What life is like for people using this service.

People using the service, relatives, staff and external professionals spoke positively about the leadership at the service and they thought it was well managed. We saw that managers were engaging with everyone using the service and stakeholders.

During this inspection we found shortfalls within some areas of the service provision. We disused these with the senior management team who were responsive to our feedback and assured us action would be taken to address identified issues by us.

Staff had received regular, formal supervision from their line manager. We noted that annual appraisal of staff performance had not been carried out since 2017. Consequently, staff skills to perform their role had not been reviewed and the need for further training had not been explored with them.

New staff received an induction before they started supporting people. Other staff received mandatory training which was mostly up to date or was planned for the near future. We observed that staff required further training in dementia awareness and epilepsy, which was still to be scheduled at the time of our inspection.

Medicines were managed safely and people received their medicines as prescribed. We noted that records related to medicines non-administration and creams application had not always been clearly maintained. These had not always clarified why people refused to take their medicines and what creams people were using.

Risk to people’s health and safety had been assessed and reviewed. However, some risk assessments could have more information on risk management strategies, to ensure all staff had easy access to it and could support people in a consistent way.

Care was provided with the consent of people. When people had reduced capacity to make decisions about their everyday care, staff had not always been provided with sufficient information on what decisions they could make and how staff could support them.

The senior management team had carried out monthly quality audits. Actions following these audits had been agreed, recorded and monitored to ensure highlighted shortfalls had been addressed. However, these audits had not been effective in identifying shortcomings identified by us during our visit.

The senior management team knew and understood their roles and responsibilities set by the Health and Social Care Act Regulations and current national guidance on best care practice.

Staff helped to support people to stay safe from harm and abuse from others. There were appropriate safeguarding procedures in place and staff followed them. Safe recruitment procedures ensured that people were supported by suitable staff. There were enough staff deployed to support people when needed. Infection control measures used by staff helped to protect people from the risk of infections. Accidents and incidents had been recorded and discussed with staff to avoid reoccurrence.

People’s needs and related risks had been assessed before they started using the service. We saw that support plans formulated were based on the initial assessment and explained how each assessed need would be met.

People were supported to have enough food and drink and had a diet that suited their nutritional requirements and personal preferences. Staff supported people to live a healthy life and have access to health professionals when needed.

People and relatives told us that the staff that supported them were kind and compassionate. Staff encouraged people to make decisions about their lives and were involved in their everyday care where possible. People’s support plans had been reviewed together with people and their representatives when appropriate.

Staff respected people’s privacy and dignity. People’s preferences as to entering their flats was discussed with them and respected. We saw staff knocking on the door before entering people’s flats. Peoples preferences regarding support of a male or female staff h

This inspection took place on 18 May 2016 and was announced. We gave the provider 48 hours’ notice of the inspection as we needed to make sure that the registered manager or another appropriate member of staff would be available to in order for us to carry out this inspection.

Gospel Oak Court is an Extra Care Housing Scheme and is registered to provide personal care to people living in their own flats within the scheme. Extra care schemes are places which enable people to live independently but can access tailor made and flexible care support when required. At the time of the inspection the service was providing care and support to 35 people some of whom were living with dementia or had a physical disability. This inspection was the first inspection of the service since it was registered in June 2014.

A registered manager was in post at the time of the 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 provider’s main office was based within the extra care scheme. On entering the building, we noted it to be clean, warm and welcoming. A concierge was available to open the door and welcome visitors to the building. Guests and visitors were promptly asked to sign in to the visitor’s book. Next to the entrance there was a coffee shop which, people living at the scheme, guests and visitors were able to access.

People told us that they felt safe and secure with the staff that supported them with their care needs. Relatives provided us with mixed views and opinions. Two relatives told us that they were happy with the care that people received, where as another two relatives were not so confident and had concerns about timekeeping and the lack of consistency in relation to receiving care from regular care staff.

The provider had a safeguarding policy and had appropriate processes in place to ensure people were protected from abuse. All staff that we spoke with had a good understanding of safeguarding and whistleblowing and knew clearly what steps should be taken to protect people from abuse.

The service had systems and processes in place to support people with their medicines safely. However, the service did not keep records of stock levels of medicines that were not part of the blister pack and were kept in individual boxes within the person’s own flat.

Care were detailed and person centred. The service carried out pre-admission assessments and as part of this assessment identified people’s individual risks associated with the care and support they required. A risk assessment was completed for each risk identified and clear guidance was provided to care staff so that risks could be minimised or mitigated. This ensured that people were kept safe at all times.

As part of the care plan process a needs assessment was completed for each person so that the service could determine appropriate staffing levels. The registered manager told us about the number of staff employed per shift during the day and the night. We noted that there was adequate staff to meet the needs of the people who required care and support.

Care plans were person centred, detailed and specific to each person and their needs. People’s likes and dislikes were recorded as well as information on how they would like to be supported. Care plans were reviewed and updated on a regular basis and were signed by the people receiving the care. Where a person was unable to sign the care plan we saw evidence of relatives or representatives signing the care plan on the person’s behalf.

People told us that the staff were adequately trained and skilled to support them with their care. Care staff demonstrated a good level of awareness in specific areas such as safeguarding and