About the service: Dame Alice Court provides support to people living in their own flats within one building. The service supports older people, younger adults, people living with a physical disability, people living with a sensory impairment and people with dementia.

People’s experience of using this service: People received personalised care to an outstanding level. People’s preferences were met and they could remain independent and in control of their care.

People and their relatives were very positive about this. One person visibly showed us how happy they were to keep their independence due to measures put in place by the management and staff team.

People were supported with dignity and respect at the end of their lives and staff went the extra mile to ensure people’s choices and preferences were met.

People were very positive and spoke highly about the care they received.

Staff were passionate about providing care to people. We saw that staff were kind and compassionate to people in their interactions.

Systems and processes kept people safe form the risk of harm and abuse. People told us they felt safe at the service when being supported with all aspects of their care including being supported with medicines.

Staff recruitment procedures were thorough and included all necessary criminal record checks.

Staff told us they received adequate training, supervision and competency assessments to carry out their job roles effectively.

People received support from healthcare professionals. Staff worked well with these professionals to ensure that people received the support they needed.

People’s privacy and dignity was respected. People were supported to remain independent in their lives as much as possible and this was promoted by the staff team. People were positive about how they could make choices and do things independently.

People were positive about the management of the service and felt able to contribute ideas about peoples care and support needs.

The management team were passionate about providing high quality person centred care.

Rating at last inspection: Good (report published 06 April 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. During this inspection we found evidence continued to support the rating of good and the service had improved to Outstanding in one area (responsive). More information is in the full report.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 18 February 2016.

Dame Alice Court provides personal care for people living within a sheltered housing scheme. The scheme is made up of 39 flats which, at the time of our inspection, were occupied by 41 people. The service provided personal care to 25 of those people.

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.

People felt that they were kept safe by members of staff, and staff were trained and knowledgeable about abuse and actions to take to avoid it. In addition, they ensured that accidents, incidents and safeguarding concerns were reported appropriately. There were risk assessments in place to provide staff with guidance about how to keep people safe and to minimise potential harm. There were sufficient numbers of staff to keep people safe and to meet their needs; members of staff had been recruited following robust procedures. People were encouraged to take their medication independently, however where required, staff were trained to support them, and there were systems in place to accurately record medication administration.

Staff members received training and supervisions from the provider, to ensure they had the skills and knowledge they needed to perform their roles. People’s consent had been sought by members of staff, before they provided them with care. There were systems in place to ensure the principles of the Mental Capacity Act 2005 were followed, if people were unable to consent to their own care. People were encouraged to be as independent as possible, however, staff were able to support people with meal preparation and booking and attending healthcare appointments, if necessary.

There was a positive and mutually beneficial relationship between people and members of staff. Staff valued the people they cared for and spent time interacting with them and building strong relationships. People had also been involved in planning their care, and the service had ensured that care plans were reflective of their needs and wishes. Staff were aware of the importance of treating people with dignity and respect, and worked to ensure that this was achieved.

People received care which was person-centred and based on their individual needs and wishes. Care plans were reviewed regularly, to ensure they were accurate and contained information about people’s current needs and wishes. People had visits scheduled in accordance with their wishes, but they could also request additional support at short notice from the service. The provider had a complaints procedure in place, which people were aware of. Few complaints were made, but those that were, were dealt with appropriately.

People were happy with the care they received from the service, and staff were motivated to provide them with the best support possible. This helped to create a positive and open atmosphere at the service. People and staff also felt that the registered manager was a regular presence at the service, and felt well supported by them. There were quality assurance procedures in place, to help identify areas for improvement and highlight positive areas of performance.

We visited the service, met with seven people using the service, spoke with two relatives and the housing manager. We also spoke with four care staff and the registered manager.

The people using the service and their relatives were all very happy with the care received. People said staff were very caring and friendly. They also told us staff were respectful, polite and they always knocked and asked before entering the flats.

We saw that each person had a care plan which they had agreed. The plan detailed the care they needed and the timings of calls.

The numbers of permanent staff had been an issue in the last 12 months and agency staff were used to supplement the numbers of staff required. This was due to plans about the service moving to a new provider. However, this had been concluded and there were no further plans to make this change. The service had been able to recruit additional permanent staff and the use of agency staff had reduced. Although the same agency staff had been used, some people did not find these carers to be as thorough as the staff from Dame Alice Court. We found that the staff we spoke with demonstrated that they took great pride in their work and the standard of care they provided was important to them.

The registered manager carried out audits and completed quality assurance processes so that the provider was kept aware of the operation of the agency. We saw these audits had taken place on a regular basis.

We spoke with four people currently using the service and one visiting relative.

People told us they were happy with the way they were treated and cared for by staff. One person told us, "The staff always speak to me in a respectful manner. I feel they treat me as they would their own family."

People we spoke with felt that their personal care was carried out in a manner that promoted their privacy and dignity.

Every person we spoke with said they felt safe at Dame Alice Court and each person assured us that if they had any concerns they could discuss it in confidence with either a team leader or the manager.

People told us that the staff treated them well and were friendly to them. They said they had regular staff who knew what they liked and how they preferred things to be done.

Two people told us they knew what was in their care plans and said they remembered being asked to sign them.