Archived: Swindon Family Breaks Service

The person named as the registered manager on this report was no longer in post at the time of our inspection, but the person is still on our records. The new manager was in post and in the process of being registered at the time of our inspection.

Two inspectors carried out this inspection over two days and we considered our inspection findings to answer the questions we always ask.

This is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We found that the service was not always safe as there was not always enough staff to meet people needs safely. We reviewed staff rotas dating back to December 2013. We looked at planners for people using the service, these are the room plans that indicate where people will be staying and for how long. We also discussed people's needs with staff and relatives. We identified people who require 1:1 attention or have complex needs that require additional support. We saw that on 13 separate occasions staff levels were not sufficient to meet these people's needs safely.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained or stored securely.

Is the service effective?

We found the service was effective. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People we spoke with told us they were asked before they received support.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at the care records for a person who required Percutaneous Endoscopic Gastronomy (PEG) care (a means of feeding when oral intake is not appropriate). We saw that clear guidance was provided to staff which enabled them to meet the person's needs. Care staff we spoke with understood these needs and were able to talk with us about them.

Is the service caring?

We found the service was caring. People we communicated with felt cared for. People who were unable to fully communicate verbally responded with smiles and gestures. Other people we spoke with told us they were very happy. One person told us, 'I am very cared for; they talk to me and listen to me'. One person's relative told us, 'The carers are brilliant, really good; you can tell it's more than a job to them'.

Relatives we spoke with felt staff were very caring. One person's relative told us, 'the staff are lovely, they make a real effort to get to know people'. Another relative said, 'It is a very caring culture my daughter loves going there'.

Is the service responsive?

We found the service was responsive. The provider took account of complaints and comments to improve the service. We looked at the complaints file and saw all complaints were recorded with clear outcomes that people were satisfied with.

People who used the service, their representatives and staff were asked for their views about care and treatment and these views were acted on. We saw that people were asked for their views annually and also following each visit.

As a respite service, people were not always accessing the service long enough for the service to need to respond to changing needs. However, we saw there was a system in place to identify people's changing needs. Each person who used the service regularly had a record in their file for changing needs to be recorded if identified.

Is the service well-led?

We found the service was well led. Care staff we spoke with felt they were well led by their manager. People's relatives we spoke with felt the manager was approachable and reliable. The manager had only been in post for a short period of time at the time of our inspection.

The provider had a system to regularly assess and monitor the quality of service people received. The service had introduced compliance audits, environmental audits and compliance and action audits. These covered all aspects of the home in terms of the care people receive and the physical quality of the environment. We also saw that learning from incidents / investigations took place and appropriate changes were implemented.

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive.

People told us they received the care and support they needed and said they were well treated by staff. Staff demonstrated a good understanding of people's specific communication needs and responded well to questions and requests for assistance.

People received the medicines they had been prescribed, however, the provider did not have appropriate arrangements in place to accurately record medicines held in the service. This increased the risks to people who used the service.

People we spoke with said they were able to raise concerns with the staff or managers and were confident that action would be taken to address the issue. One person said they would talk to either of the managers if they had a problem and was confident they would resolve their problem.