Our inspection was unannounced and took place on 3 January 2017.

At our last inspection of 1 February 2016 although the issues we identified did not warrant a breach of regulation we identified that some improvement was required. The issues included aspects of medicine management and the non-reporting of potential harm. At this inspection we found that improvements had been made.

The provider is registered to provide personal care to adults. People who used the service received their support and care in their own flats within the extra care housing complex. On the day of our inspection 22 people received personal care and support.

The manager was registered with us as is required by law and was present on the day. 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 were supported with their medicines and took them as they had been prescribed by their doctor. Processes were in place to prevent people from the risks of accidents and injuries. The registered manager and staff had taken action to protect people from harm and abuse. There were enough staff available to meet people’s needs and to keep them safe.

Staff felt that the induction training they had received and the support they had on a day to day basis was good. Staff also felt that the supervision sessions offered ensured they did their job safely and in the way that people preferred. Training records confirmed that staff had received, or had secured, the training they required to meet people’s needs and to keep them safe. Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). They knew that regarding extra care services any DoLS referral would have to be made to and approved by the court of protection. Staff supported people to have sufficient diet and fluids to prevent them experiencing ill health due to malnutrition and dehydration. People received assessment and treatment when needed from a range of health care professionals which helped to promote their health and well-being.

People were supported and cared for by staff who were kind and caring. Staff supported people to be as independent as possible. People were encouraged and supported to undertake daily tasks and attend to their own personal hygiene needs.

People were enabled to make decisions about their care and were involved in how their care was planned and delivered. Staff supported people to keep in contact with their family as this was important to them. Complaints processes were in place for people and their relatives to access if they were dissatisfied with any aspect of the service provision.

People told us that they felt that the quality of service was good. Quality monitoring of the service and feedback processes ensured that the service provided was of a good standard and met people’s needs. The provider had informed of recent incidents that they were required by law to report.

Our inspection was unannounced and took place on 1 February 2016.

At our last inspection of September 2013 the provider was meeting all of the regulations that we assessed.

The service is registered to and managed by Sandwell Council. The provider is registered to provide personal care to adults. People who used the service received their support and care in their own flats within the extra care housing complex. At the time of our inspection 28 people received personal care and support.

The manager was registered with us as is required by law. 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.

Systems did not always confirm that people were given their medicine as they had been prescribed by their doctor.

The provider had not followed processes they are required to. We had not been informed of a recent medicine incident that should have been reported to us as is required by law.

Staff had not reported some issues that required attention so that remedial action could be taken to prevent the issues reoccurring.

Processes were in place to prevent people from the risks of accidents and injuries.

People and their relatives felt that there were enough staff available to meet their [or their family members] individual needs.

Staff felt that the induction training they received the support they had on a day to day basis and the supervision sessions offered ensured they did their job safely and in the way that people preferred.

Staff training records were not up-to-date however; staff confirmed that they had received the training they required to meet people’s needs and to keep them safe.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). They knew that regarding extra care services any DoLS referral would have to be made to and approved by the court of protection.

Staff supported people to have sufficient diet and fluids to prevent them experiencing ill health due to malnutrition and dehydration.

People were enabled to make decisions about their care and they and their families were involved in how their care was planned and delivered.

Staff supported people to keep in contact with their family as this was important to them.

Staff supported people to be as independent as possible. People were encouraged and supported to undertake daily tasks and attend to their own personal hygiene needs.

People received assessment and treatment when needed from a range of health care professionals which helped to promote their health and well-being.

Complaints processes were in place for people and their relatives to access if they were dissatisfied with any aspect of the service provision.

People told us that they felt that the quality of service was good. This was also the view of relatives and staff we spoke with.

During this inspection we spoke with three people that used the service and two of their relatives. We also spoke with the manager and two care workers.

People that we spoke with said that they and their relatives were involved in agreeing and planning their care. We found that people’s views and experiences were taken into account in how the service was delivered.

People told us that their needs were being met. One person told us, “I feel they are meeting my needs well, the manager and staff are lovely people.” We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that systems were in place to ensure that people were protected from cross infections whilst they were receiving care.

People told us that they were treated well by the staff that supported them. One person told us, “They are very caring and I can’t fault them.” We found that people were cared for by staff that were trained and supported to do their job well.

People told us that they had no concerns about the care that they received. People using the service and their relatives were confident that should they raise a concern it would be listened to and addressed. We found that clear systems were in place to investigate and respond to people’s concerns

This extra care facility is owned and mantained by Sandwell Homes. The care delivered is managed and provided by Sandwell Metropolitan Borough Council.

People living within this location have their own individual flat. The support

people receive is varied ranging from prompting and monitoring to complex personal care provision.

The location comprises of 33 individual flats although only 32 are used at the present time for people to live in as one is used for other purposes.

We spent the day observing people, their routines and interactions with staff. We spoke with six people living at the location. People indicated that they were happy with the care they received and with the staff. Below are a few examples of what people told us;

“ It is my home”.

“The staff are very good”.

“I really like it here”.

We spoke with two visitors who were complimentary about the care their relative received. One visitor told us; “The staff are good and caring”.

Staff we spoke with told us that they liked working at the location. One staff member told us; “We work as a team. I know that people are well looked after here and that they are safe”.

People we spoke with did raise a concern. They told us that staff did not always use the handling and moving equipment that had been provided.

Although people were complimentary about the care provided and the staff we found two areas that need to be reassessed.These concerned care planning for moving and handling equipment and staffing levels. We discussed these with the senior staff member of duty who assured us that they would look into them.

There were 26 people living at this extra care facility on the day of our inspection. We sampled six care files, four staff files; spoke with the manager, the coordinator, four care staff and six people that used the service and / or their relatives.

All people spoken with were positive about the care they or their relative received. One person said, “They look after us very well. I am very happy with my care.” One relative told us, “The staff are excellent. The care they give my mum is the best. I can’t speak highly enough about them.” People’s needs were assessed and planned to ensure people received care that met their needs. People's needs had been assessed by external health professionals including dieticians and speech and language therapists and community nurses. This meant that people's health care needs had been monitored and met.

People told us that staff asked for their consent before providing care. One person said, “They always ask me want I want done. They always listen.” The provider had appropriate systems in place to ensure that people’s mental capacity to consent to their care was documented.

People received their medicines as prescribed by their doctor to ensure their health needs were met.

Staff training was up to date and included caring for people with dementia so that they had the knowledge to support the people they cared for.

Audit systems were in place to ensure that people received quality care that met their needs.