About the service:

Doncaster Crisis Accommodation and Helpline is a small service providing short term support to people experiencing mental health crisis. There are five beds although currently the service is funded to offer four places. People stay for a maximum of seven nights. At the time of the inspection two people were using the service, and in the last year over 150 people have received care and support at the service.

People’s experience of using this service:

People received support which was tailored to their needs, delivered by staff who treated them with respect and understood their goals and aspirations. Staff treated people with warmth and empathy, and exhibited a passion for their roles.

The management team within the service had fostered a culture of openness and continuous improvement. There was effective communication between staff and managers, underpinned by regular team meetings and staff supervision and appraisal. Staff received training and support to ensure they had the skills and knowledge to carry out their role effectively.

People had access to healthcare professionals as required. 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.

People received support in an environment that was safe. Risk assessments were thorough, and the premises were regularly audited to ensure they were safe and fit for purpose. Staff had received appropriate training in relation to health and safety.

People were protected against the risk of abuse. Staff had received training in relation to safeguarding, and records showed the provider had taken all the required steps when people were suspected to be at risk of abuse.

People’s feedback was regularly sought, so that they could contribute to ongoing improvements within the service. We saw evidence of this during the inspection.

Rating at last inspection:

The service was last inspected in April 2016, where it was rated good.

Why we inspected:

This was a planned comprehensive inspection based on the rating at the last inspection.

We inspected Doncaster Crisis Accommodation and Helpline on 1 March 201. The inspection was unannounced. Doncaster Crisis Accommodation and Helpline was last inspected in April 2014, no concerns were identified at that inspection.

Doncaster Crisis Accommodation and Helpline provides accommodation and support for up to seven days to a maximum of four people with mental health issues. On the day of the inspection three people were receiving care services from the provider. The home 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 2008 and associated Regulations about how the service is run.

During our inspection we spoke with two people who used the service. We also spoke with three care staff and the service manager.

During our visit to the service we looked at the care records for eight people and looked at records that related to how the service was managed.

People who used this service were safe. The care staff knew how to identify if a person may be at risk of harm and the action to take if they had concerns about a person’s safety.

The care staff knew the people they were supporting and the choices they had made about their care and their lives. People who used the service, and those who were important to them, were included in planning and agreeing to the care provided.

The decisions people made were respected. People were supported to maintain their independence and control over their lives. People received care from a team of staff who they knew and who knew them. People were treated with kindness and respect. People we spoke with told us, “It really is a fantastic place, it's like a haven for me.”

The registered manager used safe recruitment systems to ensure that new staff were only employed if they were suitable to work in people’s homes. The staff employed by the service were aware of their responsibility to protect people from harm or abuse. They told us they would be confident reporting any concerns to a senior person in the service or to the local authority or CQC.

There were sufficient staff, with appropriate experience, training and skills to meet people’s needs. The service was well managed and took appropriate action if expected standards were not met. This ensured people received a safe service that promoted their rights and independence.

Staff were well supported through a system of induction, training, supervision, appraisal and professional development. There was a positive culture within the service which was demonstrated by the attitudes of staff when we spoke with them and their approach to supporting people to maintain their independence.

The service was well-led. There was a comprehensive, formal quality assurance process in place. This meant that all aspects of the service were formally monitored to ensure good care was provided and planned improvements and changes could be implemented in a timely manner.

There were good systems in place for care staff or others to raise any concerns with the registered manager.

Doncaster Crisis Accommodation is a care service that provides accommodation for four people at the time of a mental health crisis for a period of seven nights. There is an outreach service that is operated from the same premises but that service does is not required to be registered with the Care Quality Commission. The service can accommodate four people at any one time in single bedrooms and the bathroom is shared. The service is operated by the National Schizophrenia Fellowship, which is a registered charity.

People told us that they felt safe whilst staying at the home; they only used the service for a period of seven nights and they told us that no unnecessary restrictions were place on them during their stay. There were appropriate risk assessments in place that allowed people to take responsibility for their actions and be as independent as possible, but remain safe. Staff had undertaken training on safeguarding adults from abuse and they displayed a good knowledge of the action they would take to manage any incidents or allegations of abuse. None of the people who had used the service were subject to Deprivation of Liberty safeguards.

There were clear care planning documents in place that described people’s individual lifestyles and support needs. People set goals for recovery at the beginning of their stay and these were reviewed at the end of their stay. They told us that staff encouraged them to carry out the goals they had agreed to on their admission rather than forcing them, and that this had helped with their recovery. All of the people we spoke with told us that their situation had improved whilst they were staying at the service. They also told us that the outreach service continued to support their recovery.

People were encouraged to make decisions about their day to day lives whilst staying at the service and when making plans for their discharge. People were asked for feedback about their stay at the service when they left and we saw that these comments were analysed and acted on when improvements to the service were needed. Staff also had the opportunity to share their views at staff meetings and supervision meetings. Any areas that required improvement were identified and action had been taken to ensure that issues and concerns had been dealt with appropriately.

On the day of the inspection we spoke with staff and people who used the service and it was evident that the service was well led and well managed. Staffing levels were continually reviewed to ensure that there were sufficient numbers of staff employed to operate the residential service and the outreach service.

People’s privacy, dignity and independence were respected. One person told us “I am involved in every one of my goals, nothing is forced.”

People experienced care, treatment and support that met their needs and protected their rights. One person told us "this place is simply fantastic." Another person said “I am involved in my goals, everything, it’s all about me.”

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One staff member said "we have a wonderful staff team and very supportive management."

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

Due to the nature of this service we were not able to speak with people who used the service on this inspection. We looked at care plans of those people who had used the service recently. We also spoke with staff and saw exit questionnaires and comments made by people who had left the service.

We checked the records of 12 people who had recently used the service. Files contained evidence of consent being obtained prior to people receiving support. One person wrote in an exit questionnaire “I was told in detail about what the service offered and what would happen whilst I was staying at the house.”

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person wrote “every single member of staff treated me with dignity and respect and were non judgemental.”

People received safe and coordinated care and support where more than one provider was involved, or when they moved between services.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

Appropriate checks had been undertaken before staff began work. We checked the files belonging to four staff. Files contained evidence that the provider carried out background checks on staff before they commenced work.

People were made aware of the complaints system. Information about the complaints procedure was provided throughout the premises and given to people upon their arrival.

People using the service told us they were happy with the care provided and were involved in decisions about their care and welfare needs. Two people told us they were able to choose what time they got up and went to bed and what times of the day they went out.

Two people using the service also told us their dignity and privacy was respected by staff. One person told us “staff always said good morning to you and always offered you a hot drink”. One person also told us that once the support had been explained to them they felt better straight away about being in the home.

We spoke with two people using the service who told us they liked their time at the home and it was nice to interact with other people. One person told us that before entering the home they did not think it would work for them but found that it was a valuable experience and they were able to set goals to aim towards. Another person told us the home was helping with support that they needed to approach the future. Staff were described as “Brilliant”, “Fantastic”, “Really helpful” and “They could never do enough”.

We spoke with two people using the service who told us they felt safe at the home and they would tell staff or the manager if they were worried about anything.