Archived: Hotel in the Park

We inspected the service against two of the five questions we ask about services: is the service Safe and is the service Well-Led? This is because risks associated with people's health needs were not always assessed and reviewed to reduce the likelihood of harm to people and consistent audits of the service were not regularly carried out.

This report only covers our findings in relation to these issues. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for ‘Hotel in the Park’ on our website at www.cqc.org.uk

Hotel in the Park is a seven bedded short breaks service that provides respite care for adults with a learning disability or autistic spectrum disorder, and helps families and carers take a break from their caring responsibilities. At the time of the inspection there were two people using the service. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager who was available on the day of our 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.

People felt safe using the service. Systems were in place and staff understood how to safeguard people from abuse. Risks were assessed, managed and reviewed to protect people from harm. Processes for reporting incidents and accidents were followed by staff.

Health and safety checks were undertaken on the premises to ensure that the environment safely met people’s needs. Policies and procedures were reviewed and updated to ensure people’s medicines were effectively managed.

Background checks were carried out on staff to ensure they were suitably vetted for their role. Sufficient numbers of staff were available to meet people’s needs when they began using the service.

Quality assurance processes were used to carry out consistent audits on the care and support people received. People and their relatives were satisfied with the way care was delivered and how the service was managed. An evaluation was carried out on people’s feedback to change how the provider delivered the service.

Hotel in the Park is a seven bedded short breaks service that provides respite care for adults with a learning disability or autistic spectrum disorder, and helps families and carers take a break from their caring responsibilities. At the time of the inspection there were five people using the service. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager who was on leave during both days of the inspection. On the days of our visits the service was overseen by the project leader and the director of services. 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.

Staff understood how to recognise and report signs of abuse in line with the provider’s safeguarding procedures and people and their relatives told us they felt safe. The provider followed their recruitment procedures to make sure that staff employed to work in the service were suitable to do so. There was enough staff deployed so that people were provided with enough support when this was needed.

Risk assessments had not been reviewed and guidelines to mitigate risks were not updated in response to people’s changing needs. Care plans were produced in an easy read format so people could understand the care they received. However people’s care records had not been reviewed to ensure they contained current information about their needs. 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 received training and when further training was required there was a plan in place to further develop their skills. Some staff had not received ongoing supervision and some areas of their annual appraisals were incomplete.

Changes in people’s healthcare needs were identified by staff and people had access to healthcare services. However some people’s health action plans had not been reviewed for a significant period of time. People were supported with their nutritional needs and medicines as required and this was recorded in their care plans.

Systems to assess, monitor and improve the service were in place but did not identify all the issues we found. Although some issues were picked up in the provider’s audits these were not acted on over a significant amount of time. Where incidents had occurred actions were put in place to improve the delivery of the service but some incident forms did not record what action was taken.

Staff treated people with dignity and respect and their views were listened to. People and their relatives told us they were supported by caring staff and because of this they enjoyed spending time at Hotel in the Park. Relatives spoke confidently about the abilities of the management team to run a good service.

People and their relatives knew how to make a complaint and told us they were satisfied with the respite service. Questionnaires were completed by people when they exited the service to provide feedback about the care they received.

We have made two recommendations in relation to fire safety and monitoring cleanliness and food safety processes. We found two breaches of regulations relating to safe care and treatment and good governance. You can see what action we asked the provider to take at the back of the full version of this report.

We used a number of different methods to help us understand the experiences of people using the service, because people using the service had complex needs which meant that not everyone was able to tell us their experiences. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. The interactions we observed showed that staff were knowledgeable about people's preferences and knew what their responses meant.

Each of the four care plans we looked at had been reviewed regularly to determine how well the care plan was achieving people's personal goals and objectives.

The staff we spoke with said that they had training about protecting vulnerable adults from abuse and each was able to describe what they would do if they needed to raise any concern.

We found that the system for the administration and handling of medicines was effective.

We found during our inspection that staff were able to dedicate time to each person individually and no one was left unattended for long periods of time.

The provider's complaints procedure was most recently updated in April 2012. We found that the complaints information was written in different accessible formats.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant that not everyone was able to tell us their experiences. We gathered evidence of people's experiences of the service by reviewing comment cards and communication that the service had with these people's families or other carers. We found that the service makes regular contact to share information about people's needs, as well as asking for feedback about how people had been cared for.

We spoke with one person who was using the service and received brief comments from two others. The people who spoke with us said 'I really like coming here', 'staff are nice' and 'I miss it when I am not able to come to stay.'