ExtraCare Charitable Trust Reeve Court Village

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.

People’s experience of using this service:

The management team had a strong community ethos and worked extremely hard to maintain a community feel within the Village. People, family members and members of the local community were regularly encouraged to be involved in the daily running of the service. Working in partnership with community groups and other health professionals was vital in ensuring people received good outcomes and a more enriched life.

A holistic approach had been adopted in the assessing, planning and delivery of people’s care and support. Regular assessments and reviews undertaken by the services’ wellbeing advisor and locksmith (dementia specialist) ensured people received timely and effective support that resulted in excellent positive outcomes. Healthcare professionals spoke extremely positively about the thorough assessments completed by the service and the impact this had on people. The collaborative working adopted by the service had resulted in people being able to live healthier lives.

Staff provided excellent care and support that was given in a way people preferred. This resulted in consistent and positive outcomes that exceeded expectations. Staff worked hard to provide a consistently better quality of life for people by supporting them to develop in areas such as social interaction and independence. People spoke highly of the support provided by staff.

People were supported to live enriched lives and do what they chose. Staff encouraged them to be as independent as possible whilst ensuring they remained safe. Risks that people faced were identified and assessed and measures were put in place to manage them and minimise the risk of harm occurring. Staff showed a good understanding of their roles and responsibilities for keeping people safe from harm. Medicines were managed safely and people received medication at the right time. People told us they felt safe living in the Village.

Staff showed a genuine motivation to deliver care in a person-centred way based on people’s preferences. The management team and staff had developed strong, familiar and positive relationships with people and family members. Throughout the inspection the management team and staff were observed to be warm and affectionate towards people. Family members described staff as being extremely caring and that staff worked hard to ensure people lived a good quality life.

The leadership of the service promoted a positive culture that was person centred and inclusive. Family members and staff all described the management team as supportive and approachable. The management team showed a continued desire to improve on the service and worked closely with other agencies and healthcare professionals in order to do this. Effective systems were in place to check on the quality and safety of the service and improvements were made when required.

Rating at last inspection: Good (report published 22 July 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

Reeve Court Village is a care at home service provided by Extra Care Charitable Trust. Reeve Court is situated on the outskirts of St Helens, Merseyside. The service is an Extra Care Housing Scheme which is registered as a domiciliary care agency providing personal care to some of the people living at the complex.

During our inspection the registered manager was present. 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 feedback we received from people was consistently good. People that used the service expressed satisfaction and spoke highly of the registered manager. One person said “I cannot speak highly enough of everyone at Reeve Court”.

People were supported to take their medicines by staff who were appropriately trained. People received care and support from staff that knew them very well, and had the knowledge and skills to meet people’s individual needs. People told us staff always treated them well and promoted their choices regarding their care, support and the activities they participated in. People and their relatives spoke very positively about staff, their comments included, “I have had consistently good support over the last three years” and ”The staff are well trained and highly skilled”.

Staff were trained in safeguarding adults and understood fully how to recognise and report any abuse. The service had policies and procedures in place that informed staff of how to keep people safe and these were followed.

Staffing ratios were in place to meet people’s assessed needs and were responsive to people’s changing needs and preferences. This enabled people to make full use of all of the facilities the complex had to offer, to go out on trips, both as a group and individually, and to experience attentive support.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which helped the registered provider determine whether they were suitable to work with vulnerable adults, before they started their employment. Staff completed a comprehensive induction programme which included competency assessments.

Risks associated with people’s care needs were anticipated, identified and monitored. Staff managed risk effectively and supported people’s decisions, so they had as much control and independence as possible. This ensured people’s safety was maintained.

Care plans and risk assessments provided staff with clear direction and guidance as to how to meet people’s individual needs. People said they were fully involved in the development of their care plans. This meant people received person centred care in a way that was meaningful to them.

People knew how to raise concerns and make complaints. People and their relatives who had raised concerns confirmed they had been dealt with promptly and satisfactorily.

There was a management structure within the service which provided clear lines of responsibility and accountability. There was a positive culture within the service, the management team provided strong leadership and led by example. Staff said “I feel well supported by the company and think all staff are recognised and valued” and “We all work well as a team and value each others skills and knowledge”.

There were quality assurance systems in place to make sure that any areas for improvement were identified and addressed. Members of the management team were visible in the service and regularly visited people and sought their views about the service.

People had the opportunity to attend a range of meetings about the service and to be involved in consultation and decision making. These included a monthly 'Street meeting', a 'Residents Association' meting and a national 'Resident's forum'. Alongside these were more informal coffee mornings and interest group meetings. People were also given the opportunity to attend meetings to review their care package.

We found that appropriate procedures were in place to support people with managing their medicines and medication practices were checked on a regular basis.

Checks had been carried out on staff before they started working for the agency. These aimed to ensure people were supported by staff who had the appropriate skills, experience and qualities they needed to carry out their roles.

People who used the service were listened to and their comments, complaints and views were used to improve the service. People using the service told us they would be happy to make a complaint if they had any concerns or complaints about the service and they felt confident that the manager would address any concerns. Complaints records showed that complaints had been investigated and responded to appropriately.

Reeve Court is part of The Extra Care Charitable Trust. On the day of our inspection the agency was providing care and support to 65 service users living in their own apartments.

We were informed by the registered manager that 76 staff members were employed including 45 care staff.

We looked at the care files of three people living at Reeve Court and throughout the day we spoke with five of the people living there.

We spoke with six people employed by the care agency and we checked the training and supervision records for all staff.

The people we spoke with said the residential support workers (RSW) had always treated them with dignity and respect.

Some comments from service users were, "It's the best move I ever made,' 'I have lived here for eight years, It's absolutely marvellous,' 'The carers are really good' and 'I am having a reassessment next week. I am hopefully having my care support increased.'