We carried out a review of the data available to us about Assisi Place 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 Assisi Place, you can give feedback on this service.
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
At our last inspection published in August 2016, the service was rated Good overall with the domain of well-led being rated as requires improvement. At this inspection we found the evidence continued to support the rating of Good overall and improvements had been made in the key question for Well-led. 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.
The service continued to provide people with safe care. There were systems in place which were intended to minimise the risks to people and keep them safe, in their daily lives. There were enough care workers to cover people’s planned care visits. Recruitment of care workers was done safely. Where people required support with their medicines, these were administered as prescribed. However, good practice was not always followed. We made a recommendation about this in the report. There were infection control systems in place to reduce the risks of cross infection.
People continued to receive an effective service. People were supported by care workers who were trained to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people required support with their dietary needs, systems were in place to deliver this. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.
People continued to receive a caring service. People had positive relationships with the care workers, team leaders and the registered manager. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued.
People continued to receive a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people that mirrored their choice. A complaints procedure was in place and complaints were acted upon and used to improve the service.
People received a well-led service. There was a registered manager in post and they were building links with the local community to improve people’s lives. Incidents were used as learning opportunities and people’s views were used to continuously develop and improve the service. The service had a quality assurance system and shortfalls were identified and addressed. As a result, the quality of the service continued to improve.
Further information is in the detailed findings below.
At the last inspection in January 2016 we found the provider had breached three regulations associated with the Health and Social Care Act 2008. We found there was no safe management of medicines, the provider had not taken appropriate steps to ensure sufficient numbers of staff were deployed in order to meet people’s needs and the registered person did not have effective systems in place to monitor the quality of service delivery. We told the provider they needed to take action; we received an action plan. At this inspection we found improvements had been made with regard to these areas.
Assisi Place is purpose built housing made up of 45 apartments where people are supported with personal care. It is owned and managed by Methodist Homes Housing Association and the domiciliary care service is delivered by Methodist Homes.
At the time of this inspection the service had a registered manager. 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.
We found people were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment procedures were in place. Staff received the training and support required to meet people’s needs.
Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect people they supported. People told us they felt safe with staff. The provider had appropriate arrangements in place to manage medicines safely.
Managers and staff understood the requirements of the Mental Capacity Act 2005. The care plans we looked at contained mental capacity assessments where appropriate. There was opportunity for people to be involved in a range of activities within the service or the local community if they wished.
Care and support plans were sufficiently detailed and provided a description of people's care and support needs. People were supported with their nutritional and hydration needs and had access to a range of healthcare services.
Staff understood people's needs and provided care and support accordingly. Staff had a good relationship and rapport with the people they supported. Staff were aware and knew how to respect people’s privacy and dignity.
The service had good management team. There was an effective system in place to respond to complaints and concerns. Effective systems were in place which ensured people received safe quality care. People had opportunity to comment on the quality of service and influence service delivery.
Assisi Place is purpose built housing made up of 45 apartments where people are supported with personal care. It is owned and managed by Methodist Homes Housing Association. The registered domiciliary care service is delivered by Methodist Homes.
At the time of the inspection, the service had a manager registered with the Care Quality Commission (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.
We saw arrangements for medication were not safe and there were not enough staff to keep people safe.
Systems were in place to monitor the quality and safety of service provision. However, we found there was no analysis of complaints, which looked for recurring themes or how lessons were learnt. Incidents had not been reviewed and there were no action plans noted or seen for the audits that had been completed.
We found there were systems in place to protect people from risk of harm, although risk assessments in people’s care and support plans were generic. Appropriate recruitment procedures were in place. There were policies and procedures in place in relation to the Mental Capacity Act 2005.
People’s care and support needs were assessed and care and support plans, in the main, identified how care and support should be delivered. People we spoke with told us they were very happy with the service they received and staff were kind and caring, treated them with dignity and respected their choices. However, people were not complimentary about the registered manager.
People who used the service told us they felt safe with the staff and the care and support they were provided with. We found people were cared for, or supported by, appropriately trained staff. Staff received support to help them understand how to deliver appropriate care. People told us they got the support they needed with meals and healthcare.
You can see what action we told the provider to take at the back of the full version of the report.
We looked at four care records for people who used the service. We saw evidence in these records that people were consulted about their preferences and plans for their care. Since the last inspection, the provider had introduced a supplementary record sheet to show people had been asked if they had any medical conditions and allergies they wanted the service to know about. Senior staff had also received advanced care plan training.
We saw evidence that people were supported by sufficient numbers of appropriate staff. The manager told us that staffing levels were based upon people's needs. She said that staff were skilled and had positive attributes to their role.
We found that there were systems in place to monitor and evaluate the quality of the service provision and that the views of people who used the service were taken into account. We saw records in respect of each person were appropriately maintained and filed in a secure accessible way.
One person said; "It is wonderful and has been since the moment I walked in.' Another commented; "We receive care from people who are genuine. They do everything graciously and are happy and cheerful.' Another person spoke of how kind and patient the staff were with them.
People also spoke highly about the quality of food provided. One person said; "They (staff) always ask if you are ready to have your lunch or your next course, they never rush you. The food is very good.'
Two of the people spoken with had some negative comments about how staff work, or about the costing for their care. These comments, in agreement with the people spoken with, were discussed with the deputy manager at the time of the inspection and situations looked into.
People said that their family and friends were made to feel welcome.
We saw that people were offered choice and staff respected their privacy and dignity while encouraging them to be as independent as possible. When we asked people if they liked living in Assisi Place they made comments such as:
'We have the best of both worlds. '
' It's a wonderful atmosphere.'
There was evidence that people took part in a wide range of activities both in the community and within Assisi Place.