About the service: Dorin Court Bungalow Short Break Service is registered to provide accommodation and personal care to up to five people on a short break or respite basis. There were three younger adults using the service at the time of the inspection.

What life is like for people using this service:

Since our last inspection in November 2017 improvements had been made. Risks to people had been mitigated and action had been taken to rectify any shortfalls identified as part of the providers own quality assurance systems.

The new registered manager had made changes to the running of the service which had led to improved outcomes for people and staff. People’s relatives and staff felt the service was well led and the registered manager 'listened' was 'open', 'approachable' and 'pro-active'.

People received safe and effective care from kind and caring staff. Staff knew people well and had a good understanding of their personality traits and emotional needs as well as their health and social care needs.

People and their relatives had been fully involved in the assessment and planning of their care before they started using the service. A care plan had been developed with each person detailing their likes, dislikes, preferences and care needs. The registered manager had identified some people’s care plans needed updating and was in the process of completing this piece of work.

Consent had been sought before any care had been delivered in line with legal requirements. 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.

Staff treated people and their relatives with kindness, dignity and respect. People’s privacy was protected and confidential information was stored securely. People were supported and encouraged to remain independent and do as much as possible for themselves. People enjoyed the range of activities on offer and were encouraged and supported to take part in social events at the service. Mealtimes were relaxed, informal and social occasions. People enjoyed the homemade food on offer and their dietary needs and preferences were met.

Steps had been taken to make sure people were safe. Risks to people had been assessed and minimised in the least restrictive way. The environment had been adapted to meet the needs of people who used wheelchairs and was clean, safe and hygienic. The premises and equipment had been routinely serviced and checked to make sure it was safe. Staff had access to protective clothing such as gloves and aprons and had completed training in infection control.

There were enough safely recruited and trained staff on duty to meet people’s needs and respond to request for assistance. Staff felt supported by the registered manager and had completed the training they needed to meet people’s assessed needs. Management and staff worked in collaboration with other stakeholders such as health and social care professionals and people’s relatives.

A complaints procedure was in place for people to follow. Although no complaints had been received there was a system in place for complaints to be recorded and responded to.

Rating at last inspection: Requires improvement (report published January 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service was rated good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 22 and 29 November 2017 and was announced. We gave 6 hours notice of the inspection because we needed to be sure that a member of the management team would be available in the office to assist with the inspection. At the last inspection during September 2015 the service was rated Good. At this inspection the service was rated requires improvement.

Dorin Court Bungalow is a short stay respite service that provides support for adults who have a learning disability. The service can support up to five people and have 36 people registered to receive respite. One the first day of our visit there were no people staying at the service and there were five people staying on the second day of our visit.

There was an interim manager at the service at the time of our inspection. The service did have a registered manager in post but they were unavailable. 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.

At this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered provider had risk assessments in place however, these did not cover all areas of risk specific to each individual to keep them safe. The registered providers audit systems had identified the requirement to review and update all risk assessments however; this had not been actioned. You can see what action we told the provider to take at the back of the full version of the report.

Staff recruitment systems were robust and this helped ensure only suitable staff were employed to work with the vulnerable people supported. All staff had undertaken an induction and had completed shadow shifts at the start of their employment. Staff had all completed essential training required for their role. Staff received support through supervision and team meetings. This meant people received safe care and support from staff that had the right skills and knowledge.

Staff had all received safeguarding training and demonstrated a good understanding of this when spoken to. There were policies, procedures and systems in place to protect people from abuse.

People's needs had been assessed prior to them using the service. A selection of care planning documents were in place that included an 'All about me' and 'My Health Passport' documents. People had been supported to participate in the preparation of their care plans.

People told us they were supported by staff that knew them well and treated them in a kind and caring way. Staff rosters showed there were enough staff to meet the needs of the people supported. People told us that the staff respected their privacy and dignity.

The complaints procedure was available in easy read and pictorial formats. People told us they felt confident to raise a concern or complaint and believed any concerns would be listened to and acted upon promptly.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we found. We saw that the registered provider had policies and guidance available to staff in relation to the MCA. Staff demonstrated a basic understanding of this and had completed training. The registered provider had made appropriate applications for Deprivation of Liberty Safeguards (DoLS) and were awaiting outcomes on these.

The registered provider had up to date policies and procedures in place to support the running of the service and these were regularly reviewed.

We visited this service on 28th September 2015 and we gave short notice to the provider prior to our visit. This service was registered with the Care Quality Commission in August 2014 and this was their first inspection.

This respite service is run by VIVO Care Choices Limited to provide care and support to adults who have a learning disability. The service can accommodate up to five people. The aim of the service is to provide a respite and short stay service and to promote independence, develop confidence and increase skills. The service is situated in Upton on the outskirts of Chester. It is close to local shops. At the time of this visit there was one person staying at the service.

There was a manager employed to work at the service who was currently applying to be registered with the Commission. 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.

People told us staff were patient, kind, and supported them well. Relatives said they were happy with the support provided and that the staff were very caring and considerate with people. Comments included “The staff are lovely” and “The staff are very friendly.”

Support plans were person centred, pictorial and gave good information about the person’s individual needs. They were well written and included a range of risk assessments which were tailored to each person’s needs. Some people were supported with their medications and we saw that safe systems were in place. However, at the time of this visit no one was being supported with medicines.

The service was clean and well maintained. Procedures were in place to ensure all appropriate safety checks had been undertaken on the building and equipment used, on a regular basis.

People and relatives said they were safe in the support of the staff. Staff were aware of safeguarding policies and procedures and had undertaken safeguarding awareness training. The manager understood the principles of the Mental Capacity Act (MCA) 2005 and the implications of that on people who used the service. Staff had an awareness of the MCA through the induction process and safeguarding training.

There were robust staff recruitment processes in place which meant that people were protected from staff that were unsuitable to work with people who may be deemed vulnerable. Staff had undertaken an induction process and had access to supervision sessions, staff meetings and training relevant to their job role.

People had access to information about the service that included a statement of purpose and service users guide. These were written in large print and included pictures to make it easier to understand the information provided.

A complaints policy was available and processes were in place should a complaint be received. The registered provider had not received any complaints and CQC had also not received any complaints about this service.

Quality assurance processes were in place which included meetings held with people who used the service and their relatives and a range of quality audits were also undertaken in relation to the service provided.