Whitley Court is an extra care housing scheme, the personal care element of which is operated by Care-Away Limited. Care-Away Limited operates under the trading name of Care Support, and are referred to by this name throughout the report. The scheme operates over two sites, Whitley Court in Paignton consisting of 62 flats and Dunboyne in Torquay consisting of 45 flats. In this report we refer to Whitley Court to cover both buildings as that is the registered name of the overall scheme. Not everyone living in the flats was in need of personal care, and some people also received only domestic support from staff employed by Care Support. This was not included in this inspection as CQC does not have a legal remit to inspect these services. 79 people were receiving some level of personal care across the two sites. They ranged in age from 19-93, and had varied needs for support associated with living with learning disabilities, poor mental health, old age, physical disability or dementia.
Care-Away Limited were first registered to deliver personal care to people in the Whitley Court scheme in July 2016, so this was their first inspection since registration at this location. The company operates other similar services in other areas of the country. This inspection of Whitley Court took place on the 11 and 12 July 2017. Further follow up phone calls to people living at the services were carried out on the 17 July 2017.
The buildings and flats at Whitley Court and Dunboyne are managed by Sanctuary Housing, and therefore did not form part of this inspection, as Sanctuary Housing are not involved in delivering the regulated activity of personal care on these sites. People either part own or rent their properties from Sanctuary Housing and personal care is delivered through Care Support to people living in the flats, as a domiciliary care service. Much of this care and support is commissioned by the local Care Trust, but people may choose to purchase any support privately through Care Support or any other domiciliary care agencies if they choose. Care Support have offices at both sites, although the main office at Whitley Court is the registered office for the delivery of the service. Services provided at both locations included a restaurant also open to the public, on site laundry, communal lounges and attractive communal garden spaces, including a roof terrace at Dunboyne.
The service has 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 registered manager spends time at each office throughout the week, and their availability is on display at the services.
People and others were kept safe from risks associated with their care through regularly reviewed risk assessments and action plans. Plans contained sufficient detail to enable staff to support people, and staff knew people’s needs well. Where people might need emergency support, plans contained detailed information on what actions staff were to take, including when to seek emergency medical support. The service liaised effectively with other agencies supporting people’s care, such as community nurses or the housing provider. This helped ensure people’s changing needs were identified and met.
There were enough staff available to ensure people received the care, support and opportunities that they needed and wanted. A full staff recruitment process had been followed for staff working at the service, which meant people were protected as far as possible from being cared for by staff who may be unsuitable. Robust policies were in place to take disciplinary action if staff failed to achieve or maintain an acceptable standard of work.
People were protected from the risks associated with medicines through assessments of risk, staff training, policies and regular monitoring and audit. Most people managed their own medicines, although some needed prompting to remember to do so. Staff directly helped some people to remain as independent as possible, for example with supporting the person to test their own blood sugar levels; the person then administered their own medicines under staff supervision. Where people’s care plans indicated they needed support with meals and nutrition, plans ensured they received a diet that met their needs and wishes. People could also have meals delivered from the on-site restaurant of they chose.
People were protected from abuse because staff understood how to keep people safe and how to report any concerns about their welfare. People’s rights to make decisions about their care and welfare were supported because the service acted in accordance with the Mental Capacity Act 2005 and the best interest’s framework. Most people living at the service had capacity to make decisions for themselves. Where there was any doubt about this an assessment was requested to identify if additional support was needed.
People were supported by staff who had the skills and knowledge to meet their needs. Staff told us they were well supported by the organisation and worked well as a team. Staff performance was monitored through spot checks and reviews, and staff received supervision where they could identify any training needs or support in their role. Risks associated with staff working were assessed, for example for staff who were pregnant. Staff told us it was a nice place to work. One who had not worked in care previously told us they wished they had done it years ago, as they enjoyed their role so much.
People gave us positive feedback about the service. We met people who felt they had improved since living at the Whitley Court; they told us they were more independent and had greatly decreased their need for care and support. Some people had moved to the scheme from residential care, and felt much happier and more secure.
People’s dignity was supported and staff treated people and their property with respect. We saw evidence of good relationships in place, and a mutual respect and positive regard. People’s dignity and property were respected.
People’s care needs were assessed by the service, and plans of care drawn up. These were kept by people in their flats. Care plans were based on people’s needs and wishes and were regularly reviewed. Plans contained sufficient detail to enable staff to give the person the support they needed, and people were involved in having a say about what care or support they wanted.
Systems were in place to manage complaints and concerns, either individually or at regular tenants meetings. Some issues raised through consultation with people were long standing issues the organisation was working to improve. People were able to have a say about the organisation at regular meetings, some of which had been facilitated by a local advocacy agency to ensure independence and encourage people to speak freely about any issues they had. Action plans were drawn up as a result to address issues in a timely way. People told us the service had improved over the last year.
People could expect to receive a good quality of service because systems were in place to assess, improve and monitor the quality and safety of the service. Regular audits were carried out, and analysis was undertaken to identify any trends or repeated concerns to be addressed.
Not everyone using the service was clear about what they could expect to receive from Extra Care Housing services, or about the roles of the different organisations involved in Extra Care Housing. Some of this was a historical issue that started before Care Support were involved with the organisation. Work was being carried out by the commissioners and the service management to address this.
Records were well maintained, up to date and accurate. Policies and procedures were accessible to staff. Notifications had been sent to the CQC of certain events as required by law.