Respite Service

Respite Service is a care home without nursing which provides a respite care service to up to five adults with learning disabilities and/or autistic spectrum disorder at any one time. The people they support may have varying additional needs including physical disabilities, mental health issues and sensory impairment. The organisation has a day centre next door to the respite service premises. However, this report only relates to the provider's provision of residential respite care. The day centre services fall outside the regulatory remit of the Care Quality Commission (CQC) and were not assessed as part of this inspection.

At the time of this inspection a total of five people had used the service since our last inspection. One person usually receives respite care for two nights a week every week, but had been away and had not stayed at the service since February 2017. Another person receives a total of 12 nights respite care a year, they decide when and how they use those allocated nights in consultation with the service. The other three people had stayed at the service on a once only basis and do not have a regular arrangement.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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. Due to other engagements the registered manager was not available during this inspection. The service manager was present and assisted us throughout the day.

Action had been taken to ensure people were safe from environmental risks when staying at the service. Recommendations from the local fire and rescue service had been met with improved fire safety arrangements put in place. A fire risk assessment had been carried out and actions taken to address deficiencies found. Arrangements had been made for ongoing monitoring and servicing of fire safety equipment. A legionella risk assessment had been carried out by a company qualified to do so. Work had been completed to rectify issues that raised concerns. Staff training in measures to reduce the risk of legionella had been provided and a system of ongoing monitoring for water safety had been implemented. All showers had been fitted with thermostatic mixing valves to reduce the risk of people being scalded by water that was too hot and radiators had been covered.

Systems had been implemented to enable the provider to assess, monitor and improve the safety of the services provided. The systems made sure that risks relating to the health, safety and welfare of people, staff and others were assessed, monitored and reduced when needed.

Staff received training in safeguarding adults. They understood their responsibilities to raise concerns and report incidents, and were supported to do so. They knew how to recognise the signs of abuse and knew what actions to take if they felt people were at risk. There were contingency plans in place to respond to emergencies.

Staff knew how people liked things done. Suitably skilled and experienced staff were available in suitable numbers to ensure people's needs could be met. The system used to calculate staffing levels took into account the needs of specific people staying at the service at any one time.

People received effective personal care and support from staff who knew them well and were well trained and supervised. People received support that was individualised to their personal preferences and needs. They were encouraged to do things for themselves and staff helped them to be as independent as they could be. Staff recognised and responded promptly to changes in the needs of people who use the service.

People's rights to make their own decisions, where possible, were protected and staff were aware of their responsibilities to ensure people's rights to make their own decisions were promoted. 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.

There were safe medicines administration systems in place so that people received their medicines when required. New medication storage arrangements had been introduced with the purchase and fitting of a medicines cupboard that met the current requirements. People's health and wellbeing was monitored and prompt action was taken to deal with any problems as needed.

People benefitted from staying at a service that had an open and friendly culture. People

enjoyed staying at the service and feedback was seen that confirmed people enjoyed their respite stays. Staff told us the management was open with them and communicated what was happening at the service and with the people who came to stay.

Respite Service is a care home without nursing which provides a respite care service to up to five adults with learning disabilities and/or autistic spectrum disorder at any one time. The people they support may have varying additional needs including physical disabilities, mental health issues and sensory impairment. At the time of our inspection there were a total of two people using the service over the year. One person receives respite care for two nights a week every week. The other person receives a total of 12 nights respite care a year, they decide when and how they use those allocated nights in consultation with the service. The organisation also has a day centre next door to the respite service premises. However, this report only relates to the provider's provision of residential respite care. The day centre services fall outside the regulatory remit of the Care Quality Commission (CQC) and were not assessed as part of this inspection.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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. Due to other engagements the registered manager was only available for a short time during this inspection. The service manager was present and assisted us throughout the day.

People told us they felt safe staying at the home. Staff understood their responsibilities to raise concerns and report incidents, and were supported to do so. They knew how to recognise the signs of abuse and knew what actions to take if they felt people were at risk. There were contingency plans in place to respond to emergencies.

People and a relative told us staff were available when they needed them and staff knew how people liked things done. Staffing levels were planned, reviewed and implemented to ensure there were enough staff to meet people's needs. The system used to calculate staffing levels took into account the specific needs of the people staying at the service at any one time.

People were encouraged to do things for themselves and staff helped them to be as independent as they could be. Staff recognised and responded promptly to changes in the needs of people who use the service.

People received effective personal care and support from staff who knew them well and were well trained and supervised. People received support that was individualised to their personal preferences and needs. Their needs were monitored and care plans were up dated where people's care or needs changed.

People's rights to make their own decisions, where possible, were protected and staff were aware of their responsibilities to ensure people's rights to make their own decisions were promoted.

There were safe medicines administration systems in place and people received their medicines when required. The service manager was aware that medicine storage at the service was not in line with current guidance and needed addressing. People's health and wellbeing was monitored and prompt action was taken to deal with any problems as needed.

People benefitted from staying at a service that had an open and friendly culture. People told us they enjoyed staying at the service and a relative told us their family member was happy there. Staff told us the management was open with them and communicated what was happening at the service and with the people who came to stay. A relative felt the service was managed well and that they could approach management and staff with any concerns.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had not assessed all risks to the health and safety of people using the service, had not done all that was reasonably practicable to mitigate any such risks and had not ensured that the premises were safe to use for their intended purpose. In addition, there was no effective system in place to enable the provider to ensure compliance with the fundamental standards. You can see what action we told the provider to take at the back of the full version of this report.