About the service: Human Support Group – Angel Court provides care and support to people living in an 'extra care' setting, some of who may be living with a dementia. Angel Court contains 45 flats and has an onsite housing manager, communal dining areas, a shop, laundry, chiropodist and hair dressers. At the time of the inspection there were 28 people receiving support.

People’s experience of using this service: During our inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to the management of medicines, safeguarding people from abuse, person centred care and the effectiveness of governance arrangements. We also found a breach of the Care Quality Commission (Registration) Regulations 2009 as the service had not notified us of specific incidents. Details of action we have asked the provider to take can be found at the end of this report.

The provider and management team did not have sufficient oversight of the service. The quality assurance systems did not effectively monitor or identify problems relating to the safety and care provided to people.

People’s medicines were not safely managed. Medicine administration records were not accurate and people were at risk of receiving the incorrect dosages of medicines. Care plans did not reflect the needs of the person and did not include all appropriate information to guide staff on how to provide support.

People did not have their needs assessed before the service provided support to them. People’s needs were not reviewed regularly in line with best practice. Care plans did not reflect reviews or updates from other health care professionals which were detailed in people’s daily notes.

There were policies and procedures in place to help keep people safe, but staff were not following these. Staff had received training in safeguarding. However, we found three instances were staff had identified a form of abuse but had not escalated this to the local safeguarding adults’ team.

The service had not notified the Care Quality Commission (CQC) of 11 incidents which had been investigated by the local authority.

People gave positive feedback about the care provided by staff. Staff were respectful of people’s privacy and dignity. Staff worked with other health care professionals to provide support to people. People were encouraged to maintain social relationships.

Staff recruitment was safe. Staff had received training as part of their induction and this was reviewed regularly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: This was the first inspection of the service since it was registered in November 2018.

Why we inspected: This inspection was carried out due to concerns we had received from partnership agencies and our own intelligence monitoring.

Follow up: We will continue to monitor the service through information we receive from the service, provider, the public and partnership agencies. As part of our process we will be requesting an action plan to be completed to address the issues identified and meeting with the provider to obtain assurances that they will meet the regulations. We will re-visit the service in line with our inspection programme. If we receive any concerning information we may inspect sooner.