8 April 2014
During a routine inspection
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who lived at the home about their experience and talking to staff and the provider. We also reviewed documentation and records kept at the home.
If you wish to see the evidence supporting our summary please read the full report.
This is a new respite care service and there had not been many people who had accessed respite care. Therefore we have not been able gain comments from a number of people who used the service or their representatives.
Is the service safe?
People who used the service were given appropriate information and support regarding their care and treatment. People's needs were assessed and care and treatment was planned and delivered in a way that was intended to ensure people's safety. We noted that most people went as an emergency admission to the home. However, the provider had ensured that a comprehensive assessment was carried out before people were admitted to the home. This was to ensure the staff were able to meet the needs of the people and therefore people were safe at the home.
Care and treatment was planned and delivered in a way that was intended to promote people's welfare. Staff used robust risk assessments. There were risk assessments in place with people's planned care. For example when people went out to day centres, out shopping and when they took part in activities. The plan of care stated what support people needed and how it should be delivered to minimise any negative impact to people themselves or others. There was another example where the care plan stated the number of staff needed to support a person so that they could maintain their independence and be safe.
People who used services were only deprived of their liberty when this had been authorised by the Court of Protection, or by a Supervisory Body under the Deprivation of Liberty Safeguards (DoLS). We found evidence where the manager had followed the correct procedures to ensure a best interest decision was made through DoLS to ensure safety of a person they were looking after. The decision was made wholly to make sure the person was safe.
People were protected from the risk of abuse or unlawful or excessive control or restraint, because the provider had made suitable arrangements so that staff were competent in identifying the possibility of abuse and preventing abuse from happening. People we came into contact with appeared relaxed and cheerful. One person put their thumb up when asked if they felt comfortable and safe in the home.
There were effective recruitment and selection processes in place to ensure suitably qualified, skilled and experienced staff were employed. We checked staff files and found the provider had maintained a rigorous recruitment process and staff received induction. Staff were supervised to make sure people received care which was safe and appropriate.
Is the service effective?
People who used the service understood the care and treatment choices available to them. People who used the service were given support to understand the care and treatment choices available to them at the home by the staff. During the initial assessment staff made sure the person seeking care and their representatives, who may be in some circumstances be their advocates were made aware of the choices available to them. We saw documentation of people's likes, dislikes and preferences in their care records.
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care files we checked confirmed that initial assessments had been carried out by the staff at the home before people moved into the home. This was to ensure the home was able to effectively meet the needs of the people who came for respite care
Is the service caring?
People's diversity, values and human rights were respected. Staff said they had received training on valuing people's diversity and protecting people's human rights. They gave us examples which confirmed they had a good understanding. A member of staff said, 'The key to respecting and caring is taking account of people's diversity and rights.'
People's care and treatment was planned and delivered in a way that protected them from unlawful discrimination. We observed staff treating people with respect and helped them with their daily activities such as personal care and social activities. We saw staff taking a person out to the park during our visit. We asked a person whether they were happy at the home. They nodded their head and smiled and looked happy.
Is the service responsive?
People were supported in promoting their independence and community involvement. We observed people were enabled by staff to get involved in their community activities and they were given suitable support.
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Staff used robust risk assessments when planning care and support. When planning care staff took steps to minimise any harm to people and others in risk assessments . For example when enabling a person's independence staff identified their medical condition put them at risk when travelling on public transport alone. Therefore their care plan stated that they should always have support staff with them when travelling.
There were effective recruitment and selection processes in place to ensure suitably qualified, skilled and experienced staff were employed. The provider had systems in place to refer staff to the appropriate bodies if they were no longer fit to work in health or social care settings.
The manager told us they had processes in place to identify staff who were no longer fit to work in health or social care and that they took appropriate action when they identified this.
Is the service well-led?
The provider had made sure staff had the skills when explaining to people in a way they understood what choices were available in respect of their care and treatment. We saw documentation of people's likes, dislikes and preference in their care records. Therefore people who used the service understood the care and treatment choices available to them.
There were arrangements in place to deal with foreseeable emergencies. The manager and staff we spoke with were knowledgeable about the procedures to follow if there was an emergency. We saw instructions within care plans as to how people should be evacuated in the event of an emergency. The provider had made sure staff were familiar with the policies in place to deal with emergencies.
The manager ensured people's care and treatment reflected relevant research and guidance by making arrangements that staff accessed relevant training and development.
The manager made arrangements so that decisions about care and treatment were made by the appropriate staff at the appropriate level. This is a respite service for people with learning difficulties. The manager had ensured that staff worked closely with community workers, case workers and other professionals including the people's GPs to ensure continuity of care for people who were at respite.
The manager had systems in place to learn from investigations of incidents and accidents and also to take account of complaints and comments from people.