Cheshire East Short Breaks is run by Cheshire East Council. The service provides respite care services including accommodation and personal care for up to four adults with learning disabilities at number 9 Warwick Mews, Macclesfield, Cheshire. On the first day of our inspection there was one person using the service however, they were out and not present during our site visit.

The care service had not originally 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. However, we found that people were given choice, their independence was promoted and there was the service had an inclusive culture.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to receive a safe service and were protected from harm, discrimination and abuse. Accidents and incidents were recorded and where appropriate actions taken to mitigate the risk of recurrence. Risks were assessed and measures implemented to manage, risk assessments were reviewed and monitored when people’s needs changed. Medicines were managed and administered safely and we saw that robust procedures were in place. There were sufficient staff to meet people’s needs and recruitment procedures were safe. The premises were well maintained and checks were carried out to ensure they were safe. Staff had access to personal protective equipment (gloves and aprons).

People continued to receive an effective service. An assessment of people’s needs was carried out before they came to stay at Cheshire East Short Breaks and staff sought information about any changes before people returned. Staff had received a wide range of health and social care related training and also specialist training for specific health needs including epilepsy. Regular staff supervisions, appraisals and direct observation of staff practice were carried out. The service could source relief staff from the provider’s other locations. This enabled the registered manager to be confident that relief staff were fully aware of policies and procedures and had received the same level of training as permanent staff. People were supported to have choice and were supported in the least restrictive way. The principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind and compassionate. We saw that people’s individual communication needs were considered. People’s views were sought during and following each visit. People’s privacy, dignity and independence were promoted and they were treated fairly and without discrimination.

People continued to receive a responsive service. People’s preferences, likes and dislikes were clearly recorded in their personal support plan. The service was homely and person-centred. People were supported to develop their independence. Assistive technology such as door alarms, pendants and pagers were used to support people’s individual needs. Several documents were available in easy read formats.

People continued to receive a service which was well-led. Audits were carried out to assess and monitor the quality of the service and where actions had been identified these were had been completed. We found information which we had not been informed about. We could see from the records available that the registered manager had dealt with these incidents robustly and that they had been reported to other agencies as required. The provider confir

We visited the short breaks service on 30th January 2014 and looked at outcomes 2, 4, 9, 12 and 16. We found the service compliant with these outcomes. We spoke with two people who used the service as well as staff working there.

People using the service told us they were very happy with the service. They liked the staff that supported them. "I was nervous about coming here but the staff have been really nice and that has helped. I have just been chilling out and taking it easy”.

Assessment of people's need was thorough and person centred and focused on their

individual circumstances and immediate to longer-term needs. Care and support plans placed an emphasis on people's right to be self-determining in how they lived their lives and took risks.

Peoples' capacity to make their wishes known was recorded and appropriate support plans were in place to support people’s communication methods.

The right of people to take informed risks had been acknowledged and risk assessments ensured a balance of safety and effectiveness. People were given guidance and support to keep safe in the service and in the community.

People were cared for by staff that were recruited appropriately, well trained and supported to do their job.

People said they were consulted all the time about the service they received.

We spoke with three people who were staying at Warwick Mews and two relatives of these people. One person who used the service accompanied us during the visit and gave detailed information about care planning, activities and the general management of the service. People told us that the service was excellent and provided quality services. Comments included "we are told about everything that goes on", "we are given full information about the staff and services provided", “and I know when I am coming here and what we will do." One person told us that they called Warwick Mews their holiday home; they said the "staff were very kind and helpful."

Relatives told us that they had been consulted about their relative's needs and had seen their care plan. They told us that they had received a welcome pack which included a DVD all about the service. They told us that they and their relative had been invited to visit the service prior to staying there.

All the people we spoke with during our visit praised the service and made positive comments about the staff and the standard of care provided. People said that they felt safe and well looked after. They said they had no worries whatsoever about the standards of care and understanding within the home.

People told us they were consulted about their views of the service and if they thought any improvements were needed. One person told us they felt very much a part of the service and "staff always asked for their opinion on everything."

This inspection took place on 3 December 2015 and was unannounced. Telephone interviews took place on the 4 and 8 December 2015. Cheshire East Short Breaks is located in Macclesfield close to local amenities. Cheshire East Short Breaks is run by Cheshire East Council Care4CE. The service provides short break care services including accommodation and personal care for adults with learning disabilities. The service is purpose built and has four bedrooms. At the time of our visit there was one person staying at the home. There is a large accessible car park provided for visitors. Staff explained that people who stayed at the service preferred to be referred to as customers. We have used this preferred term throughout this report. Staff are on duty 24 hours a day and provide sleep in duties.

The service had a registered manager. 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 and associated regulations about how the service is run.

We spoke with people living at the service and relatives/representatives who acted on their family member’s behalf. They were positive about Cheshire East Short Breaks and praised all the staff and the care and support provided.

We observed how staff spoke and interacted with customers and found that they were supported with dignity and respect. We observed a friendly rapport between customers being supported and the staff. The atmosphere was relaxing and calm.

We found the staff had a good understanding of supporting customers when they lacked capacity, including the requirements of the Deprivation of Liberty Safeguards (DoLS.) Staff took appropriate actions to fully support customers who lacked capacity to make decisions for themselves.

We found care plans focused on the individual person. They contained guidance to enable staff to know how to support each customer with their needs and requests. Staff had a good understanding and knowledge of each customer’s individual needs and preferences. Some of the customers that stayed at the service used non verbal signs to communicate. Staff were trained and aware of how customers communicated their preferences and choices. Plans were in place to support people's communication methods. Staff used easy read formats to help some customers to better understand their support plan.

The service had a complaints procedure and relatives were confident that they could raise their opinions and discuss any issues with senior staff. They did not raise any concerns during our visit.

The service operated safe recruitment of staff and ensured that staff employed were suitable to work with people staying at Cheshire East Short Breaks. Appropriate pre-employment checks were carried out to enable the management of the service to have adequate information before employing staff.

Staff had received regular supervision and training to assist them in their job roles and in their personal development. The provider offered a wide range of training to all of their staff team to ensure they fully understood their customer’s needs.

Various audits at the service were carried out on a regular basis by the manager and the provider to help ensure that appropriate standards were maintained throughout the home.