Bristol ECHS

Updated 29 June 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one Inspector, one Assistant Inspector and an Expert by Experience who is a person that 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 bought or 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. Alongside this the service provides domiciliary care to people living in their own homes.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who lived at the extra care housing scheme and four members of staff including the registered manager and care staff. The Assistant Inspector spoke to ten members of staff that worked across both services and the Expert by Experience spoke to ten family members and two people who used the service.

We reviewed a range of records. This included five people's care records and medication records. We looked at three staff records in relation to recruitment and the management of staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 29 June 2022

About the service

Bristol ECHS is a service that provides personal care to people living in an extra care housing scheme. People live in their own flats within the complex and staff are based on site to deliver their commissioned care packages. The service also provides personal care to people in their own homes within a small radius of the office. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. Throughout the report we refer to the extra care housing scheme as extra care housing scheme and those people receiving care in their homes outside of the complex are described as receiving 'domiciliary care'. This is how staff distinguished between the two aspects of the service.

The service provides support to 37 people in the extra care housing scheme with 34 people receiving personal care. Within the domiciliary care service 48 people were receiving a service with 46 people receiving 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.

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

People were happy and positive about the care and support received. People were confident to raise any concerns with staff and the registered manager. Risk assessments and audits were reviewed regularly to ensure potential risk of harm was minimised.

Staffing levels were enough to meet people's needs and protected them from harm. Staff recruitment procedures were robust and pre-employment checks were undertaken to ensure suitable staff were employed to support vulnerable people. Staff had received training to meet the needs of people using the service. They had also received regular supervision and an appraisal of their work performance. People received their medicines as required, from trained and competent staff. Staff ensured people were protected from the risk of acquiring an infection during the provision of their care.

The registered manager and staff demonstrated a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported with maintaining a balanced diet and the people who used the service chose their meals and these were provided in line with their preferences.

The staff were kind and caring. People were treated with dignity and respect. Staff knew people well and how to communicate with them. Staff went above and beyond their contractual obligations to support people in their care. Staff regularly fundraised for different activities for people using the service.

The service was responsive to people's health and social needs. People's care records were reflective of people's individual care needs and preferences and were reviewed on a regular basis. Care plans were adapted to support the changing needs of people. The service provided a person centred holistic approach. People knew about the service's complaints procedures and knew how to make a complaint. People were supported and helped to maintain their health and to access health services when they needed them.

People received a service that was well led. The management promoted a positive culture that was open and transparent. The registered manager demonstrated good visible leadership and understood their responsibilities. Quality assurance practices were robust and used to make improvements. Staff were motivated and reflected pride in their work. They talked about people in a way which demonstrated they wanted to support them as much as possible and provide the best standards of care.

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.

Rating at last inspection

Under the previous provider, the last rating for the service was outstanding (published on 18 July 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

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

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