5 Horse Leaze is a short break service based in a fully accessible bungalow. The service provides respite and short stays for up to six people with a learning disability. At the time of inspection there were three people staying at the service and one person being supported by staff in hospital. The service was last inspected in September 2015 and was rated as Good overall but was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because the service did not have effective arrangements in place for the safe administration of medicines. At this inspection, we found that the provider had addressed the issues and medicines were now being managed safely.

There was a registered manager at the service 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.

The service was safe and people who used the service were protected from harm. Staff were knowledgeable about safeguarding and what to do if they had any concerns and how to report them. People who used the service told us they felt safe.

Risk assessments were personalised and robust and updated if there were any changes to people’s needs.

People with behavioural needs were supported using positive behaviour support techniques.

Staffing levels were sufficient to meet the needs of the people who used the service and care workers demonstrated they had the relevant knowledge to support people with their care. The registered manager told us there was always enough staff to cover any absences.

Recruitment practices were safe and records confirmed this. The service obtained references and carried out checks to ensure that staff could work with vulnerable people.

Newly recruited care staff received an induction and shadowed other members of staff on various shifts. Training for care staff was provided on a regular basis and updated regularly. All staff had a 100 per cent completion rate for their training. Staff spoke positively about the training they were provided and told us about a culture of staff helping one another at the service.

Care workers demonstrated a good understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

The service was supporting people who were subject to DoLS and had submitted notifications to the Care Quality Commission.

People were supported with maintaining a balanced diet in line with specific needs. People told us they enjoyed the food.

People were supported to have access to healthcare services and receive on-going support. The service made referrals to healthcare professionals when necessary.

Care workers demonstrated a caring and supportive approach towards people who used the service and we observed positive interactions and rapport between them. People who used the service and their relatives told us that staff were caring.

The service promoted the independence of the people who used the service and people felt respected and treated with dignity. People who used the service were supported to maintain their religious and cultural needs.

Despite the nature of the service being ‘short stay’ for the purposes of respite, people were supported to learn and enhance their skills during their time at 5 Horse Leaze, with the view of facilitating people to use their new and developed skills upon returning to the community. Care plans were person centred and focused on people’s individual needs. People were encouraged to set goals for things they wanted to do and people’s achievements were recorded to motivate them.

People who used the service were involved in the recruitment of new staff and sat on the interview panel and given the opport

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Staff we spoke with told us they "always" asked for people's consent before they delivered care or treatment to them.

One person we spoke with told us the care they received was "good". We found there was documentary evidence in people's files they were risk assessed before they received care from the service. Risk assessments in people's files included manual handling and transition needs. We saw that where risks had been identified there were actions in place to ensure the person's safety and welfare.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others. Staff we spoke with told us they worked with other external services to ensure people received the care they needed.

Appropriate checks were undertaken before staff began work. We reviewed four staff records. We found documentary evidence staff provided two references of previous employment and proof of address. There was evidence that medical and criminal record checks were undertaken by the provider.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

We carried out a visit on 19 February 2013 and we looked at the personal care and treatment records of people who use the service. We talked with people who use the service and observed how they were being cared for. We talked with carers and / or family members, talked with staff and talked with relevant professionals parties.

Some of the people we spoke with said that they had choices in relation to clothing and meals and said that they had information about the placement before they came to live there. Other people who were present on the day of the inspection had limited verbal communication skills. Professional parties we spoke with said that there had been good communication between themselves and the provider. They also said that the staff on site had been able to demonstrate skills in dealing with challenging behaviour in their experience. When we spoke with relatives of people who use services and the feedback they gave was of a positive nature.

At the time of our inspection visit there were two people using the service. People using this service have varying levels of verbal and non-verbal communication due to their disability. We observed that one person appeared to be enjoying a pictorial cards game with a member of staff. Another person told us that they had been supported by staff to visit a close relative that morning, and that they liked spending time at 5 Horse Leaze. We read comments that the service received last year from the relatives of people that use the service. All of the comments were very positive, including “The staff are wonderful. They are so happy, caring and friendly”, “X seems very happy when she comes here; the staff are very nice” and “It’s very helpful as we have a break from all of the heavy stuff”.

5 Horse Leaze is a short break service based in a fully accessible bungalow. The service provides respite and short stays for up to six people with a learning disability. Staff work with families who need a break from caring and offer a few hours, days or weeks support to people in their own home, the community or at Horse Leaze. At the time of inspection there were two people staying at the service and 29 people using the day service across the different weekdays.

There was a registered manager at this service. 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.

We found the systems in place to ensure the safe management and administration of medicines were not always effective. Staff were knowledgeable about the procedures relating to safeguarding and whistleblowing. Safe recruitment checks were carried out for new staff and there were adequate numbers of staff to meet people’s needs. People had an assessment of their needs and risk assessments were carried out to ensure safe care was provided. There were effective systems in place to check and maintain the safety and suitability of the premises and these were up-to-date. The service had a plan in place so staff knew what to do in an emergency and how to obtain support.

Staff received supervision and appraisals to ensure good quality care was provided. There were opportunities for staff to receive training and skill development. The registered manager was knowledgeable about the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. Staff were knowledgeable about when they needed to obtain consent from people and how they would do this. People had a choice of food from varied and nutritious menus and were able to access healthcare professionals during their short stays if needed.

People and their representatives thought staff were caring. Positive caring interactions were observed between staff and people using the service. Staff knew how to enable people to make choices and were knowledgeable about respecting privacy and dignity. People were assisted to develop their skills in independent living.

Staff knew the people they were supporting including their preferences which ensured a personalised service was provided. There were a variety of activities offered to ensure people had their social and emotional needs met. People and families knew how to raise concerns or make a complaint and these were responded to within the timescales set in the provider’s policy.

The provider had systems to check the quality of the service provided. People and their representatives were able to give feedback through satisfaction surveys. Staff attended regular team meetings to receive updates on the service, the people using the service and to ensure consistent good quality care was provided.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.