Background to this inspection
Updated
25 December 2020
The inspection
As part of a pilot into virtual inspections of domiciliary and extra-care housing services, the Care Quality Commission conducted an inspection of this provider between 5th and 15th October 2020. The inspection was carried out with the consent of the provider and was part of a pilot to gather information to inform CQC whether it might be possible to conduct inspections in a different way in the future. We completed this inspection using virtual methods and online tools such as video calls and phone calls to gather the information we rely on to form a judgement on the care and support provided. At no time did we visit the provider’s or location’s office as we usually would when conducting an inspection.
Inspection team
The inspection was carried out by two inspectors, one of whom being a pharmacy inspector. The team also included an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support 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 people’s personal care and support service.
The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 5 October 2020 and ended on 15 October 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with eight people who used the service and seven relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, the head of care, the wellbeing advisors, administrators, team leaders and care workers.
We reviewed a range of records. These were sent to us as this was a virtual inspection. This included five people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
25 December 2020
This report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.
About the service
People using the service lived in extra care housing in Reeve Court Village, St. Helens. People lived in their own properties; either in apartments or in bungalows on the site. The Reeve Court Village also had some shared facilities such as a gym and a bistro.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. There were 43 people in receipt of care when we started this inspection. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
People’s well being and lives were greatly enhanced by the innovative and dynamic approaches of the service. The registered manager and the team had introduced innovative practices to enhance people's lives.The service was managed by a senior team who utilised the provider's quality monitoring systems and who also developed their own systems to ensure people had excellent care delivery.
The provider had implemented a new system of discreetly monitoring people who were living with dementia. This alerted staff to movement in properties indicating a person was, for example, not sleeping, not moving around as before, not using their heating or not preparing food of drinks for themselves.
People told us they felt safe and well cared for, especially during the Covid-19 pandemic. Good arrangements were in place to ensure people stayed safe and good infection controls were in place when staff delivered care and support.
Staff had been suitably trained in how to safeguard people from harm and abuse. Potential or actual harm was monitored and management of risks allowed for good outcomes for people. People with protected characteristics were extremely well supported by the open culture in the service.
The service had enough suitably recruited, inducted and trained staff to deliver care and give people support in all aspects of their lives. Staff were knowledgeable, highly motivated and extremely caring. Staffing levels were extremely responsive to people's changing needs as the service was trusted to make urgent care decisions by commissioners. The employment of two well-being advisors, as well as the team delivering direct care, helped people to stay as well as possible.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We were assured this service worked within the principles of the MCA. Care and support was delivered only with the consent of the person.
People told us the staff team were kind, caring, respectful and polite. People were consulted through regular surveys, meetings and by staff who delivered care. People told us their views were respected and any issues responded to swiftly.
People had appropriate levels of care delivered because a good system of care planning and delivery was in place. The nurse employed on site assessed and monitored people's health needs and helped them to access excellent levels of health care support. The provider also had a dementia and mental health well-being advisor who was trained in caring for people living with dementia and other mental health needs. This meant staff had ready access to specialist knowledge and practical support to allow people to stay as independent as possible.
Access to health care had continued at a high level during lockdown because these two members of staff had monitored any changes in vulnerable people and had helped them use virtual platforms to access health care support. Medicines administration and disposal were kept under careful monitoring during the pandemic.
The provider had continued to provide Covid-19 safe activities and entertainments during the pandemic to support people's well-being and the staff team were very aware of the need to maintain a positive culture in the service. People told us, and thank you cards and surveys showed us, the continuing high levels of engagement had helped to maintain and enhance both mental and physical well-being.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Outstanding [published 08/06/2019]
Why we inspected
This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the Provider.
The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Extra Care Charitable Trust Reeve Court Village on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.