Background to this inspection
Updated
7 October 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by one inspector and 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.
Service and service type
This service provides care and support to people living in specialist ‘extra care’ housing.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider would be in the office to support the inspection.
Inspection activity started on 04 August 2022 and ended on 17 August 2022. We visited the location’s service on 04 August 2022.
What we did before the inspection
We reviewed information we had received about the service since its registration. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan our inspection.
During the inspection
We spoke with two people and nine relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager and care staff. We reviewed a range of records. This included four people’s care records, three staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service.
Updated
7 October 2022
About the service
Sumners Farm Close provides care 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 the occupant's own home and people's care and housing are provided under separate contractual agreements. CQC does not regulate the premises used for extra care housing. This inspection looked at people’s personal care service. At the time of the inspection 24 people were receiving support with their personal care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
The provider had not always ensured there were enough staff available to provide people with personalised care which reflected their needs and preferences. Staff told us they did not have enough time to support people effectively and this impacted on the quality of care provided. Relatives confirmed people’s care visits were sometimes delayed or rushed.
Not all staff had up to date training to support them in understanding people’s needs. Staff did not always feel supported in their roles. Recruitment processes for new staff were not always completed robustly. We have made a recommendation about the provider’s employment checks.
People and relatives knew how to raise concerns but did not always feel their concerns were responded to effectively. We have made recommendation about the provider's complaints processes. Staff did not always feel listened to or valued and did not feel able to raise concerns with the provider.
Staff were aware of how to keep people safe from harm. However, the provider had not ensured safeguarding records were kept accurately and not all staff had updated safeguarding training in place.
People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
The provider had not used their auditing systems effectively to monitor the quality and safety of the service. The processes in place had not highlighted the concerns we found during the inspection and we could not be assured the provider had clear oversight of the service.
We received mixed feedback about whether staff used personal protective equipment [PPE] appropriately and how the provider communicated with people and relatives about the risks associated with the control and spread of infection. We have made a recommendation about the provider’s infection prevention and control measures.
People had care plans and risk assessments in place which detailed how they liked to be supported and guidance was available for staff to support people safely with their medicines. People were encouraged to maintain as much independence as possible and the provider worked alongside other healthcare professionals to support people’s care needs and improve their care.
People and relatives told us staff were generally kind and respectful of people’s privacy. People and relatives told us they felt involved in the service and found the registered manager and staff approachable and friendly. The provider responded promptly to the feedback we gave during our inspection, supplying additional information to address the concerns raised.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 6 April 2020. This is their first inspection under the current provider.
The last rating for the service under the previous provider was Good, published on 10 April 2019.
Why we inspected
This was a planned inspection as the service had not been rated under the current provider.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to staffing levels, training and oversight of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.