice.

Staff were caring, kind and treated people with respect. People were listened to and were involved in their care and what they did on a day to day basis. People’s right to privacy was maintained by the actions and care given by staff members.

People’s personal and health care needs were met and care records provided staff with enough guidance in how to do this. A complaints system was in place and there was information so people knew who to speak with if they had concerns. Staff had guidance about caring for people at the end of their lives.

Staff were supported by the registered manager, who had identified areas for improvement and developed a plan to address these. The provider’s monitoring process looked at systems throughout the service, identified issues and staff took the appropriate action to resolve these. People’s, relatives and staff views were sought, with positive results.

Further information is in the detailed findings below

Nichols Court Extra Care Scheme is a domiciliary and extra care service that is registered to provide personal care to people living in their own homes at Nichols Court. At the time of our inspection there were 32 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 provider had appointed a new manager but they had not yet taken up their position.

Staff’s suitability to work with people using the service was assessed before they were offered employment. People’s assessed care needs were met in a timely manner by suitably trained and qualified staff.

Staff were trained and knowledgeable about the procedures to ensure people were kept safe from harm. Staff were aware of their role in reporting any incident should it occur to organisation including the local safe guarding authority.

Medicines management and administration was undertaken in a safe way. This was by staff whose competency to do this safely was regularly assessed.

The registered manager was aware of the process to be followed should any person have a need to be lawfully deprived of their liberty. They and staff were knowledgeable about the situations where an assessment of people’s mental capacity was required. The service was working within the principles of the Mental Capacity Act 2005.

Staff knew the people they cared for well, their levels of independence and respected their privacy and dignity. Appropriate risk management strategies and records were in place for events and subjects including falls and medicines administration.

People, their relatives or family members were involved in the process of assessing their care needs. People’s care was provided where the service was able to safely do this.

People’s health care needs were identified by staff and met by a range of health care professionals including a GP occupational therapist or GP.

People were supported with their independence to live in their own home as long as they wanted to. People were supported with their nutritional needs and staff ensured people ate and drank sufficient quantities.

Staff were provided with a formal induction, regular and effective training, supervision and mentoring that was appropriate for staff’s roles.

People were provided with information, guidance and support on how to provide compliments, report any concerns as well as any suggestions for improving the care they received. The provider took appropriate action to ensure any complaints were addressed to the complainant’s satisfaction.

A range of effective audit and quality assurance procedures were in place. The provider had processes in place to help ensure that the CQC is notified about events that they are required, by law, to do so.

Care planning documents were written in a personalised way and gave staff detailed guidance on the care each person required to meet their needs.

Medicine management had improved since our last inspection so that medicines were now managed better. People received their medicines safely and as they were prescribed.

Staff were recruited well, with all required checks in place before they started their employment. Staff undertook a thorough induction, which included working alongside experienced staff and undertaking training in relevant topics so that they were equipped to carry out their role.

The provider had a system in place to check that people were satisfied with the service. This included a written questionnaire, which was sent to people each year, and various monitoring checks on a number of aspects of the service.

Care records showed that staff were given guidance on people's needs and how people preferred those needs to be met. Risks were assessed, however the written guidance for staff did not provide sufficient detail on the ways in which the risks could be minimised.

Staff had received a wide range of training relevant to their role, and said they felt they were supported well by the manager and senior staff. One of the staff told us, 'I love my job, I absolutely love it. This is a lovely place to work.' There were sufficient staff employed to ensure people received the care they needed.

The provider had an effective complaints procedure in place. Everyone we spoke with knew how to complain, and to whom, but they all told us they had not had any reason to do so.

However, we found that medicines were not managed well enough to ensure people received their medicines safely and as they were prescribed.