Housing & Care 21 - Paddy Geere House provides personal care to people living in their own flats within an extra care housing complex. At the time of our inspection there were 38 people using the service.

During our last inspection on 25 March 2015, the service was rated Good. At this inspection we found the service remained Good.

The service has a registered manager. A registered manager is a person who has registered with the CQC 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 using the service told us that they felt safe. There were systems in place designed to safeguard people from the risk of possible harm. Personalised risk assessments were completed and updated as required.

The service continued to have robust recruitment procedures in place. There were sufficient staff on duty to meet people’s needs. Staff had received training in the safe storage, recording and administration of medicines.

Staff understood their roles and responsibilities in relation to infection control and food hygiene and they had received training in these areas.

Staff were knowledgeable and competent in their roles and were supported by way of supervision and appraisals, to provide feedback on performance and plan future personal development.

People were supported to maintain choice and control over their lives and staff supported them in the least restrictive way possible. People were supported to maintain their health and well-being and to access health care services.

Staff were kind, respectful and maintained people's dignity and privacy. Positive relationships existed between people and staff. The staff were knowledgeable about the people they supported.

People were involved in planning their support and deciding how they were supported. People had detailed care plans, which reflected their needs and had been reviewed at regular intervals and after significant events.

People and staff knew how to raise concerns. Information regarding the complaints procedure was available in the reception area of the service. The service had a consistent process for receiving and recording complaints, concerns and compliments.

Quality assurance processes were in place. Feedback on the service was encouraged and people were provided with frequent opportunities to express their views on the care and support they received.

There was an open culture. People and staff found the registered manager supportive and approachable. The service sought the advice of other organisations upon management and quality assurance.

Further information is in the detailed findings below.

This inspection took place on 25 March 2015 and was unannounced.

The service provides care and support to people living independently in 36 flats at Paddy Geere House. On the day of our inspection support was being provided to 31 people.

There was 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.’

The care service at Paddy Geere House is provided by Housing and Care 21. People have a rental agreement with Abbeyfield Orwell who own the flats. Abbeyfield Orwell also provide cleaning services, lunch time meals and entertainment for people living in the service.

People felt safe receiving support from the service. Staff had been trained in safeguarding vulnerable adults and were able to demonstrate a working knowledge of safeguarding procedures.

People’s care plans were reviewed annually and more frequently if changes were required. Risks to people from receiving care were addressed as part of their care planning. Although some risk assessments were seen to be generic and not relevant to the person.

There were sufficient staff to provide care which met people’s needs. Recruitment procedures were followed to ensure only people suitable to work with vulnerable people were employed.

Medication was administered safely and as prescribed. Medication audits were carried out and where discrepancies or omissions were identified action was taken to address the cause.

Staff were provided with regular training, supervision and appraisals. This meant that they had been provided with the skills required to meet people's needs. The manager met staff regularly to discuss their work performance and plan their training and development needs.

People told us they were happy with the care that was provided and that it met their needs. They told us staff treated them with kindness and respect. Where appropriate people were supported to have a healthy diet and have sufficient to eat and drink.

Staff were supported by the manager. They described an open, friendly, caring culture where they were able to raise any issues or concerns that they had.

The management team monitored quality and safety of the service regularly and action was taken to address any deficiencies that were found and to improve the service.

We inspected this service to assess compliance with Regulation 13 Medicines Management following issues we had identified and raised at our previous inspection in July 2013. We spoke with four people who usd the service. They said they were pleased with the support staff gave them with medicines. We found appropriate arrangements in place for the recording, handling and safe administration of medicines. We noted improvements had been made to the way medicines were administered to people and our checks found medicines were given to people correctly.

We inspected this service to assess compliance with Medicines Management following and record keeping issues we identified and raised at our previous inspection on 10 April 2013 and also following reports we had received about medicine errors arising at the service.

People we spoke with said generally they were pleased with the support staff gave them with medicines. However, we found evidence of further errors and overall concerns with the way medicines were managed for people and recorded.

Care plans we inspected contained details of the support people required and care staff had signed to confirm they had read them.

We spoke with 3 people using the service. They told us, "The care is fantastic" and "The staff are very conscientious."

We found that the service plans planned care in consultation with the person requiring the care and carried out risk assessments in relation to that care. Staff were appropriately trained and received regular supervision. However, staff had not signed the care plans to confirm they had read and understood people's care needs.

The service did not accurately record the administration of medication.

We had the opportunity to talk with five of the people who use the service. All of the people we spoke with were happy with the care they received. They told us that they were supported in the way they wanted to be and were able to make their own minds up about the decisions they took regarding their care. They were complimentary about the people who supported them.

One person who we asked what they thought of the quality of care said, “The carers are good, they do everything I want.” Another person told us that, “The new manager is very helpful, she does what she can.”