During an assessment under our new approach
About the service
Tollemache Road Respite Service is a care home which operates as a respite service where people stay for short breaks. Up to 10 people can book in and stay at the service at a time. We carried out our assessment over a 2-week period. Each week of the assessment, there were 7 people using the service.
Who the service is for
This is a specialist respite service for autistic people and people with a learning disability.
Key findings
We carried out this assessment on 7 September, 9 September and 15 September 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.
We assessed the provider against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
Staff were recruited safely and staff had the skills and knowledge to support people effectively. This included training to support autistic people and people with a learning disability.
Medicines were administered safely. Risks were assessed before people started to use the service and people were involved in the process. These risks were reviewed before each stay to ensure any changes in care needs were known, and staff understood how to support people effectively, and safely. This included any changes in specialist advice or guidance. A family member told us, “They check [Name’s] needs on a regular basis and adapt what we need. They are fantastic with [Name], [Name] is happy and loves going.” Another family member confirmed, “When I book [Name] in, they ask if anything new I need to make them aware of, they ask me, it’s risk assessed when you register them in.”
When people needed specialist support with their care or to take their medicines, for example because of a specific health condition, staff received specialist training and, where appropriate, observations of practice were completed.
There were effective systems in place to safeguard people from abuse. When incidents or accidents happened, other agencies where informed when appropriate and systems were in place to look at how lessons could be learnt to avoid a reoccurrence. Family members felt confident in how any incidents were managed. One told us, “If anything happened, [Name] would tell us. If I didn’t feel confident in that sense or if I felt a risk, I’d not leave [Name] there.”
The environment and equipment were clean, safe and well maintained. Regular fire drills were conducted to ensure staff and people who were staying at the service knew what to do in the event of an emergency.
People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. Nobody was being deprived of their liberty. People were not subject to unlawful or excessive restrictions, they had choice, control and freedom over their lives. People confirmed staff knocked on their bedroom doors before entering. One family member explained staff have used picture cards with their loved one to gain consent and to support effective decision making.
Care plans highlighted people’s preferences in care. Staff demonstrated a very strong commitment to person-centred support and care. We observed kind and caring interactions between people and staff and people were supported to maintain their independence and usual daily routines and activities. Some people liked to help staff during their stay. One person told us, “I put the cutlery and mats out and sometimes help with other things.”
Processes were in place to ensure people had equity in experience and outcomes during their stay. For example, activities and meals were planned with people at the start of the week to ensure everyone had the opportunity to choose activities and meals which were important to them and enhanced their experience. One person told us they had chosen the cinema and macaroni cheese for their stay. A staff member told us of a recent activity when everyone chose to go out for tea rather than have a cooked meal. People spoke positively about the food provided at the service. Comments included, “The dinners are good” and “I like the food.”
The provider had a clear shared vision and strategy, and staff told us they felt valued and supported. A staff member said, “[The registered manager] is nice. They are good. We would go to them or the deputy manager. If there was a problem, they would sort it.”
A system of audits and checks was in place which was effective to monitor the quality of the service and identify any improvements. There was a culture of learning and improvement. Leaders worked with people, their families, other professionals and staff to continually strive to improve the service.
Visiting professionals gave positive feedback about the service and positive partnership working. Comments included, “I value the way their staff take the time to understand my clients’ complex needs and ensure [Name] is happy and settled throughout their stay” and “On several occasions, I have had to connect with the service to provide emergency respite for individuals experiencing difficulties in their usual place of residence. Tollemache have always provided a calm and professional approach to these scenarios, assessing thoroughly and ensuring that even in a crisis, the individual receives a person-centred experience.”
Staff were also responsive to peoples changes in circumstance. During our assessment a person stayed longer than planned due to a personal circumstance occurring. A family member told us of another time when their loved on stayed on longer than planned due to a family emergency. They spoke of the relief that gave them and said, “That to us was out of this world, fantastic.”
There was a strong sense of teamwork between staff who spoke with pride about working at Tollemache Road Respite Service. One staff member said, “We are a good team and we get on well.”