Background to this inspection
Updated
5 December 2019
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 Care Act 2014.
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. 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.
A new manager had been appointed and was in the process of registering with the Care Quality Commission. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service a short period notice of the inspection. This was because we needed to be sure the provider or manager would be in the office to support the inspection.
Inspection activity started on 29 October and ended on 1 November 2019. We visited the office location on 29 October 2019.
What we did before inspection
We reviewed information we had received about the service since the last inspection. This included statutory notifications sent to us by the provider about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We used all of this information to plan our inspection.
During the inspection
We spoke with eight people who used the service and five relatives by telephone to find out about their experience of the care provided. We visited the office and spoke with the care manager, manager, representative of the provider and two staff. We reviewed a range of records. These included six care records, four staff files and records relating to the management of the service. We visited two people in their homes and looked at the care records and daily notes completed by care staff.
After the inspection
We continued to seek clarification from the care manager to validate evidence found. We reviewed written feedback from a healthcare professional and spoke with two of the commissioning team at the local authority. We spoke with a further staff member by telephone.
Updated
5 December 2019
About the service
Margaret House 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 or owned and is the occupant's own home.
There are 39 one and two-bedroom apartments at Margaret House. Not everyone who lived at Margaret House 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. There were 33 people receiving care and support at the time of this inspection.
People’s experience of using this service and what we found People told us they felt safe with staff who supported them. Risks to people had been identified and assessed and were managed safely by staff. Staff supported people to take their medicines or reminded them when they were due. People were protected from the risk of infection. Staff wore disposable aprons and gloves when providing people with personal care.
People spoke positively about the staff who supported them and had confidence in their skills and experience. Staff had regular supervisions and an annual appraisal. People enjoyed the lunchtime meals and some were supported by staff to prepare other meals in their homes. People had access to a range of healthcare professionals and support.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice
People were looked after by kind and caring staff who knew them well. In one person’s review they commented, ‘Excellent service, all staff lovely and caring'. People were encouraged to be involved in decisions relating to their care. People's diverse needs were catered for and they were treated with dignity and respect.
Care was personalised to meet people's needs. Care plans provided detailed information and guidance for staff on people's care and support needs, likes and dislikes, and the way they wanted to receive personal care. Information could be provided to people in an accessible format. Activities were organised according to people's preferences, interests and suggestions. Complaints were dealt with in line with the provider's policy.
People considered the service was well-organised. The care manager provided a visible presence and was available to people if they wished to discuss their care. People were encouraged in their involvement and development of the service and their feedback was encouraged. Quality assurance systems were in place to measure and monitor the standard of the service and drive improvement. Areas of concern identified at our previous inspection had been addressed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 5 November 2018).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.