The inspection took place from 30 August to 12 September 2018 and was announced. The visit to the provider’s office took place on 30 August and 12 September 2018 and was announced. Further inspection activity included visits to Extra Care locations to meet people who used the service.

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 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.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.’

The provider had policies and procedures in place to keep people safe. Staff were trained in safeguarding. The registered manager maintained a log of all accidents, incidents and safeguarding concerns. They ensured lessons learnt were disseminated to staff as part of supervision and team meetings.

Risks to people were assessed with control measures in place for staff support and guidance.

Medicines were managed safely by trained staff whose competency to administer medicines was checked regularly.

The provider ensured staffing levels met the needs of people who used the service. Staff were appropriately trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff supported people with their nutritional needs to maintain a healthy varied diet. People had access to health care professionals when necessary.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. People told us staff supported them to uphold their privacy..

Care records were written in a person-centred way. People’s individual wishes, needs and choices were considered. People’s care and support was reviewed on a regular basis.

People were supported to attend activities and entertainment within the setting.

The provider had an effective complaints procedure in place and people who used the service and relatives were aware of how to make a complaint.

The provider had accessible information in different formats for people if requested.

The registered manager and staff worked with other stakeholders such as healthcare professionals. Community links were maintained with people accessing local amenities such as shops and churches.

The provider had an effective quality assurance process in place. Staff said they felt supported by the management team.

Reablement South is designed to help people recover from a period of serious illness or injury which may have resulted in hospital treatment. The service provides a range of rehabilitation, care and support services for up to six weeks. The service operates throughout the south area of County Durham. Extra Care works with housing providers in seven housing schemes in County Durham. All the schemes provide different numbers of flats within each site with 24 hour help for older people being available. Extra Care staff provide assistance with personal care, bathing, meal preparation, supervision and assistance with medicines.

We carried out this announced inspection on 14, 15 and 16 March 2016. We met with the registered managers and staff on 14 March and also spoke with people using the service and we looked at records on the 15 and 16 March.

We met with both registered managers of the Reablement South and Extra Care service. Both had been in post since the services began and had many years of service with in the local authority. 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.

For the reablement service, a team of supervisors and support officers were based in the office location with team leaders and reablement workers providing the direct service in people’s own homes.

For the Extra Care Service supervisors were employed at all seven of the service’s schemes around County Durham and they facilitated the day to day running of the extra care services and liaised with the housing provider where needed.

People we spoke with who received personal care felt the staff were knowledgeable, skilled and the care package met their needs. In the Extra Care service staff knew the people they were supporting well. People who used the told us they felt comfortable with the members of staff who were supporting them. Staff told us people received good care and support.

Staff undertook the management of medicines safely. There were procedures in place to support staff and staff we spoke with told us they were trained and felt confident in medicines management.

People told us they felt confident that should concerns be raised these would be dealt with appropriately. People told us they could contact the registered managers or staff at the service if they needed to discuss anything. People said they had the opportunity to talk about their opinions of the service during reviews and through meetings.

People were supported to maintain good health and had access to healthcare professionals and services. Where needed people were seen or referrals were made to the GP, district nursing service, occupational therapist, community physiotherapist and dietician.

People told us they were supported to prepare food and drinks of their choice. This helped to ensure that nutritional needs were met. People told us they were encouraged and supported to be independent with meal preparation.

People told us staff respected their privacy and dignity. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity.

The registered managers and staff we spoke with told us they had attended training in the Mental Capacity Act (MCA) 2005. MCA is legislation to protect and empower people who may not be able to make their own decisions, particularly about their health care, welfare or finances.

Records we saw confirmed Durham County Council had effective recruitment and selection policies in place which ensured staff members were of good character and had the required skills to perform their work.

Staff we spoke with told us they felt supported and they spoke highly of the training provided by the service. We saw that meetings with

During our visit we found people's privacy, dignity and independence were respected. We spoke with several people who used the service. They said staff respected their choices, privacy and dignity. One person said, “They are polite, respectful and kind at all times.”

We found personal care was planned and delivered in a way which ensured people's safety and welfare. One person said, “I can’t tell you how good this is. I have regular help with exactly what I need and if I need more, it’s at the press of a button.”

The provider had made suitable arrangements to protect vulnerable people and respond appropriately to any allegation of abuse. One person told us she had confidence in the carers support. She said, “I’m safe, cared for and I have a community and friends around me.”

We found staff received appropriate professional development. People told us they were happy with the support they received. One person told us, “The staff are very good, well trained and knowledgeable.”

People who used the service and their representatives were asked for their views about the service. We saw their responses were acknowledged and acted on. In a survey of both services almost all of those who responded said the quality of their lives had been improved.