About the service: Bishopstoke Park is a retirement village consisting of privately owned apartments and a registered residential care home. The retirement village includes a wellness centre and spa, restaurant, café a general store and a library. The provider (Anchor Hanover Group) is registered with CQC to provide a personal care service to people living in their own apartments in the retirement village. The residential care service is registered separately with CQC. This inspection relates only to the personal care service provided for people in the retirement village.

At the time of our inspection nine people were receiving the personal care service.

The registered manager’s responsibilities had recently increased as they had also become registered for a new Anchor service. This service was in the process of being developed but in the future it was planned that her time would be spent between the two services with a team leader taking day to day management responsibility for each site.

People’s experience of using this service:

Most people using the service described it in very positive terms. They described a caring and helpful staff team who provided them with reliable care in line with their expectations. Seven people required one member of staff to support them. Assistance required included some help with washing and dressing, prompting them or assisting to take medications, preparation of hot drinks and meals and escorting to and from the dining room. People told us staff managed these tasks well and that they were supportive and reliable. We found a good service was being provided to people who needed this level of support.

The service did not provide safe care to people who required greater levels of support, particularly those who needed assistance to move.

This was the current experience of two people.

Whilst one person who needed this amount of support was full of praise for the service provided the other person said they did not always feel safe when they were being assisted to move.

We found the lack of clear guidance regarding how to assist people to move safely was of such concern we notified the local authority under safeguarding protocols. The local authority has the lead responsibility for ensuring individuals are kept safe. The local authority involvement is ongoing at the time of this report.

We found six breaches of The Health and Social Care Act 2008 during this inspection.

Systems and processes to safeguard people were not effective as people had contacted CQC to raise concerns and they felt these had not been acted upon by the provider.

The provider had not taken all reasonably practical steps to mitigate risk, particularly when they assisted people to move.

There were not sufficient staff deployed to meet peoples' collective assessed needs.

Staff were not provided with suitable training and support in a timely way to enable them to carry out the duties they were employed to perform.

Concerns raised had not been investigated and appropriate action had not been taken to rectify any shortfall identified.

Governance systems in place were ineffective and feedback given was not used to evaluate the service and to drive improvement.

Rating at last inspection: The service was rated as Good at the last inspection in March 2017.

Why we inspected: This was a planned inspection which was brought forward due to concerns raised to CQC

Follow up:

As we have rated the service as inadequate, the service will be placed in 'special measures'. Services in special measures will be kept under review and, if we have not already taken immediate action to propose to cancel the provider's registration of the service, it will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe, so that there is still a rating of inad

This inspection took place on 16 February 2017 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be available in the office.

The service 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 bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate agreements; this inspection looked at their personal care arrangements. At the time of our inspection the service was providing personal care to five older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

A registered manager was not in post at the time of our inspection. 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. The service was currently in the process of registering the manager for the regulated activity of personal care.

Most people’s care plans and risk assessments provided comprehensive information and were reviewed regularly. However, these did not include information about people’s health conditions such as diabetes plans were not always adequate to support people appropriately.

People and their families told us they felt safe and secure when receiving care. Relevant recruitment checks were conducted before staff started working at Bishopstoke Park to make sure they were of good character and had the necessary skills.

Staff received training in safeguarding adults. They completed a wide range of training and felt it supported them in their job role. New staff completed an induction designed to ensure staff understood their new role before being permitted to work unsupervised. Staff told us they felt supported and received regular supervision and support to discuss areas of development. There were sufficient numbers of staff to maintain the schedule of care visits to meet people’s needs.

People who used the service felt they were treated with kindness and said their privacy and dignity was respected. People received their medicines safely. Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices.

Staff knew what was important to people and encouraged them to be as independent as possible. People were supported to lead full and varied lives and encouraged to make choices and had access to a range of activities.

Staff were responsive to people’s needs which were detailed in people’s care plans. Care plans were regularly reviewed to ensure people received personalised care. People felt listened to and a complaints procedure was in place.

Staff felt supported by the manager and could visit the office to discuss any concerns. Procedures were in place to investigate complaints and learn from any accidents or incidents. There were systems in place to monitor the quality and safety of the service provided.

The inspection was carried out on the 14 January 2016. Forty-eight hours’ notice of the inspection was given to ensure that the registered manager, staff and people we needed to speak with were available.

Bishopstoke Park provides personal care to older adults living in their own homes on an assisted living development. At the time of our inspection two people were receiving personal care from Bishopstoke Park.

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.

There were enough staff to support people effectively and staff were knowledgeable about how to spot the signs of abuse and report it appropriately. People said they felt safe with care staff and were complimentary about the staff caring for them. The registered manager took immediate action to ensure missing information for essential pre-employment checks was available. Medicines were managed safely and people received their medicines when they needed them.

People said they were satisfied with the service. They told us care was provided with respect for their dignity. Staff, and the registered manager, knew how the Mental Capacity Act 2005 affected their work. They always asked for consent from people before providing care

People’s care plans were person-centred and their preferences were respected. Care plans were reviewed regularly and people felt involved in the way their care was planned and delivered. People were asked for feedback on the service they received and any concerns were addressed promptly.

Staff had completed training appropriate to their role and an on-going plan of training was in place.

People said staff were caring and that they promoted a friendly atmosphere with them. Staff spoke about people in a kind and caring manner.

Staff said they worked well as a team and that the managers provided support and guidance as they needed it. Procedures were in place to investigate complaints and learn from any accidents or incidents.