Archived: Cecil Gardens

Updated 1 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The Inspection team consisted of three inspectors, an assistant inspector and two Experts 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 rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (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 CQC. This means that 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 short notice of the inspection. This was because we needed to be sure that the provider’s representative or registered manager would be in the office to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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. We used this information to plan and support our inspection.

During the inspection

We spoke with 20 people who used the service and three relatives about their experience of the care provided. We spoke with14 members of staff including the regional manager, registered manager, quality manager, team leaders and care workers.

We reviewed a range of records. This included 12 people’s care records and multiple medication records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service were also reviewed. These included staff training, complaints, safeguarding and quality monitoring.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 1 January 2020

About the service

Cecil Gardens is an extra care housing complex providing 95 individual flats. Not everyone living there receives a regulated activity. The service can provide care and support to people living with dementia, learning disabilities or autistic spectrum disorder, mental health, older people, younger adults, people who misuse drugs and alcohol, people with physical disabilities and people with sensory impairment.

The Care Quality Commission only inspects the service being received by people provided with ‘personal care’, for example, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of the inspection, 68 people were receiving the regulated activity of personal care. There were also 94 people who lived in the surrounding area who also received calls for personal care from Hales Group Limited.

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

Since the last inspection, there had been improvements in medicines management, record keeping and quality monitoring. The quality of care records in relation to risk, consent and daily recordings had improved. Where people required support with their medicines this was managed safely; the number of medicine errors had significantly reduced.

The provider’s quality monitoring system had improved. Audits, surveys and meetings were completed, and shortfalls addressed. All feedback was used to make continuous improvements to the service.

Staff were recruited safely. There were enough staff to complete the care calls. Most people confirmed they received care at their preferred times from their regular care staff, but at times some people had not received care from a consistent group of staff. We have made a recommendation about this.

People were supported to remain independent and access local activities within the community. People told us staff respected their privacy, although one person raised issues around staff access to their apartment, which we have passed to the registered manager to follow up.

People and relatives said the service was safe. They were supported by staff with the skills and knowledge to meet their needs. Staff had regular training and felt confident in their role. Risks to people’s health and wellbeing were assessed and mitigated. Where required, people had access to appropriate equipment and were supported to ensure their homes remained safe.

People were supported to maintain a healthy diet when this was part of their care plan. The registered manager had developed positive links with health care professionals which promoted people’s wellbeing.

People and family members told us staff were kind and caring and they felt at ease with them.

People felt listened to and told us staff had time to sit and chat with them. 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 details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating and update for this service was requires improvement (published 23 November 2018). At the time, there were concerns with safe administration of medicines, records and ensuring a good quality assurance system.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.