Peppercorn House is a domiciliary care agency. It provides personal care to people living in their own flats in a sheltered housing complex. It provides a service to adults. At the time of this announced inspection of 17 May 2018 there were 22 people who used the service. We gave the service 24 hours’ notice of our inspection to make sure that someone was available.

At our last inspection of 3 February 2016 the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated 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.

The service continued to be safe. This included systems designed to minimise the risks to people, including from abuse and in their daily lives. There were systems in place for the service to learn from incidents to improve the service. There were care workers to cover people’s planned care visits. Recruitment of care workers was done safely. Where people required support with their medicines, these were administered safely. There were infection control procedures in place to guide care workers in how to minimise the risks of cross infection.

The service continued to be effective. People were supported by care workers who were trained and supported to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people required support with their dietary needs, systems were in place to deliver this. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide consistent care.

The service continued to be caring. People had positive relationships with the care workers. People’s dignity, privacy and independence were respected and promoted. Their views were listened to and valued.

The service continued to be responsive. People received care which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place and concerns were acted upon and used to improve the service.

The service continued to be well-led. The service used comments from people and incidents to learn from and to drive improvement. The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.

Further information is in the detailed findings below.

Peppercorn House is extra care sheltered accommodation providing personal care to people living in their own flats. When we inspected on 3 February 2016 there were 20 people using the service.

This was an announced inspection. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available.

A 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 we spoke with including one person’s relative were complimentary about the care provided. They told us they received safe and effective care by care workers who were kind and compassionate.

Systems were in place which safeguarded the people who used the service from the potential risk of abuse. Care workers knew how to recognise and report any suspicions of abuse. They understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

There were sufficient numbers of care workers who had been recruited safely and who had the skills and knowledge to provide care and support to people in the way they preferred. People were treated with kindness by the care workers. Care workers respected people’s privacy and dignity and interacted with them in a caring and compassionate manner.

People received care and support which was planned and delivered to meet their specific needs. People and/or their representatives, where appropriate, were involved in making decisions about their care and support arrangements.

Where required people were safely supported with their dietary needs. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

There was an open and transparent culture in the service. The registered manager demonstrated effective leadership skills and care workers said they felt valued and supported. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and acted on. The service had a quality assurance system with identified shortfalls, which were addressed promptly; this helped the service to continually improve.

We talked with six people who used the service to gain their views and experiences. People told us that they received good care and their views and choices were listened to and acted on. One person told us, “It’s very good here, people seem happy, and the staff are excellent at their job. That makes a difference. They (staff) are kind it comes naturally, it’s not a chore for them to help people.” Another person told us, “I don’t have any concerns, if there is a problem I speak with the staff and we work together. They listen to me and that is important. They help me keep on top of things and don’t fob me off.”

We spoke with three visitors to the service who were positive about the care and treatment their friend/relative received. One person told us, “I am really happy with the care provided here. There are always people (staff) around to keep an eye on (person using the service). This is a great relief and peace of mind for me.” Another person said, “Since they (person using the service) have come here they have improved so much. It’s a much nicer environment for them being here than in a nursing home. There is much more freedom to come and visit them in their own flat and the staff help them remain independent. They (person using the service) are always involved in something that’s going on here.”

We looked at five care plans which were person centred with information for staff on how to meet individual’s health and care needs. People’s choices and preferences were reflected in the care records and written in a way that promoted independence.

We looked at medication records which showed there were arrangements in place for the safe handling, storage and administration of medicines.

We saw that the service provided enough qualified, skilled and experienced staff to meet people’s needs. We looked at staff records and spoke with five members of staff who told us they were being appropriately supervised and supported. We talked with three staff members about meeting people’s needs and they were knowledgeable about the people they supported.

We saw that the provider had systems and procedures in place to regularly monitor and assess the quality of the service provided. We also looked at the way that complaints were recorded and dealt with, and saw that they were handled in line with the provider's policy.

During our inspection we observed that the interaction between staff and people using the service was friendly, respectful and professional. Staff respected people’s privacy and dignity and sought their agreement before providing any support or assistance. One person told us that when they were supported with their personal care needs, “The staff here treat me with dignity and respect and it’s never been seen as a problem. They deal with it professionally and this has improved my confidence and helped me become more independent and get my freedom back.”

We spoke with four people who used the service. They told us they experienced good care and their healthcare needs were met.

We asked people if they were not happy about their care or treatment what they would do and people told us they would speak to the care workers or registered manager if they had concerns. One person told us “It is a lovely place, very welcoming and the manager and carers are very nice.”

People told us there was enough trained care workers to support them with their needs. One person said “They (care workers) are very nice, friendly, smiling and laughing; nothing is too much trouble for them.” Another person told us the care workers “Check first what you need as some days I can do more for myself and are very patient and don’t rush you.”

People we spoke with told us they were fully consulted about their care plans and had been asked for their views about the service they receive. They all said their privacy and dignity was respected and they felt safe with their care workers.

Everyone we spoke with told us they found their care workers honest, reliable and trustworthy.

People we spoke with told us that they were very happy with care they received at Peppercorn House. We were told that “it’s a wonderful place, the people are so lovely”, “all staff are great”” and “I never feel awkward when staff attend to me”. One person told us that they “couldn’t believe it to be true that people can be so kind” and another person said that they “just love it (at Peppercorn House) and would advise anyone to come”.

We were also told by people using the service that staff encourage people to be independent with one person commenting that “I keep independent, the staff will only help me with the things I cannot do for myself”.