Tollemache Road Respite Service

We found the following examples of good practice.

• The service followed safe visiting procedures.

• Temperature checks were completed on all visitors and evidence of negative test for COVID-19 was a requirement before entry into the building.

• Shielding and social distancing rules were complied with. The environment had been adapted to support social distancing. Each room within the building had a clear sign on each door of the maximum occupancy at any one time. This was for the benefit of staff, people living in the home and visitors.

• Safe procedures were followed for admitting people to the service. People were only admitted following evidence of a negative COVID-19 test.

• Stocks of the right standard of personal protective equipment (PPE) were well maintained and staff used and disposed of it correctly.

• The registered manager had implemented new systems, for example staff where provided with clothing they changed into and out of in the premises. This meant the clothing was always washed on site and reduced the risk of any contamination.

• Staff had access to regular testing.

• Guidance on the use of PPE and current infection prevention and control (IPC) procedures were clearly visible across the service. PPE stations were available through out the home.

• Staff knowledge and practice in regard to infection prevention and control procedures for example, 'donning and doffing' PPE and hand washing, was regularly checked. This was also a revisited through staff meetings and through handover sessions.

• The provider had access to see through masks to enable effective communication with people if this was deemed necessary.

• Communication between the home and relatives was maintained through email and letters.

The service provides short stay respite services for up to 10 adults who have a learning disability or a physical disability. The number of people staying at the service at any one time varied from week to week. At the time of this inspection there were seven people using the service.

This was the first inspection for this service.

People in Tollemache Road Respite Service receive accommodation and nursing or personal care as a package under contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The care service had not 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.” Registering the Right Support CQC policy

Registering the Right Support gives guidance surrounding the maximum amount of people a home providing support to people with learning disabilities should have. Guidance states this should be six however Tollemache Road Respite Service could have up to 10 people staying in the home at one time. We saw that the home itself was situated in a residential area and that people with learning disabilities who were using the service were able to live as ordinary a life as any citizen.

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. The service had a registered manager in post.

People we spoke with told us they felt safe at the respite service and they had no worries or concerns. People’s relatives and friends also told us they felt people were safe. The staff at the home knew the people they were supporting and the care they needed. We observed staff to be kind and respectful towards people. The home provided a range of activities that was person led to interest people.

Care plans and risk assessments were person centred and they detailed how people wished and needed to be cared for. They were regularly reviewed and updated each time a person came in to the service for respite. Peoples medications were stored and administered safely.

The registered manager and staff understood the requirements of the Mental Capacity Act 2005 (MCA). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected and we saw how people’s independence was supported.

There was a safeguarding policy in place and staff were aware of the safeguarding procedure in relation to safeguarding adults and all were aware of the need to inform the manager immediately.

There were a range of audits in place to assess and monitor the quality and safety of the service provided. Examples included, medication audits, infection control audit and premises checks. People’s views and opinions on the service provided were regularly sought. For example, there was evidence of satisfaction surveys being carried out and each person was encouraged to give feedback at the end of each stay.

There was a robust recruitment process. There was sufficient staff employed at the respite service to meet people’s support needs. The staffing levels were maintained with the services own bank staff. This contributed to the quality of the care being delivered. Staff received induction, supervision and training appropriate to their role. They told us that they felt well supported and effective in their roles.

The staff were friendly, welcoming and we observed good relationships were maintained with people living in the home and a kind and respectful approach towards people’s care. The manager continued to be a visible presence in and about the home and it was obvious that she knew the people who lived in the home well.

We saw that the service’s environment and people’s bedrooms were nice, clean and well kept. There was also a series of health and safety checks in place to ensure the building was safe.