Burnley, Pendle & Rossendale Short Break Services

We found the following examples of good practice.

The short stay service provided a spacious, comfortable and hygienically clean environment. Rigorous cleaning schedules and programmes were in place to ensure the risks of cross infection was minimised between the short breaks offered to people.

The layout of the service and the communal areas were suitable to support social distancing. The atmosphere of the service was calm and relaxed. We observed staff attending to people's needs throughout our visit.

People's health and well-being was carefully monitored during their stay and good communication links were maintained with each person’s next of kin or carer.

A regular programme of testing for COVID-19 was in place for staff and systems were established to ensure all professionals attending the home could demonstrate they were double vaccinated against COVID-19

Staff had been trained in infection control. We observed staff were using PPE appropriately. There were sufficient staff to provide continuity of support should there be a staff shortage.

Infection prevention and control audits took place which ensured the registered manager had oversight of all aspects of infection control. Policies, procedures and risk assessments related to COVID-19 were up to date. These supported staff to keep people safe.

Burnley, Pendle and Rossendale Short Breaks Service is registered to provide short term respite care and accommodation for people with a learning disability and autism. The home is registered to support up to six people at any one time. The accommodation is all based on ground level and is accessible to all people who use the service. There were six people staying at the home at the time of inspection.

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

People’s experience of using this service:

People felt safe and were extremely happy at the service. Staff had a good understanding of abuse and felt confident raising concerns. Risk assessments were robust. The service supported some individuals with very complex needs and there were behavioural risk assessments and strategies in place to ensure that this was managed effectively. The service was person-centred and support plans focussed on all aspects of their life. One-page profiles were in place and information was provided in easy read formats, such as safeguarding and complaints policy. People knew who to speak to if they had a complaint and felt able to express concerns to staff.

People's morning, evening and night time routines were detailed and it was clear that all people were supported consistently in a person centred way.

Assessments of need were extremely person centred and comprehensive. Reviews were taking place as required and appropriate referrals to external services were made. People's health and wellbeing was well documented, and people experienced positive outcomes.

There were 'champions' in the service who actively supported staff to make sure people experienced a high-quality service leading to a better quality of life. We were made aware of numerous positive outcomes for individuals where the team had gone the extra mile for individuals and their families.

There were enough staff to meet people's needs effectively and staff told us they were clear what roles and responsibilities were required of them during their shift. Staff were very competent and were aware of their responsibilities in terms of infection control. Good practice guidelines were being followed. The service had a welcoming atmosphere and was extremely clean and tidy.

Staff told us they had an appropriate induction and had received appropriate training to confidently carry out their role. Medicines were managed safely and we observed staff undertaking daily medication audits.

Communication was excellent within the service and people had access to communication passports and hospital passports. People had a choice of meals and pictorial information around menus were displayed.

Staff were extremely caring and knew the people they supported well. People at the service were content and at ease in the presence of the staff team. We saw positive interactions between staff and service users, demonstrating, warmth, humour and compassion. There were several thank you cards and compliments from families praising the staff and management.

People were placed at the heart of the service and staff supported people to have access to meaningful activities and engage in positive risk taking. Initial work with people who were new to the service was exceptional and the service supported people to move on to other services, to ensure consistency. People were treated with dignity and respect and were encouraged to develop relationships.

Staff felt extremely well supported by the registered manager who had high standards and had embedded a person centred ethos throughout the service. The team felt listened to and their experience and knowledge of individuals was acknowledged by the registered manager. Morale was excellent and staff were rewarded for their commitment to the service. It was evident that the staff and management team were incredibly passionate about the people that they supported.

Audits were being undertaken and accidents and incidents were being managed appropriately. There was an open culture of learning from incidents and we saw that appropriate actions were documented when incidents occurred.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice. We saw evidence of decision specific capacity assessments and the service had developed an MCA key ring to help guide staff.

Rating at last inspection:

At the last inspection the service was rated outstanding (published 7 November 2016).

Why we inspected:

We carried out this inspection based on the previous rating of the service.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

Burnley Pendle & Rossendale Short Break Services (Haddon House) is a purpose built home situated in Burnley. The home provides care and support for up to 6 people with a learning disability and or physical disability in single occupancy rooms. Bedrooms were spacious and had en suite facilities. There were various aids to support people with mobility difficulties such as overhead tracking, specialist bathing facilities, dining space for wheelchairs and beds specific to people’s needs. All areas were tastefully decorated and furnished to a high standard. There were 5 people accommodated in the home at the time of the inspection.

The service was managed by 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.

During this inspection we found the service was meeting the current regulations.

The service provided an outstanding level of care and support that placed people at the heart of their care and promoted their right to be self-determining in how they lived their lives. All the people, their relatives, visiting professionals and staff we spoke with had nothing but praise for the service and the excellent quality of life people experienced. People’s rights to privacy, dignity, and freedom of choice were firmly embedded into the culture of the home and people’s diversity was embraced.

People living in the home and their relatives described the service as excellent. They said there was and never had been any cause for concern in how people were treated. Staff were described as having ‘special qualities’, ‘professional’, ‘caring and understanding’.

There was sufficient staff who had been carefully recruited and matched directly with people to ensure people received a personal service.

Safeguarding referral procedures were in place and staff had a good understanding around recognising the signs of abuse and had undertaken safeguarding training. Staff were clear about their responsibilities for reporting incidents in line with local guidance.

Risks to people’s health, welfare and safety were managed very well. Risk assessments were thorough and informed staff of the actions to take to support people safely. Staff fully understood how people with limited or no use of words communicated distress in different situations or circumstances and had been trained in positive behaviour support.

There were appropriate arrangements in place in relation to the safe storage, receipt, administration and disposal of medicines. Staff responsible for administering medicines had been trained.

Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions for themselves. Staff understood the importance of gaining consent from people and the principles of best interest decisions. People with limited use of words and where English was not their first language, were supported very well through preferred communication methods, such as interpreters, body language, and use of pictorial signs to express their wishes and choices. Routine choices such as preferred daily routines and level of support from staff for personal care was acknowledged and respected.

All people we spoke with were very positive about staff knowledge and skills and felt their needs were being met appropriately. Staff felt confident in their roles because they were well trained and supported by the registered manager to gain further skills and qualifications relevant to their work. They were highly motivated and committed to providing a high quality of care.

People were provided with a nutritionally balanced diet. Staff worked closely with healthcare professionals to ensure people’s dietary needs were met and potential problems associated with nutritional intake were avoided. Special diets were catered for including those diets relating to cultural and religious observance.

The home provided a well maintained very pleasant and homely environment for people. It was fully equipped to support people with a physical and learning disability.

People’s care and support was kept under continuous review. The service worked in partnership with relevant health and social care professionals to ensure people’s changing needs were being managed well. This meant people received prompt, co-ordinated and effective care.

People were cared for by staff who demonstrated exceptional insight and understanding of people’s personal values and needs. The service was described as going above and beyond people’s expectations. There was a culture of valuing people embedded within the service. Privacy, dignity, independence, choice and rights were at the heart of the service they received.

Staff demonstrated through their actions, people were very important and unique. Staff had been very well trained to ensure people’s rights were upheld. We found staff were very respectful to people, attentive to their needs and treated people with kindness and respect in their day to day care. People using the service, relatives, visitors and health professionals all spoke very highly of the high standards afforded to people using the service. The care was described as ‘going above and beyond’ ‘exceptional’ and ‘remarkable’.

Assessment of people’s needs was an on-going process which meant any changes to their care was managed very well. Communication between people using the service, relatives and staff was seen to be excellent. People who had difficulty using words or expressing their needs were very well supported to use other methods of communication to relay their wishes and feelings.

People were supported to live full and active lives and use local services and facilities. Activities for people were personal to their requirements and expressed wishes, meaningful and varied.

Raising issues was an on-going theme within the service with the purpose of raising standards and people were actively encouraged to give feedback on their experience. The complaints procedure was accessible to all and a ‘niggles book’ was kept to record minor issues people raised. People had confidence in the registered manager to deal professionally with any complaint they raised.

People, their relatives, staff and professionals to the home described the management and leadership of the service as exceptional. The registered manager was referred to as an excellent leader who placed people at the heart of everything they did.

Equality and diversity, privacy, dignity, freedom of choice was firmly embedded and reflected in the high standards of care people received.

There was an excellent standard of organisation within the service that fully supported continuous improvement and ensured people received a high quality service.

Staff were valued and respected and this was reflected in their work ethics.

We found there were effective systems to assess and monitor the quality of the service. People using the service, their relatives, professionals and staff contributed to the evaluation of the service and were actively encouraged to make recommendations for improvement. Results of surveys showed a very high satisfaction with the facilities, the staff and registered manager.

There was an effective and thorough quality assurance system in place to ensure any improvements needed within the service were recognised and the necessary action was taken to implement any changes.

Below is a summary of what we found. The summary is based on our observations during the inspection and discussions with people who used the service. We also spoke with the team leader, staff members and we looked at records.

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

Is the service safe?

People told us they felt safe. Comments made to us included, 'I feel safe because there is always someone around if I need them' and 'I feel safe here because the staff are kind and talk to me.' Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to record and review complaints, accidents and incidents. This should help reduce the risk to people and help the service to continually improve.

There were policies in place in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff understood the need to seek consent from people before they provided any care. This should help ensure people's rights were safeguarded.

Recruitment procedures were safe and thorough. Staff were supported to gain appropriate skills and knowledge for their role. This should help ensure people received safe and appropriate care.

Is the service effective?

The two people we spoke with told us they were happy with the care they received and their needs had been met. It was clear from our observations and discussions with staff that they knew people well and had a good understanding of their care and support needs.Staff had received training to meet the needs of people who used the service.

Specialist dietary, mobility and equipment needs had been identified in care plans where required. Risk assessments were regularly reviewed and care plans amended to reflect people's changing needs.

Is the service caring?

People were supported by kind and attentive staff. We observed staff took care to support and protect people.

Is the service responsive?

People's needs had been assessed before they moved into the home. Records we looked at showed us people had the opportunity to meet with their key worker to review their care.

Systems were in place to ensure staff had access to up to date information regarding people's needs. This should help ensure they were supported to respond appropriately to any changes to a person's condition.

Is the service well led?

The service worked well with other agencies to make sure people received care in a joined up way. This information helped to ensure the person was provided with the care they required when they were away from the home.

Quality assurance processes were in place in the home. Records we looked at showed us people had completed a satisfaction survey. People who used the service were regularly asked their opinion about the service. Regular meetings were held with staff. These provided the opportunity for staff to discuss any concerns or practice issues in the home.

We reviewed information about two people's care and found that their care needs were being planned for. We found that the staff understood people's care needs and how to protect them from risk and harm.

Records we looked at showed people's needs were assessed and care and treatment was planned and delivered in line with the individual care plan. We found that the care plans were accompanied by risk assessments and risk management plans to ensure people were protected from unsafe care practices.

We found that there were effective systems in place for the safe storage and administration of medicines.

We saw that there were effective recruitment procedures in place to ensure that people who used the service were protected from harm through good staff recruitment.

One of the people we spoke with made various positive comments about the staff team: "They have gone out of their way to make my relative's life better" and "Nothing is too much trouble for the staff."

People were provided with care plans that are regularly reviewed so that people have the most appropriate support to meet their needs and if these needs change, the support they receive is amended to reflect those needs.

People said they felt safe living in the home and were able to discuss concerns or issues with the staff if they wished to. We saw that the people using the service are involved in planning their care and are in control of how their support is provided for them. Risk assessments are reviewed regularly in respect of the person's needs, the environment and behaviour so that service users and staff are safeguarded.