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Inspection carried out on 2 November 2018

During a routine inspection

This comprehensive inspection took place on 2 and 5 November 2018 and was unannounced on the first day.

Cascade Residential/Short Breaks is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service can accommodate up to a maximum of eight people. The main house had three floors and accommodated four people at the time of this inspection. Some people had their own bedroom and shared communal areas and a kitchen, and others had their own flat.

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.

At the last comprehensive inspection in March 2016, the service was rated good overall. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good in four of the five key questions, improving to outstanding in the effective question. This means the overall rating for the service remains good.

The service had a registered manager in post at the time of our inspection. 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.

This service was extremely effective and staff were proactive in ensuring people were supported to live a heathy, meaningful and fulfilling life. The service embraced supporting people to develop and regain their independence. There was a broad range of learning and social opportunities for people. As a result of this, people had recognised positive improvements made to their lives.

The service worked proactively in partnership with other professionals to develop care based upon good practice. This demonstrated there was a truly holistic and individual approach to assessing, planning and delivering peoples care and support.

People benefitted from a service which had an open and inclusive culture. Staff were very happy working at the service and spoke to us with knowledge and passion about their roles, and were clear about their responsibilities. Staff were trained and supported to carry out their roles.

Care plans were very person centred and detailed, and provided clear guidance to staff on how to support people. People's diverse needs were identified and incorporated into their care plans where required. Information was provided to people in an accessible format.

Staff supported people in line with their individualised care plans to manage individual risks and care needs.

Medicines were managed safely.

Safe recruitment practices were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. There was enough staff on duty to meet people's needs.

Checks were made to ensure that the environment was a safe place for people who lived there.

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

People were consulted and involved in decisions about their care and support; they were treated with dignity and respect.

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Inspection carried out on 17 March 2016

During a routine inspection

This inspection took place on 17 March 2016 and was unannounced. The service was previously registered as Cascade Residential and this was the first inspection since the service was registered as Cascade Residential / Short breaks.

The service is registered to provide accommodation and support for up to 8 people with a learning disability, specifically people with Autistic Spectrum Disorder. Some people have their own flat and others have a bedroom and share communal areas of the home. The home is situated in Withernsea, a seaside town in the East Riding of Yorkshire. It is close to the sea front and town centre amenities and there is on-street parking.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager in post who was registered with the Care Quality Commission (CQC). 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.

At this inspection we found that the service was safe. People’s needs were assessed and comprehensive risk assessments put in place to reduce the risk of avoidable harm. Staff had received training on safeguarding adults from abuse and understood their responsibilities in respect of reporting any concerns.

Staff who had responsibility for the administration of medication had completed appropriate training. Medicines were administered safely by staff and the arrangements for storage and recording were satisfactory.

People were supported to make decisions and their rights were protected in line with relevant legislation and guidance. People were supported to access healthcare services. We saw that advice and guidance from healthcare professionals was incorporated into care plans to ensure that staff provided effective care and support. People’s nutritional needs were met; their likes, dislikes and special diets were known by staff and were catered for.

The service had an effective recruitment process and this ensured only people considered suitable to work with vulnerable people had been employed. We saw that there were sufficient numbers of staff employed to meet the needs of people who lived at the home.

Staff told us they were happy with the training provided for them, and we saw that there were effective induction training and refresher training programmes in place.

We observed that staff were kind, caring and attentive to people’s needs and that they respected people’s privacy and dignity. Staff encouraged people to make decisions and have choice and control over their daily routines.

Care plans were updated regularly and information shared so that staff were aware of people’s changing needs.

We saw that a number of compliments had also been received by the service and that any complaints had been dealt with in accordance with the home’s policy and procedure, and to the complainant’s satisfaction.

Managers were proactive in monitoring the quality of care and support provided and in driving improvements within the service. There was clear organisation and leadership with good communication between the registered provider, registered manager, deputy manager and staff. We observed that records were well maintained.