Care and Support Service Sandford Station is a domiciliary care service, which provides support to people who live in their own homes. The provider is registered to support people with a wide range of needs including dementia, older people, and people who have physical disabilities. 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. People using the service lived in flats and houses in a large gated community. Not everyone living at Sandford Station receives 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.

We inspected the service on 13 April 2018. The provider was given 48 hours' notice of our visit; because we needed to be sure that, someone would be in the location's office when we visited. At the time of our inspection, there were 36 people using the service; primarily the service supported older people. At the last inspection in December 2015, the service was rated Good overall. At this inspection, we found the service remained Good.

The service had a registered manager in place. 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.

Staff demonstrated knowledge of how to support people who may be vulnerable. They were able to identify elements of potential abuse and neglect and they knew how to report incidents. They knew the people they supported well.

People we spoke with told us they felt safe, respected and well cared for. Staff had good knowledge about people's needs. They worked well together as a team, sharing knowledge and ideas, which would enhance the service.

All staff that were employed at the service were recruited safely. References were sought prior to employment commencing and employment checks were completed to support the registered manager in making safe decisions about whom they employed. A comprehensive induction and training package was available to all staff and they were supported through regular supervision and appraisal.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and encouraged them to remain independent. Staff understood that people should be consulted about their care and they understood the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards.

Best interest decisions involved people's representatives when required. Staff worked in a person centred manner and treated people with dignity and respect.

Staff had positive, genuine relationships with the people they supported. People were treated with kindness and compassion and they told us staff were caring.

Care plans were centred on the needs and preferences of the person and detailed individual requirements. Care plans were regularly reviewed and kept up to date when people's needs changed. People were involved in devising their care plan and they had active input into the reviews of their care.

People's choices and preferences were valued and recognised. We received consistently positive feedback from people who used the service.

People knew how to complain and they were confident that any complaint made would be dealt with.

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We undertook an announced inspection of Care and Support Services – Sandford Station on 3 November 2015. When the service was last inspected in February 2014 there were no breaches of the legal requirements identified.

Care and Support Service – Sandford Station provides personal care to people living in privately owned or privately rented apartments within the provider’s retirement community site. The service also supports people nominated by North Somerset Council. All of the people at the service have 24 hour access to staff in the event of an emergency. People who lived within the retirement community have access to facilities such as a swimming pool, gym, a small shop, a hairdressing salon as well as a restaurant area. At the time of our inspection the service was providing personal care to 29 people.

A registered manager was in post at the time of 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.

People felt safe and were well cared for by the staff team. One person described the service as, “Being part of a big family.” People said their scheduled care appointments were completed as agreed and where they needed support they received their medicines on time. We saw that medicines records were completed accurately and audits were effective.

Staff knew how to identify and respond to suspected abuse and the provider had appropriate policies to guide and support staff. There were processes in place to ensure that staff recruitment was safe and completed in accordance with legal requirements. Reported incidents and accidents were reviewed and people benefited from a daily reporting system that allowed them to inform the service they were safe.

Staff received appropriate training to deliver effective care and people commented they received personal care from well trained staff. The provider had an induction for new staff aligned to the care certificate and staff received support through supervision and appraisal. People told us that although they accessed their own GP, they felt assured staff would support them if required.

People told us the staff at the service were caring and said they had a good relationship with staff. We made observations of positive interactions between staff and the people they supported. The service had received numerous compliments from people and their relatives about the care and support provided. Staff understood the people they supported well.

People felt the service was responsive. People gave examples of when the service had been responsive to their changing care needs through the short term increase in care and support. People’s care needs were reviewed and people were involved in their care planning and reviews. The provider’s complaints procedure had been followed when required and issues at the service were resolved quickly.

People understood the management structure at the service and said the current retirement community manager was friendly and approachable. Staff spoke very positively about the management at the service and told us they enjoyed their role and said there was a good team ethos. There were systems that monitored the quality of service provided to people, and key messages were communicated to staff and people who received care.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

We spoke with nine members of staff, four people who use the service and two relatives.

People who use the service told us that they were included in decisions made about their care and that they were treated with dignity and respect.

We found that provider had systems in place to promote successful partnership working with other health and social care service providers.

One person said, “There is something built into these carers; they ask you if you want something before you know that you want it”.

People who use the service and their families expressed extremely high satisfaction with the service they received from care and Support Sandford Station.

Care and Support Sandford Station had systems in place to promote the welfare and safe care of people who use the service.

A person who uses the service said, “This is not the old fashioned way of treating old people; here you have a voice”.

We found that Care and Support Sandford Station had systems in place to assess and monitor the quality of the service provided which included seeking the views of people who use the service and their representatives.

We spoke with three people who received a service from the care and support service at Sandford Station. All the people we spoke with were very positive about the service they received. People we spoke with made the following comments about the service: “They (the care staff) make every effort to provide for your wishes” and “the staff provide an excellent service”

During our visit we saw care staff interacting with people in a positive and encouraging way.

People’s needs were assessed before they started to receive a service. Care plans we viewed gave clear guidance to staff on how the person liked that support to be provided. Staff we spoke with told us that the care plans were clear and that they were up to date.

People we spoke with told us that they liked the care staff and felt safe. One person said “the carers a very good, always happy to see you, we often have a laugh together”.

We spoke with five members of staff who were clear on the different types of abuse that they could come across. They explained to us the actions that they would take if they suspected abuse.

Staff we spoke with told us that they felt well supported in their roles. They said that the management were very approachable and supportive.