Octavia Housing -Bridge Water House

About the service

Octavia Housing – Bridge Water House is an extra care scheme. This is a specialist housing where people can live independently in their own flats. The provider offered personal care to people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The provider also ran a lunch club and organised activities in communal areas. People were able to join these if they wanted.

At the time of our inspection, 32 people were receiving personal care and support. Most people were older adults. There were also people with learning disabilities, people with mental health needs and people with physical disabilities using the service.

People’s experience of using this service and what we found

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support: Risks to people's safety and wellbeing were managed. However, these had not always been fully assessed or planned for. Staff knew people well and could meet their needs but without proper assessment and plans, there was a chance people would not receive the right support. We discussed this with the registered manager so they could make the required improvements.

People were supported to have choice, control, and independence over their own lives. Staff focused on people's strengths and promoted these. People were supported to pursue their own interests. People lived in a safe environment and had their own private flats which staff helped them to keep clean. Staff supported people to access other professionals such as doctors, advocacy services and social workers. People were supported to take their medicines when needed and as prescribed.

Right care: People were treated well and with kindness. Staff understood people's diverse needs and met these. People's privacy and dignity were respected, and staff were compassionate, caring and polite. Staff understood how to protect people from poor care and abuse. There were enough skilled staff to meet people's needs and to keep them safe. People were supported to make choices and to communicate their needs. People were supported to take positive risks.

Right culture: People led inclusive and empowered lives because of the ethos, values, attitudes and behaviour of management and staff. People received good quality person centred care. Staff understood about people's needs and had information about best practice for supporting people with learning disabilities, autism and dementia. Staff turnover was low, and staff were happy working at the service. Staff felt well supported. People using the service, staff and other stakeholders were asked for their views and these were valued. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 27 April 2018).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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 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.

People were provided with flexible care and support on-site to enable them to live as independently as possible. Support included personal care and support with medicines, meal preparation, shopping and cleaning. There were 36 flats which included two ‘shared ownership’ flats. At the time of our inspection there were 27 people using the service.

There was no registered manager in post at the time of our inspection. A manager was employed by the provider to oversee the service and another similar service nearby and had applied to be registered. 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 manager was only briefly available and we were assisted by the service manager and other members of the senior team throughout our visit.

There were systems and processes in place to protect people from the risk of harm. There were enough staff on duty to meet people's needs and there were contingency plans in the event of staff absence. Employment checks were in place to obtain information about new staff before they were allowed to support people.

Care plans and risk assessments were reviewed and updated whenever people's needs changed. People and relatives told us they were involved in the planning and reviewing of their care and support and felt valued.

The risks to people's safety and wellbeing were assessed and regularly reviewed. People were supported to manage their own safety and remain as independent as they could be. The provider had processes in place for the recording and investigation of incidents and accidents.

People were given the support they needed with medicines and there were regular audits by staff and the management team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to this. They ensured people were given choices and the opportunity to make decisions.

People were protected by the provider’s arrangements in relation to the prevention and control of infection. People told us that staff adopted high standards of cleanliness and hygiene and always put on fresh gloves and aprons during personal care. The provider had a procedure regarding infection control and the staff had specific training in this area.

The provider ensured people's nutritional needs were met. People were able to dine downstairs in the communal dining room if they wished. Some of the people using the service shopped for ingredients and cooked their own food in their flats.

People were supported by staff who were sufficiently trained and supervised. The service liaised with other services to share ideas and good practice.

People’s healthcare needs were met and staff supported them to attend medical appointments if support was required.

People's care plans were comprehensive and detailed people’s identified individual needs. They were personalised to reflect people’s wishes and what was important to them.

Staff had received training in end of life and there were plans for the management team to undertake training in this subject. There were plans to introduce advanced care plans and discuss end of life wishes with people and their relatives.

A wide range of activities were arranged that met people’s individual interests and people were consulted about what they wanted to do.

Staff were caring and treated people with dignity, compassion and respect. Support plans were clear and comprehensive and included people's individual needs, detailed what was important to them, how they made decisions and how they wanted their care to be provided.

Throughout the inspection, we observed staff supporting people in a way that took into account their diversity, values and human rights. People confirmed they were supported to make decisions about their activities.

Information about how to make a complaint was available to people and their families, and they felt confident that any complaint would be addressed by the management.

There was a clear management structure at the service, and people and staff told us that the management team were supportive and approachable. There was a transparent and open culture within the service and people and staff were supported to raise concerns and make suggestions about where improvements could be made.

The provider had effective systems in place to monitor the quality of the service and where issues were identified, these were addressed promptly.