8 and 10 December 2014
During a routine inspection
This was an announced inspection which took place on 8 and 10 December 2014. The service was last inspected in September 2013 when it was found to be meeting all the regulations we reviewed.
Pembroke Court is the registered office for Places for People Individual Support Ltd, from which personal care and support is provided to people who live in five extra care housing schemes in Darwen and Blackburn. One of the schemes provides care and support to people with dementia related needs. At the time of our inspection there were 70 people using the service across these five sites.
The provider had a registered manager in place as required by the conditions of their registration with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.
We spoke with 16 people who used the service; of these 15 people were happy with the service they received from Places for People staff and told us they always felt safe when they received any care or support. One person who used the service told us they did not always feel safe when staff supported them. This person was also concerned that they had not been involved in reviewing their care and that the service was not sufficiently responsive to their request to change their care plan.
Staff had received safeguarding training and were aware of the actions they should take to protect people who used the service. People told us they received their medicines as prescribed and we found that all staff had completed training in the safe administration of medicines.
Staff demonstrated an awareness of the principles of the Mental Capacity Act (MCA) 2005. This legislation is designed to ensure people’s rights to make their own decisions, wherever possible, are upheld. People who used the service told us they were supported to make choices about how their care was delivered.
There were systems in place to provide staff with support, induction, supervision and appraisal. Staff at all sites told us they enjoyed working for Places for People and considered they received the support they needed to effectively carry out their role.
Senior staff in the service conducted checks and audits to monitor the performance of staff. When necessary, supervision and appraisal systems were used to review practice or behaviour.
People’s health needs were assessed and people were supported to access appropriate services to meet these needs. Where appropriate, staff provided support to ensure people’s nutritional needs were met.
Records we looked at showed people’s care plans and risk assessments were updated to reflect their changing needs. However, we found limited evidence that people had been involved in reviewing and providing feedback on the care and support they received.
People told us there were always sufficient numbers of staff on duty to meet their needs. We saw the service had robust recruitment procedures in place; these should help protect people from the risk of being cared for by unsuitable staff.
People who used the service and their relatives were mainly positive about the attitude and approach of staff. A health professional we spoke with told us they considered staff at the site they visited were exceptional in the support they provided to people. All the staff we spoke with were able to show that they knew people who used the service well. They all demonstrated a commitment to providing high quality care and support to people, including end of life care.
There was a lack of consistency in the way the service was organised across the sites. This meant staff at one site did not always know in advance of their shift which people they would be supporting. Although people who used the service told us they did not always know which staff would be caring for them each day, they did not express any concerns about this as they considered all staff were equally good.
Although there were quality assurance systems in place for each of the sites, we found these were not sufficiently robust to ensure action had always been taken where the need for improvement in the service had been identified.