This service provides care 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 bought or 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 the domiciliary care service provided for 23 people living at Pantiles House.

At our last inspection in April 2016, we rated the service Good overall. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated any serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

An experienced registered manager was in post. 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 using the service told us they liked living at Pantiles House and felt safe there. They said they were treated in a respectful and caring manner by regular staff members who knew them well and supported them effectively.

People were supported by sufficient numbers of staff who were trained and well supported in their job roles. Staff members had been safely recruited and had received a full induction to the service. Staff we spoke with were confident that they provided a good service to people and said they would recommend Pantiles House to their family and friends. They had access to supervision and additional support when required.

Staff understood how to help protect people from the risk of abuse. The service had procedures in place to report any safeguarding concerns to the local authority. People and staff were protected from potential risk of harm as the service had identified and assessed any risks to them and reviewed these on a regular basis. People had assessments which were individual to the person and their strengths and needs.

Medicines were administered in a safe way. Staff received training and a competency framework was in place to make sure they understood and followed safe procedures for administering medicines. Regular audits took place to make sure people received their medicines as prescribed.

Staff had received training in the MCA (Mental Capacity Act) and understood the importance of gaining people’s consent before assisting them.

The service completed a detailed personalised care plan for each person. They kept people’s needs under review and made changes as required.

People using the service felt able to raise any concerns or complaints. There was a procedure in place for people to follow if they wanted to raise any issues. Staff also said they felt comfortable in raising any concerns should they have any.

The service was well led. A longstanding registered manager monitored the quality of the service and new systems were being introduced to further ensure this. Staff and people who used the service found the management team approachable and responsive.

The inspection took place on 7 April 2016 and was unannounced. At our previous inspection in September 2014, we found the provider was meeting the regulations in relation to the outcomes we inspected. 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.

Pantiles House is registered to provide support for older people who require personal care and support in their own homes to enable them to retain their independence. The service is provided within an extra care housing scheme and some people receive domiciliary care support in their own flats from staff who are based in the same building. On the day of our visit there were 23 people receiving care and support.

People felt safe and were protected from abuse by staff that had a good understanding of how to identify abuse, and knew how to respond appropriately to any concerns to keep people safe.

Specific and general risks to people’s safety had been assessed and were detailed clearly within their care plans. Staff used these to assist people to remain as independent as possible.

There were sufficient staff to support people in their own homes with their required care needs. Staff had been recruited using a robust recruitment process.

Safe systems and processes were in place to ensure that medicines were handled, administered and disposed of safely.

New staff received a robust induction to the service to help them prepare for their role and responsibilities. Staff were also provided with a variety of training, based upon people’s needs, to help them to carry out their roles effectively. They had regular supervision meetings with the registered manager and annual appraisals to support them to meet people’s needs.

Policies and procedures were in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected.

People’s dietary requirements had been assessed. They were supported to make menu choices and encouraged to be independent in meal preparation if this was appropriate.

Appropriate action was taken in response to illness or changes in people’s physical and mental health. When required, staff supported people to attend healthcare appointments, if they could not be supported by relatives.

Staff treated people courteously, with kindness and care, respecting their expressed wishes and preferences. They provided care and support based upon assessed needs and worked hard with people to maintain their privacy and dignity.

People were able to contribute to the assessment and planning of their care packages. Staff provided care and support based upon assessed needs.

People knew how to make a complaint if they needed to, and were confident that the service would listen to them. The registered manager investigated and responded to people’s complaints in accordance with the provider’s complaints procedure.

The registered manager consistently monitored and reviewed the quality of care people received. The service encouraged feedback from people and their representatives. This was then used to identify, plan and make improvements to the service.

When we visited Pantiles House we spoke with six people who used the service, four relatives, the manager, the care team leader and two support staff. We reviewed five people's care files and four staff files.

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Was the service safe?

People who use the service were treated with respect and dignity by staff. They told us they liked their care worker to wear their badges and uniforms as it helped them to feel safe; one person said, “Yes my support worker wears their uniform and they wear their badge. I now know the person anyway”. Other people told us it helped them to feel safe, “to know who the people were who were knocking on their doors”.

Recruitment practice was safe and thorough. The manager ensured that support staff were appropriately qualified to meet the care needs of people who used the service. Risk assessments were undertaken to minimise the risks both to the person using the service and to support staff. This has helped to ensure that people’s needs were met safely.

Was the service effective?

People who use the service had their care and support needs assessed, together with risk assessments and they were involved in their care and support planning. We inspected five people’s care files. They included essential information about the person’s needs and risk assessment information and service delivery or care plans.

We found that staff had received regular and appropriate training and supervision and were able to ensure they were able to meet the specific needs of people using the service.

Was the service caring?

One person told us, “Yes I do have a support plan; it sets out a weekly timetable of the care I can expect to receive.” That person showed us their care folder that included their support plan together with other useful information such as the complaints procedure, which was in their flat. Another relative said, “We are kept fully informed about the care being provided and we are asked for our views and preferences”.

People who use the service told us they had discussed their care plans with staff and that they were able to discuss relevant issues and make decisions about what they wanted to do. This reflected the caring service ethos that we found on the day of the inspection.

Was the service responsive?

People who use the service were able to ask for changes in their care and support as their needs changed. Care plans had been reviewed regularly.

We spoke to six people and four relatives about the quality of the care they received. One person said, “The staff can’t do enough for me, they are fantastic”. Another person said, “It’s the best decision I made – the quality of care here is excellent”. A relative told us, “The care that my relative receives here is excellent, I have always found the staff here to be helpful and friendly, I have no complaints at all”.

All the people we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and although no complaints had been made since the last inspection staff indicated that they would be supportive of anyone who needed to complain. People can therefore be assured that complaints would be investigated and action taken as necessary.

Is the service well-led?

The manager and the care team leader carried out regular checks to assess and monitor the quality of service provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the service, their representatives and staff were listened to. People told us that they were asked for their feedback on the services they received and that they filled out a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the agency. This helped to ensure that people received a good quality service.

On the day of our visit we spoke with four people who used the service and five members of staff including the manager. All the people we spoke with told us that people who used this service were treated with dignity and respect. Observations of interactions between staff and people confirmed this.

People told us they were happy with the care they received. Comments included that staff were "so helpful" and "I feel supported." Care was provided taking into account people's welfare and safety.

People told us they were happy and felt safe at the home. We saw that staff had been trained effectively in safeguarding vulnerable people. Records showed us that the provider had responded efficiently when there was a change in people's health care needs.

Staff were appropriately checked before they commenced employment. The provider had taken steps that ensured that all staff were qualified and trained to provide an effective service for people who lived at the home.

People we spoke with told us they were involved in how the service was run. The provider undertook appropriate checks to monitor the quality of the service.

On the day of our inspection we were able to speak with three people using the service, a relative and a visiting healthcare professional. One person told us ‘It’s alright here. They treat me well’. Another person said ‘I can’t find fault with any of the carers. I couldn’t be in a safer place’. Another person told us ‘I’m quite happy here. Staff are very good and helpful’. A relative said staff treated their mother with dignity and respect. A visiting healthcare professional told us they thought the service was well run and the manager dealt with things quickly.

We looked at the plans in place to provide care and support to people using the service. We found there were instructions and guidance for staff about how to meet people’s care and support needs. We saw risks to their health, safety and wellbeing had been identified with a plan in place for staff to manage these.

We found guidance and instructions had been made available to staff on prevention and control of infection and how to maintain cleanliness.

The service had systems and records in place to audit medications and carried out regular checks to make sure staff correctly administered medication to people using the service.

Staff employed by the service had access to suitable training and development opportunities.

There was a system in place for dealing with complaints. People using the service had been given appropriate information about how and to whom they could make a complaint to.

The feedback we received from people living at the service was very positive. They said they felt well supported by polite staff who respected their privacy and dignity.

Feedback about the care and support provided included 'the staff are smashing - they get me up and give me breakfast', 'they come quick - always on the spot', 'I'm very well looked after' and 'its all fine'.

Comments about the staff included ‘always very nice', 'I get on alright with them', 'they are very nice people - it makes a big difference', 'they are very well chosen' and 'the staff are smashing'.

The people we spoke to felt able to raise any issues they had with the manager and were confident that these would be acted upon. One person stated 'I'm an interfering person so I would speak up' whilst other comments from people using the service included 'It's never happened but I would speak to the manager' and 'I can talk to the manager if I have any problems'.

Five people we spoke commented about the on site restaurant service now only being open for three days each week. Comments included 'this place needs a restaurant service every day of the week', 'we need it at least five or six days a week', 'not satisfactory' and 'I'm missing it very much'.