Support for Living Limited - 19 Haymill Close Shortbreak Service

About the service

Support for Living Limited - 19 Haymill Close Shortbreak Service is a residential care home providing short stay accommodation for adults with a learning disability and autistic people living in the London Borough of Ealing. The service provides periods of planned and emergency respite care to people throughout the year, commissioned by the London Borough of Ealing.

Up to 7 people can stay at the service at any time. On the day of the inspection 3 people were staying at the service.

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

Right Support

Staff supported people with their medicines safely. Staff worked with other agencies to support people’s needs. There were infection prevention and control arrangements in place. People were supported by staff to pursue their interests. Staff supported people to achieve their aspirations and goals. The service worked with people to plan for when they experienced periods of distress and to support them safely at such times.

Right Care

People received person-centred care and support. Staff knew and understood people and responded to their individual needs. Staff had training on how to recognise and respond to safeguarding concerns. The service worked with other agencies to do so. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff communicated with people in ways that met their needs. People's support plans reflected their preferences and needs to promote their safety and wellbeing.

Right Culture

The provider operated monitoring processes to help ensure people consistently received good quality care and support. Whilst some care records were not always consistently clear or detailed enough, this did not impact on the quality of care provided. We discussed this with the registered manager so they could make the necessary improvements and they responded to this promptly. People and those important to them were involved in planning their care. Staff turnover was low, which supported people to receive consistent care from staff who knew them well. Staff and managers knew and understood people well and were responsive to their support needs. The provider had a clear vision for the service based on improving people's quality of life and staff worked to make this happen.

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

Rating at last inspection

The last rating for this service was good (published 10 May 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Support for Living Limited - 19 Haymill Close Shortbreak Service on our website at www.cqc.org.uk.

Follow up

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

Support for Living Limited - 19 Haymill Close Shortbreak Service is a 'care home' type of service. The service provides support to 22 people through periods of planned respite care throughout the year. At any one time the service can accommodate a maximum of 3 people staying overnight. The accommodation is provided in a bungalow where all people have their own rooms.The service also supports people who need respite on an emergency basis. All the people who use the service live in the London Borough of Ealing.

The provider for Support for Living Limited - 19 Haymill Close Shortbreak Service is Support for Living Limited under the brand name of Certitude. In this inspection report we will refer to the provider as Certitude.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good.

Relatives described staff as caring towards people. There had not been recent relatives meetings or events and some relatives had missed this support. However, the registered manager had identified this and had taken steps to address this by inviting relatives to see the new refurbishments when they were completed.

Staff knew how to recognise safeguarding adults concerns and the registered manager reported and where necessary investigated concerns appropriately.

The registered manager assessed people’s individual staffing needs to ensure there were sufficient staff on duty. The provider had robust recruitment processes and the registered manager was in the process of recruiting more permanent staff.

People had risk assessments that identified the risks and the measures required to keep them safe from harm. People staying at the service had complex behavioural support needs and there was good guidance for staff to manage behaviour that might challenge the service. The staff worked closely with the provider Certitude’s intensive support team and the local authority psychology team to work successfully with people.

People prior to placement were robustly assessed and they had detailed care plans that contained clear guidance for staff about meeting their needs.

Care plans informed staff how people communicated their wishes. Staff respected people and maintained their privacy and dignity.

Staff had received appropriate supervision and training to support them to undertake work with people who had complex needs.

People were supported to have maximum choice and control of their lives and staff provided care in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager undertook checks and audits and Certitude’s quality assurance team analysed and monitored the data from the audits to maintain a high standard of service.

Certitude held events to celebrate staff achievements and to recognise their contribution to the success of the organisation.

The provider promoted the rights of people with learning disabilities and worked with a number of other agencies to address the issues facing people.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

Relatives we spoke with told us they felt their family member was safe and well cared for when using the respite service. They both said their family members were 'safe' and 'secure' at the service. Arrangements were in place for the safe management of medicines.

Staff had undertaken training which allowed them to care for people safely. Staff had a good understanding of people's needs and any triggers that resulted in behaviour that challenged the service. We observed throughout our inspection that staff respected people's dignity and protected their rights. Risk assessments were carried out, centred on the person and these promoted people's welfare and independence while ensuring their safety. Systems were in place to manage incidents and accidents, so that the staff and provider learnt from them.

Staff had undertaken training on the Mental Capacity Act 2005 and were aware of their responsibilities in relation to Deprivation of Liberty Safeguards (DoLS). No DoLS applications had been submitted and staff were aware of the importance of ensuring they acted in people's best interests.

Is the service effective?

There were sufficient numbers of staff with the right skills and experience to meet people's needs effectively. Care plans we viewed provided staff with detailed guidance on how to care and support people. They were centred on the person, their individual needs, choices and preferences.

People's health was monitored and appropriate referrals were made to other professionals if people's needs changed. The service was proactive in seeking guidance and support from other professionals to support people's health and wellbeing.

Staff received effective training, supervision and appraisal.

Is the service caring?

We observed staff treating people with dignity, respect and consideration throughout our visit. Staff had a good understanding of people's individual needs, preferences and communication skills. People were encouraged to make decisions and choices where they were able to.

The relatives we spoke with told us they were happy with the care and support that the service provided. Comments we received included 'they are very good at keeping me informed' and 'I'd be dead without this service, it is the only thing that I have got which allows me a break'.

Is the service responsive?

The staff team worked closely with other healthcare professionals such as the behavioural therapist to promote people's safety. Where people had raised any concerns or complaints these were investigated and the outcome shared with the complainant. Comments we received included 'any concerns I have raised have been listened to and addressed'.

Sufficient numbers of staff were on duty to meet people's needs and these were kept under review so that the service could respond when people's needs changed.

Is the service well-led?

The service was led by a registered manager, and she was supported by a well-established staff team Staff we spoke with were positive about the support and guidance they received from the management team. The manager demonstrated good leadership skills and was supportive to people using the service, relatives and staff. Staff had a good understanding of their roles and responsibilities.

There were systems in place to monitor the quality of the service so that where required areas for improvement were identified and addressed

We looked at the support plans for three people using the service. We saw the plans detailed people's health, social and personal care needs and how these would be met during their stays. Support plans were updated regularly and, where possible, people were involved in reviewing the care and support they received. Where people did not have the capacity to consent to their care, the provider acted in accordance with legal requirements.

The provider had policies and procedures for safeguarding people using the service. Care workers understood the procedures and were trained to identify possible abuse. A member of staff told us 'I report to my manager if I had any concerns.'

There were sufficient staff working in the service to meet people's care and support needs. One member of staff told us 'you have to work together but it's a good team.'

The records we saw were up to date and securely stored.

We saw staff responding promptly to people's needs, and being flexible where people changed their minds about what they wanted to do. Staff also encouraged and involved people in planning activities at the service.

Staff enjoyed working at the service and received support and training for their role, which ensured that people got the right support.