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Respond Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 July 2018

Respond is a residential adult care service for short-term respite which is managed by Slough Borough Council. The service currently provides critical respite care to adults with learning disabilities. It offers both planned and emergency support to enable families to take scheduled breaks from their role of caring for people living at home. The service also provides an emergency placement facility. At the time of our visit the provider was carrying out a programme of building works and re-development for Respond and another one of its services. This meant six people from another service had temporarily moved into the respite service. Therefore, only two out of the eight available beds were used for respite. During our inspection there were two people using the respite service.

A manager was in post and was registered with us since October 2010. 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 and associated Regulations about how the service is run.

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 difficulties and autism using the service can live ordinary a life as any citizen.

At our previous inspection on 13 and 14 January 2016 we found a breach of Regulation 18 of the Care Quality Commission Registration Regulations 2009. We asked the provider to take action to make improvements in the key question of well-led. This was because the service did not notify us without delay of DoLS authorisations approved by the supervisory body and safeguarding alerts raised with the local authority. We asked the provider to send us an action plan to show the what improvements would be made, by 28 March 2016. The provider failed to submit the action plan.

During this inspection, we found the service still did not notify us of certain events. When notifiable safety incidents happened, the registered manager did not follow actions as required under the duty of candour regulation. Although relatives felt the service was well managed, we found a negative workplace culture amongst staff, who felt unsupported and not listened to. Governance and performance management systems were not always reliable and effective.

Staff were not appropriately inducted; trained and supervised. People’s personal safety had been assessed and plans were in place to minimise identified risks. We noted these were not always reviewed.

People were supported to have maximum choice and control of their lives. However, the service was not always compliant with Mental Capacity Act 2005 and its codes of practice, as some people were unlawfully deprived of their freedom.

Relatives were positive about the caring nature of staff. We heard comments such as, “Staff members are fantastic, wonderful, and very patient; I have never had any problems. They speak to my daughter as if she is a human being” and “I know the staff well and I trust them. My son comes back (home) very happy and is very comfortable at the unit and with all the staff. I think the unit has a homely feel.”

Staff knew people’s care and support needs. We observed they were very friendly, caring and had a very good rapport with the people they interacted with. Staff gave examples of how they protected people’s privacy, confidentiality and promoted their independence.

Relatives felt their family members were kept safe from abuse. A relative commented, “Once there was bruising and staff phoned straight away to find out if I was aware, which I was and I know she gets bruises when she rides the cycle.”

Staff knew how to protect people from harm. There were sufficient numbers of suitable sta

Inspection areas

Safe

Requires improvement

Updated 13 July 2018

The service was not always safe.

People’s personal safety had been assessed and plans were in place to minimise identified risks. However, these were not regularly reviewed.

Relatives felt people were safe from harm and staff had a good understanding of how to do this.

There were sufficient numbers of suitable staff; recruitment practices ensured vulnerable adults were protected and medicines were administered safely.

Effective

Requires improvement

Updated 13 July 2018

The service was not always effective.

The service did not always act in accordance with the Mental Capacity Act 2005.

Staff did not receive appropriate induction; training and supervision.

People’s nutritional and health needs were met.

Caring

Good

Updated 13 July 2018

The service was caring.

Relatives gave positive feedback when discussing the caring nature of the staff.

Staff were observed to be friendly; caring and had a very good rapport with the people they interacted with.

People’s privacy, confidentiality and staff promoted their independence.

Responsive

Good

Updated 13 July 2018

The service was responsive.

Relatives felt the service was responsive to people’s needs.

Care plans were person-centred and the service ensured people with a disability or sensory loss had access and understood information they were given.

Relatives knew how to raise concerns. Complaints were responded to appropriately.

Well-led

Requires improvement

Updated 13 July 2018

The service was not always well-led.

The service was not transparent when notifiable safety incidents happened.

Although relatives felt the service was well-managed, we found a negative workplace culture amongst staff, who felt unsupported and not listened to.

Governance and performance management systems were not always reliable and effective.