Spring Hill Court

Updated 18 January 2019

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

Inspection site visit activity started on 13 November and ended on 16 November 2018. It was announced on both days. We gave the service 72 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Before the inspection we contacted the local Healthwatch and the local authority safeguarding and quality performance teams to obtain their views about the service. Healthwatch is an independent consumer group, which gathers and represents the views of the public about health and social care services in England. We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales. The provider had sent us their Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

The inspection was carried out by one inspector. During our inspection we looked at the care files and medication records of four people using the service. We looked at one staff recruitment file and three staff supervision, training and observation records. We reviewed records relating to the management of the service and a wide variety of policies and procedures including safeguarding and recruitment.

We spoke with two care workers, a team leader and the registered manager during the site visit. We talked with four people that used the service. Two professionals told us about their experiences of working with the service; an occupational therapist and the housing scheme manager.

Updated 18 January 2019

Spring Hill Court was inspected on 13 and 16 November 2018. The inspection was announced on both days. This was the service’s first inspection following registering with the Care Quality Commission (CQC) in December 2017. The service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 bought or 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.

Spring Hill Court provides support for adults aged 55 and over. There are 39 flats at the extra care housing facility. The housing scheme has accessible communal areas, a hairdressers and treatment room available for use by external organisations and professionals, such as chiropodists. Respite and guest flats were available for people or visitors staying at the service for short periods.

Not everyone using Spring Hill Court receives 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. At the time of inspection there were 12 people receiving a regulated activity. The service provides planned care visits and an emergency responder service to all those living in the housing scheme.

The service is registered to provide support for people with dementia, learning disabilities or autistic spectrum disorder, mental health needs, older people, people with a physical disability and those with sensory impairment. At the time of inspection, the majority of people receiving a service were older people.

Where services support people with learning disabilities or autism we expect them to be developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any other citizen. There were no people with a learning disability or autism using the service when we inspected. Therefore, we were unable to assess and monitor if the service was following this guidance.

There was a registered manager in post. A registered manager is a person who has registered with 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.

Staff understood their responsibilities to safeguard people using the service. They were able to identify signs which would indicate people may be experiencing abuse and were aware of different types of abuse.

Risks to people using the service were assessed and control measures put in place to reduce the likelihood of risk occurring. When new risks to people were identified following accidents and incidents, the cause of these was explored. Support from relevant professionals and updated risk assessments were put in place.

Medicines were managed safely overall. The support people required to take their medicines safely was assessed. Staff received training and competency checks prior to administering medicines. We have made a recommendation about ‘when required’ medicines.

New staff received an induction and underwent a six-month probation period to help them familiarise themselves with their role and consider their suitability. Staff received supervision to support their professional development.

Staff received appropriate training to support them in their roles. People felt staff were sufficiently trained and careful in their approach when assisting them. The roles of other health and social care professionals was understood. Staff knew when to seek advice from them.

People received support to maintain an adequate food and drink intake. Staff were aware of any special dietary requirements people had and supported people’s preferences.

People had positive working relationships with the care staff supporting them. For some people, building trusting relationships took time. They appreciated how staff respected this. People enjoyed the interaction they had with care workers, sharing in their interests.

People were treated with dignity and respect. Equality and diversity were understood, staff ensured they offered the same level of commitment to all people living in the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff supported people to be independent and in-control of their lives. Support was provided in a way that enabled people to do tasks for themselves where possible. When people needed support to be involved in making decisions about their lives, advocacy services had been made available to them.

People were encouraged to be involved in the Spring Hill Court community. They were reminded about upcoming events and supported to attend these. Staff were aware of people who had an increased risk of social isolation and spent time interacting with them.

Care plans contained person-centred details about people’s relationships and how they would like their support providing. People were given choices about their care. Reviews were used to ensure care plans remained up to date and provided an opportunity for people to provide feedback on the quality of the care and support they had received. People were aware of how to comment and raise complaints should they need to.

People and staff were engaged in the running of the service. They were able to approach managers to express their views or seek advice. People received quality visits and questionnaires, seeking their feedback on their experiences of care within the service.

Staff shared knowledge at staff meetings through presentations on different topics relevant to care, such as mental health. Team leaders and the registered manager attended other meetings with their peers working in the provider’s services.

The registered manager understood their responsibilities. They followed the provider’s policies to address staff sickness. Differences between staff members were resolved sensitively and effectively.

A range of audits were used to monitor and maintain quality and safety within the service. This included care file and medication administration record audits. In some audits it was not always clear what action would be taken to make changes. The registered manager planned to review this. Medication errors were explored. These issues were addressed to ensure care workers had the required level of knowledge and skill to provide this support.