Housing 21 - Limestone View

The provider was given 24 hours' notice because the location provides an extra care service and we needed to be sure that someone would be in. At the time of the inspection the service was supporting 21 people with personal care.

Housing & Care 21 – Limestone View provides personal care and support to older people who live in their own apartments. There are 50 apartments altogether. Some of the people who use the service are living with dementia. Apartments are located on one site in Settle around an office and communal areas. There is a café on site which can be used by the public, as well as the local library. There is also a hair salon based on the premises which is open to people using the service and the public. The aim of the service is to support people to live independently.

On the day of the inspection, we visited two people who used the service in their own apartments, spoke with one person's relative and a visitor of another person using the service. We also spoke with four people in communal areas of the housing complex. We spoke with the manager, the care team leader, five support workers and a visiting GP. We looked at five people's care records, medication records, five staff files, training records, call schedules and other records related to the management of the service. Following the inspection, on 1 September 2017, we contacted the relatives of three people by telephone to speak with them about their experience of the service. We also spoke with a member of social care staff from the local authority and a community staff nurse from the district nursing team.

The service had a registered manager. However, they were not on site on the day of the inspection. 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. There was a manager on site who assisted us with the inspection.

People told us they felt safe and could speak to any of the staff if they were worried about anything. The manager understood their responsibilities for safeguarding people and staff were trained to understand and recognise abuse. They knew who to report concerns about people's safety and welfare within the organisation and knew where to access contact numbers to external agencies if necessary. Staff confirmed safeguarding was regularly discussed in supervision sessions with management to support their knowledge.

Systems were in place to ensure medicines were managed safely. Observational checks on staff competencies were carried out as well as weekly medication audits.

Risks to people's safety and welfare were identified and managed. Risk assessments clearly identified the

risks to people and what could be done to mitigate the risks and keep them safe whilst promoting independence.

People received a service that was based on their personal needs and wishes. Care plans were personalised. Staff felt they had enough information to meet people's needs, including receiving regular up to date information. Changes in people's needs were identified and their care packages were amended to meet their changing needs. The service was flexible and responded positively to people's requests where possible. People who used the service felt able to make requests and express their opinions and views. Health and social care professionals were regularly involved in people's care to ensure they received the right care and treatment.

Without exception, all of the people we spoke with and their relatives provided positive feedback about the service. People said they would recommend the service to anyone who needed extra support. They described the service as a community where they felt included. People we spoke with told us staff were kind, caring and compassionate. We observed genuine warmth between people and the staff who supported them. Relatives we spoke with informed us the staff showed a high level of compassion and sensitivity towards their family members. They also said that staff went out of their way to promote the independence of the people they provided care for. All the people we spoke with explained how staff went over and above what they expected from them and they couldn't ask for anything more. People told us the support they received improved their well-being and sense of inclusion. Staff were positive about the people they supported and the service provided.

People were supported to prepare meals. We saw people's nutritional needs and preferences were taken into account.

We found the service was working in accordance with the Mental Capacity Act 2005 and this helped to make sure people's rights were protected. Where there was any concern regarding a person's capacity to understand a particular decision the correct process was followed to make sure any actions taken were in their best interests.

There was a complaints procedure. The people we spoke with said they would speak with one of the staff or the manager if they had any concerns.

The management team were committed to continuous improvement. Feedback from people, whether positive or negative, was used as an opportunity for improvement. The manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.

The five questions we ask about services and what we found