About the service:

Southcroft is a specialist ‘extra care’ housing scheme that was providing personal care to 16 adults at the time of the inspection.

People’s experience of using this service:

People spoke positively about the staff. One person told us, “This is a wonderful place, all the staff are lovely. I feel lucky to live here.”

Staff did not receive regular supervisions and yearly appraisals in line with the provider’s own policy and procedure. Staff told us they would like more support.

There were enough staff available to ensure people’s needs were met. The provider had safe recruitment procedures in place to make sure staff had the required skills and were of suitable character and background.

Procedures were in place to make sure people received their medicines as prescribed.

People were consulted and listened to about their care and support needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People told us they enjoyed the food served at Southcroft. People were supported to eat and drink to maintain a balanced diet. People were supported to maintain good health and have access to health and social care services as required.

There was a range of activities available to people.

People and staff were asked for their opinion of the quality of the service via regular meetings and annual surveys.

The service had up to date policies and procedures which reflected current legislation and good practice guidance.

There were effective systems in place to monitor and improve the quality of the service provided.

More information is in the full report.

Rating at last inspection:

Good (report published on 14 October 2016). The overall rating has dropped to Requires Improvement at this inspection.

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

Southcroft is a domiciliary care agency registered to provide personal care for older people living at the Southcroft extra care scheme. Southcroft comprises of 37 one bedroomed apartments, seven of which are for couples. The service has three floors, with lift and wheelchair access throughout. There is a garden and car park.

At the time of the inspection the service was supporting 14 people living at Southcroft. One person had just started using the service. We spoke with six people by telephone to obtain their views of the support provided.

We spoke with the registered manager and the administrator during the inspection. We telephoned eight care staff and were able to speak with three of them to obtain their views and experience of working for this service.

The registered manager was given short notice of our inspection. We did this because the registered manager is sometimes out of the office and we needed to be sure that they would be available.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

The service was last inspected on 15 April 2014 and was meeting the requirements of the regulations we checked at that time. This was the first rated inspection of the service.

People had risk assessments in place, which were designed to ensure that potential risks to people were managed and minimised whilst still promoting independence. People told us their care plans were regularly reviewed to meet their changing needs.

We saw there were sufficient staff to provide support to people using the service. The service employed permanent and relief staff. The registered manager told us the provider employed relief staff so they did not need to use agency staff to cover for unexpected staff absences and annual leave. People told us they would like to be supported by regular staff and know who would be supporting them each day. We shared this feedback with the registered manager.

Systems were in place to manage people’s medicines

Four people spoken with were satisfied with the quality of care they had received. Two people expressed mixed views about the quality of care they had received. One person thought that the training of the relief staff could be improved so that it was of the same standard as the permanent staff. Another person described how some staff would move items around without telling them. The person thought this was well intentioned but they could not find things and if things needed to be moved they could do it themselves. We shared this feedback with the registered manager so appropriate action could be taken.

People were supported with their health and dietary needs, where this was part of their plan of care. Some people were supported to attend hospital appointments and appointments at their GP.

A copy of the service activity events calendar was displayed in different areas of the service. The activities included: craft morning, coffee mornings in the service’s Bistro, knitter natter, salvation army visit, games night in the lounge and film and music night in the lounge.

People made very positive comments about the staff. Their comments included “they [staff] are very nice, them that come, they don’t gossip about anyone, well they don’t have the time”, “it’s lovely, they are all nice ladies [staff]” and “when you go down for lunch they ask you how you are”. We also received positive comments about the chaplain who was employed by the service.

We received positive comments about the chaplain who was employed by the service. People’s comments included: “the chaplain is very nice” and “the chaplain is lovely, a true Christian

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

This is a summary of what we found-

Is the service safe?

People spoken with told us that staff treated them with dignity and respect and that they felt "safe".

All staff spoken with were clear about what their roles and responsibilities were and the action they would take if they saw or suspected any abuse. We saw that the service had a process in place to respond to and to record safeguarding concerns. We found that the service had a copy of the local protocols and followed them to safeguard people from harm.

We found the arrangements in place to record people's financial transactions needed to be more robust to safeguard people who used the service from financial abuse.

Is the service effective?

People’s health and care needs were assessed with them, and they were involved in writing their care plans. We found that the service had not reviewed one person's care plan and risk assessments in response to their needs changing. The manager assured us that the person's care plan and risk assessment would be reviewed following the inspection.

We spoke with the manager who told us that a representative from each of the three floors attended the support meetings at the service. It was the floor representative’s responsibility to gain the views of other people living on their floor. We looked at the minutes of the support meeting held in November 2013. We saw that the group had a budget which they could use to purchase items. There was a range of topics discussed at the meeting including the accounts and planning an event. This told us the service actively sought out the views of people.

Is the service caring?

We observed staff giving care and assistance to people in the communal areas. They were respectful and treated people in a caring and supportive way. We spoke with two members of staff who were able to describe how they maintained people’s privacy and dignity whilst providing personal care support. They also told us how they promoted choice and independence. One staff member commented: “I always ask what they [people] want doing, if they are independent I don’t want to take anything away from them”.

People spoken with were satisfied with the quality of care they had received and made positive comments about the staff. Their comments included: “very good, can’t find fault with the staff”, “all the staff are very friendly, no problems at all”, “when I wasn’t well somebody came to help me to have a shower”, “when I came out of hospital I had such wonderful care”, “the way they helped me today was excellent”, “there is nowhere better than this place” and “when I needed help they were there, now I am a bit more independent I have started making my own meals again”.

People’s personal preferences and interests were recorded in care plans and support was being provided in accordance with people’s wishes.

We saw that the service promoted people’s wellbeing by taking account of their needs including daytime activities.

Is the service responsive?

People spoken with told us that staff respected their privacy and treated them with dignity and respect. People expressed how much they valued having their own flat and being able to maintain their privacy. One person commented: “it’s lovely to have your own space and privacy”. People also told us that staff respected their decisions. One person commented: “they [the staff] respect your decisions; I choose what I want to do and what activities to join in”.

A copy of the service’s complaints procedure was included in people’s care plans. People told us if they had any concerns they would raise these with the manager of Southcroft or alternatively with the registered manager who visited the service regularly.

Is the service well-led?

We saw that staff training and supervisions were being monitored. This helped to ensure that people received a good quality service at all times.

We saw that there was a range of quality monitoring checks in place to make sure that managers and staff learned from audit checks. These checks included the following: health and safety, medication and care plan audits. We found the medication and care plan checks could be more robust to ensure people received a good quality of service and appropriate care.