Archived: Prince of Wales Respite (Breakaway Hotel)

Prince of Wales Respite (Breakaway Hotel) provides respite care for adults with learning disabilities. People stay for varying periods. Some people may also have sensory or physical impairments. The home also offers one emergency placement. The service is provided by the London Borough of Camden. There were three people using the service at the time of the inspection.

There was a registered manager in post. 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.

Relative told us they thought the service was safe and people using the service had their needs met.

There were safe systems in place with regards to recognising and reporting potential abuse and harm. Staff knew the types of abuse that may occur as well as how to recognise the signs.

Medicines were administered safely in line with medicines policy at the home. Records were accurate in relation to administration and they were stored appropriately.

Staff had received training in and understood the principles of the Mental Capacity Act. People were encouraged to make their own day to day decisions about what they liked to wear, the food they liked to eat and the activities they took part in.

People received a balanced diet and food and drink choices were varied. People were encouraged to be involved in decisions around what wanted to eat and drink.

People were appropriately supported to access health and other services during their visits to the service.

Staff awareness of equality and diversity aspects of people care were integral to how support was delivered at the home and was included in people’s individual care plan.

Dignity and privacy was maintained and staff ensured this was respected whilst providing personal care.

People were receiving care, treatment and support that met their needs. Care records contained detailed pre-admission information that was updated before each stay.

Complaints policies and procedures were in place and any action taken as a result of complaints were used for learning and shared with staff.

As part of quality monitoring, people would have an opportunity to complete a feedback form after each stay. The form was translated into an accessible format for people to understand.

Maintenance checks regarding the safety of equipment and the premises were taking place on a regular basis and records of were completed after each visit.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on discussions with management during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Safeguarding procedures at the service were robust and reflected local authority policy, and staff received appropriate training and information. Staff understood their responsibilities in safeguarding the people they supported and who to contact in the event of a concern. Staff underwent training in deprivation of liberty and mental capacity although no applications had needed to be submitted. This meant that people's human rights were safeguarded as required.

Staff were familiar with people's risk assessments and how to manage and mitigate those risks.

Relatives of people using the service felt that their family members were cared for safely.

Staff used appropriate methods of communication to ensure that people consented to the care provided and were able to express their views and concerns. Support plans were developed and agreed in advance with parents or carers of people using the service.

Systems were in place to make sure that accidents and incidents were reported along with complaints and other concerns and action taken when required. This reduced risks to people and helped the service to continually improve its performance.

There were procedures for managing emergencies. Staff had appropriate training and were aware of relevant procedures and contacts to access help and support.

There was suitable induction training for new staff, regular training updates and on-going supervision to ensure that staff carried out their duties safely.

Is the service effective?

People using the service experienced care that was planned and delivered to meet their needs and mitigate any risks. People using the service and their relatives were involved in the development of their support plans which were personalised and took account of preferences, cultural and religious requirements

Care needs were reviewed on a regular basis and support plans could be modified if needs changed. Support plans were up to date and daily reports showed that the care delivered reflected the current plan. People had a schedule of activities and each person had a key worker who had responsibility for overseeing their care and coordinating activities.

Is the service caring?

We observed that people were cared for by kind and sympathetic staff. Staff we spoke with were aware of the importance of understanding individual preferences and routines and using ways to communicate with people that were unable to express themselves verbally.

Relatives of people we spoke with told us they were happy with the care and support provided, and that staff were supportive and knowledgeable about individual needs.

One parent remarked, 'The staff are very friendly and very well informed.'

Another parent commented, 'We were involved in drawing up the care plan ' my child is always happy to come here.'

Is the service responsive?

People using the service received a regular customer survey in which they were asked to rate aspects of the service and support they received, although the results of these surveys were not available.

There was regular contact with the parents or carers of people using the service and pre-respite checks were made before each visit so that any changes to needs or risks could be taken into account. Monthly meetings were held with other health professionals to discuss the care of each person so that any concerns could be addressed promptly and changes made to the care and support provided if required.

There was a complaints procedure which was available for people using the service and in a format that was accessible to people and their relatives. One complaint had been recorded and had been investigated and managed appropriately.

Is the service well-led?

The provider had a variety of systems to monitor the quality of service provided and audit their performance.

People using the service and their relatives were provided with information about the service and were contacted regularly to obtain their feedback and views.

There were appropriate procedures for dealing with complaints and reporting accidents and incidents.

Staff had regular training and supervision to ensure that their skills were up to date and appropriate. This helped to ensure that people received a good quality service.

The home has six single rooms. Five of the rooms may be booked in advance, with one reserved for an emergency placement. The home currently provides respite breaks for approximately 40 people. Each person may stay at the home for up to 56 days a year. On the day of our visit there were four people using the service.

The people had complex needs and were not able to speak with us regarding their experience of the home. We spoke with a number of relatives and carers regarding the service. The relatives and carers were very positive in their comments. One carer told us 'It's lovely there.' Another said, 'The staff are all wonderful.' They said they were involved in planning and reviewing people's care each time they stayed at the home.

The home was tidy and fairly well maintained. Records were generally in good order. Staff told us they were happy in their work and they felt very supported by managers. We saw friendly interaction between staff members and people using the service. Various activities were provided which were appropriate to people's care needs.

The home provides short stay respite care for up to six people with learning difficulties. Around forty people regularly use the service. Some have been attending for many years. Their care needs varied, some receiving a high level of support, including one-to-one care. Their needs were assessed and regularly reviewed and the care provided was person-centred and individualised. People using the service attended a day centre on week days, returning to the home in the afternoon. The home arranged various evening and weekend activities in accordance with people's preferences and appropriate to their needs.

People staying at the home at the time of our visits were non-verbal and therefore not able to tell us of their experiences. Accordingly, we spoke with a number of their relatives and a care manager responsible for two of the people. A relative told us the service was 'wonderful' and that they would be 'lost without it.' Another said their relative 'loved' the home and got 'very excited' when they knew they were attending. The care manager said 'it's an honour to place people there.'