Chrysalis Holidays

Chrysalis Holidays provides supported holidays domestically and overseas for adults with learning disabilities. All holidays are led by an experienced manager and the activities are undertaken by qualified professionals where appropriate. The service is managed from an office located in Newton le Willows.

The service has a registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers they are registered persons. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection published in November 2017 we found that there were a number of improvements needed in relation to support, training and supervision, also quality audit systems had not identified areas for improvement. These were breaches of Regulation 18 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Effective and Well-led to at least good. The provider sent us an action plan that specified how they would meet the requirements of the identified breaches.

This inspection was undertaken to check the required improvements had been made. We found that the registered provider was meeting all the legal requirements.

The registered provider had audit systems in place that were regularly and consistently undertaken. The audit system identified areas of good practice along with areas highlighted for development and improvement.

People and their relatives spoke positively about the activities that had been undertaken during their holidays. People had the opportunity to participate in a wide range of activities of their choice.

The registered provider had safe recruitment practices in place. All staff had completed an induction at the start of their employment and undertaken shadow shifts with an experienced team member. Essential training was consistently completed along with refresher training when required in accordance with good practice guidelines. Staff received support through supervision and team meetings. Staff told us they felt well supported.

People's needs were assessed before they commenced any holidays with the service. This information was used to create care plans and risk assessments specific to the individual. These documents included clear guidance for staff on how to meet people's individual needs. People's needs that related to age, disability, religion and other protected characteristics were considered throughout the assessment and care planning process.

Staff demonstrated a good understanding of safeguarding and had all received training. Staff felt confident to raise any concerns they had and believed they would be acted upon promptly by the management team. The registered provider had safeguarding policies and procedures in place.

People had developed positive relationships with the staff that supported them during their holidays. Privacy and dignity of people was respected and people's independence was promoted through documentation.

Medicines were managed safely in accordance with best practice guidelines. There were medicines policies and procedures in place, staff that managed people's medicines had all received training and had their competency regularly assessed.

People were complimentary about the food and drink they had during their holidays. They told us they were always offered choice and supported as required.

The Care Quality Commission as required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and report on what we found. We saw the registered provider had policies and procedures available for staff to follow in relation to the MCA. Staff demonstrated a basic understanding of this and had all completed training.

Feedback from people and their relatives was consistently sought following every holiday and used to identify new holiday ideas as well as areas for development and improvement.

There was a clear complaints policy and procedure in place available in accessible formats. Relatives told us they felt confident to raise any concerns and thought they would be promptly acted upon.

Policies and procedures were available to staff to offer them guidance within their role and employment. These were regularly reviewed and updated by the registered provider.

At this inspection we found the provider had addressed the recruitment issues but we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to staff training, supervision and good governance.

Chrysalis Holidays provides supported holidays domestically and overseas for adults with learning disabilities. All holidays are led by an experienced manager and the activities are undertaken by qualified professionals where appropriate. The service is managed from an office located in Newton le Willows.

At the time of the inspection the service had a registered manager. 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 using the service told us they felt safe. We saw the service had appropriate safeguarding policies and procedures in place. Staff had received some level of training in safeguarding vulnerable adults and children; however some staff were overdue refresher sessions in these areas. Despite this, when questioned staff were able to demonstrate a good understanding of how to report both safeguarding and whistleblowing concerns.

People using the service, professionals involved with booking or commissioning holidays and staff members told us enough staff were employed to meet people’s needs. Staffing levels were allocated based on the needs of the people attending the holiday, with an additional staff member assigned to assist on more complex holidays.

We saw that robust recruitment procedures were in place to ensure staff working for the service met the required standards. This involved all staff having a Disclosure and Baring Service (DBS) check, references and full work history documented.

Staff comments about the quantity and quality of induction and refresher training varied. We were told training was usually held once or twice a year, but saw no plan in place to ensure new staff members could access practical training sessions outside of these planned training dates. The training matrix showed some staff members required refresher training in a number of areas. We also noted training people had completed in their previous employment had been included on the training matrix, rather than just sessions facilitated by the service.

Staff completed bi-annual appraisals; however supervision meetings were not facilitated. Staff meetings were held at the end of each holiday, but these focussed on the ‘customers’ experiences and any issues identified, rather than being a learning and supportive forum for staff.

We saw there was a policy and system in place to ensure the safe management of medicines. People we spoke with confirmed they received appropriate support to ensure medicines were taken when required and as prescribed.

People spoke positively about the standard of care received. People told us that staff treated them kindly, with dignity and respect whilst also promoting their independence wherever possible. People were complimentary about the staff who supported them, which was captured on feedback sheets and cards and letters sent to the service.

We looked at seven care plans and although these tended to consist of only three pages, they contained important and personalised information about the people who used the service. The care plans also contained individual risk assessments, which helped to ensure people’s safety was maintained. We saw that people had been involved in planning their care and were asked to update their care plan and risk assessment prior to each holiday, to ensure the staff knew how best to support them. We saw new processes had been introduced to address issues with the timely receipt of updated information.

We saw the provider did not have a range of systems and procedures in place to monitor the quality of the service. The only current audit in place was for personnel files, to ensure these contained all necessary checks and information. Quality monitoring of holidays had been completed three times in 2016, but had yet to take place this year. The registered manager told us these were planned, however due to having to support holidays most weeks, had yet to be completed.