This inspection site visit took place on 3 and 5 July 2018 and was announced.

Poppy Court is an ‘extra care’ housing scheme. People live in their own homes where care and housing are provided under separate contractual agreements. CQC does not regulate the premises used for extra care housing. We only inspect the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating.

Poppy Court provides personal care and support to people within a complex of 48 apartments and 10 bungalows. Not everyone living at Poppy Court received personal care. At the time of our visit 31 people were in receipt of personal care from the provider.

The apartments are arranged over three floors with a lift and stairs to each floor. Staff provide care at pre-arranged times and people have access to call bells for staff to respond whenever additional help is required. People also have access to communal lounges and a dining room.

At our last comprehensive inspection in June 2017 the provider was not meeting all the regulations. We found a breach in Regulation 12, in relation to safe management of medicines, and improvements were required in the key questions ‘is the service’ safe, effective, responsive, and well led. We rated Poppy Court as ‘Requires Improvement’ overall.

We asked the provider to complete an action plan to show what they would do and by when to improve the key questions to at least good. At this inspection we found the provider was no longer in breach of the regulations and the required improvements had been made. We rated the service as Good.

Since the last inspection the registered manager had resigned. 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. Following the resignation of the registered manager, the provider’s area manager for Poppy Court registered as manager on an interim basis, until another registered manager was recruited. A new manager had been employed by the provider in May 2018 and was in the process of registering with us. The new manager supported this inspection and we refer to them as ‘the manager’ within the report.

People received varying levels of personal care and support depending on their needs. Some people only required wellbeing checks or minimal assistance with personal care. Others required assistance with administration of medication, continence care, showering/bathing, nutritional support and with mobility.

People felt safe living at Poppy Court and with the staff that visited them. Staff had completed safeguarding training and understood how to keep people safe from avoidable harm and abuse. Risks to people’s safety were assessed and plans provided guidance for staff about how to reduce known risks. People who required assistance to take their medicines, received these as prescribed by staff who had completed training to do this safely.

People had an assessment completed at the start of their service to make sure staff could meet their care and support needs. Staff received regular training that provided them with the skills and knowledge to support people’s needs and had regular checks on their practice to make sure they continued to support people safely. Recruitment checks were completed on new staff to ensure they were suitable to work with people who used the service. There was enough staff available to allocate all the visits people required and to meet people's needs safely.

People were visited by a team of staff that they knew and who they said were kind and considerate. Staff respected people's privacy and supported people to live independently in their own homes. Staff arrived around the time arranged and stayed long enough to do everything p

This inspection took place on 8 June 2017 and was announced 24 hours before our visit to see if people who lived at the service would be available to speak with us.

Poppy Court provides an extra care service of personal care and support to people within a complex of 48 apartments and 10 bungalows. Staff provide care at pre-arranged times and people have access to call bells for staff to respond whenever additional help is required. The complex is spread over three floors with a lift and stairs to each floor. People have access to communal lounges and a dining room where they can have lunch or tea. At the time of our visit 45 people were in receipt of personal care from the provider.

We last inspected the service in July 2015. At our last visit we had rated the service as ‘Good’ overall. During this visit we found standards had fallen and the rating was now ‘Requires Improvement’ overall. We found however, that the provider was aware of most of the concerns found at this inspection, and had already started to take steps to improve the service.

The service did not have 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.

The previous registered manager had left in March 2017 and the service was being overseen by the provider’s operations manager, a locality manager and a temporary scheme manager, whilst recruitment for a new scheme manager and care staff was underway. A new scheme manager joined the service two weeks after our inspection visit.

In early 2017, there had been significant restructuring of the provider’s management teams that supported the service. People told us they had found the recent changes in the management of the service unsettling and some felt the provider had not kept them fully informed. Some staff felt morale had declined and they had not felt supported by the provider. However others felt that the service was beginning to improve and that the new management team were approachable and supportive.

People received varying levels of support depending on their needs. Some people only required a minimal assistance with personal care. Others required assistance with administration of medication, continence care, nutritional support and with mobility.

People told us they felt safe living in their accommodation and with the staff who delivered their care. Staff were aware of the action they needed to take if they had any concerns about people’s safety or health and wellbeing. However, risks related to people’s health and well-being were not always fully or accurately assessed and care plans did not always include important information about risks to people’s health. Staff were however, able to talk confidently about how they managed those risks.

Medicines were not consistently administered correctly to people or managed well. The provider had identified this and was taking robust action to make improvements.

Staff allocation sheets showed there were sufficient staff to cover the scheduled calls to people. Some people told us there were occasions when they had to wait if they requested assistance between their scheduled calls. The provider employed agency staff to support staff numbers on each shift and was actively recruiting new staff to the service.

Staff received an induction and training when they started working at Poppy Court. Some training was out of date, but there were plans to ensure all staff completed the required training to ensure their work safely met people’s needs. Staff received supervision meetings to discuss their work and training needs.

Care plans were not consistently kept up to date and information was difficult to find. The provider was reviewing all the care plans to ens

This inspection took place on 21 July 2015 and was unannounced.

Poppy Court provides an extra care service of personal care and support to people within a complex of 48 apartments and 10 bungalows. Staff provide care at pre-arranged times and people have access to call bells for staff to respond whenever additional help is required. The complex is spread over three floors with a lift and stairs to each floor. People have access to communal lounges and a dining room where they can have lunch or tea. At the time of our visit 62 people were living within the complex.

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.

At our previous inspection in April 2014, we found three breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008. During this inspection we found progress had been made in addressing our concerns, but further action was needed to consolidate the improvements made.

People received varying levels of support depending on their needs. Some people only required a wellbeing check or minimal assistance with personal care. Others required assistance with administration of medication, continence care, nutritional support and with mobility. People told us they felt safe living in their accommodation and with the staff who delivered their care. Staff were aware of the action they needed to take if they had any concerns about people’s safety or health and wellbeing.

The staff allocation sheets showed there were sufficient staff to cover the scheduled calls to people. However, people told us there were occasions when they had to wait if they requested assistance between their scheduled calls. The registered manager had identified that due to an increase in people’s needs, more staff were required on each shift. New staff had been recruited and were awaiting the outcome of checks to ensure they were safe to work with people before starting work at the service.

Staff received a detailed induction and training when they started working at Poppy Court. Some training was out of date, but there were plans to ensure all staff completed the required training so their work reflected best practice. Staff received supervision and support and told us the registered manager and senior staff were “open and very easy to approach” and “responsive”.

Care plans did not always include important information about risks to people’s health, but staff were able to talk confidently about how they managed those risks.

Care plans were detailed and written in a person-centred way that supported staff in delivering care and assistance that met people’s individual needs. People were happy with the care they received and said staff were caring and friendly. Staff respected people’s privacy and maintained people’s dignity when providing care. The manager and staff understood the principles of the Mental Capacity Act (MCA) and gained people’s consent before they provided personal care. All the people we spoke with clearly recognised that due to the support and care provided by staff, they were able to enjoy living relatively independently in their own homes.

There were processes to monitor quality through feedback from people and a programme of checks and audits.

Poppy Court provides an extra care service to people. The complex is made up of 48 flats and 10 bungalows. The people who live there have assured short hold tenancy. The service provides personal care for those tenants who require it. All tenants have access to call bells for the service to respond to whenever additional help is required.

People told us they were happy with the care and support they received from staff. They described the support provided as ‘caring’ and they said if they needed help, care staff came when called. People told us they were treated with dignity and respect.

We saw a system was in place to record all accidents and incidents at Poppy Court. However, these incidents were not being analysed by the manager to ensure people’s individual risks were being managed. We saw the care plans were not updated following an incident to reflect the risk and how to manage the risk to people. This meant care staff did not have clear instruction to keep people safe.

We spoke with staff to assess their understanding and when Deprivation of Liberty Safeguard (DoLs) should be used. We found staff were not clear about DoLs and were not able to demonstrate when this should be applied. This meant people’s best interests had not been recognised by the service.

People’s safety was put at risk because care records were not sufficiently detailed or up to date to guide staff and did not accurately reflect people’s care needs. 

People were involved in most decisions about their care and support. We saw staff understood people’s care and support needs; they were kind and thoughtful towards people and promoted their independence.

People told us they were well cared for overall. This was confirmed when we spoke with visitors on the day. Care staff knew how to protect people’s dignity when they delivered personal care. People told us they were involved when making choices of their care provision.

Staff and people who lived at the service told us the manager was not always available at the service. This meant the day to day running of the service was being managed by the team leader and not the registered manager. This impacted on people who lived at Poppy Court as monitoring of records, for example, care record had not been carried out by the manager.

We visited Poppy Court on 15 July 2013. Nobody knew we would be visiting. We spoke with five people who had tenancies at Poppy Court and who received varying levels of support from care staff. We spoke with four members of staff and the manager.

People we spoke with were happy with the care and support they received from staff. One person said, “I’m very happy here. It is the best move I have ever made.” Another told us, “I love it. I’m not moving. I’m quite happy here.” We saw records contained detailed instructions as to how staff were to support people in a way they preferred.

People were involved in making decisions about their care and support and signed records to confirm their consent.

Staff who administered medicines received medication training and had an assessment of their competency. There was a procedure in place for auditing medication records and for managing any adverse incidents in the administration of medicines.

New staff received an induction to the service. Staff were supported to gain qualifications in health and social care and provided with regular training.

The service had a complaints policy which was available to the people living their and their relatives. People told us they would refer any complaints to the manager.

We visited Poppy Court on 10 August 2012. The people who live at Poppy Court have assured shorthold tenancies. No one knew we would be visiting.

During our visit we spoke with the manager, three members of staff and five of the people who used the service.

People who lived at Poppy Court received varying levels of personal care and support. Some people only required well being checks, whilst others received a higher level of support and care.

People confirmed staff respected their independence and privacy. People were encouraged to contribute to the running of the service through regular meetings and annual questionnaires.

People spoke positively about the care and support they received. One person told us, "I wouldn't be anywhere else. You are left to yourself if you want." Another person told us, "It's lovely. It is very nice. Very comfortable."

Staff understood the importance of reporting any abuse or potential abuse. The activities co-ordinator had held a safeguarding event to support people in identifying different forms of abuse and who they could report concerns to.

There were sufficient numbers of staff to deliver safe and individual care to the people who lived at Poppy Court. Staff told us they felt supported by their managers. They spoke enthusiastically about their roles and the service provided.

The provider had systems in place to gather information and monitor the quality of service provided.