The inspection took place on the 3 November 2016 and was announced.

Eco Nights provides a respite care service for younger adults who have a range of complex needs such as learning disability, autism and physical disability. At the time of our inspection 27 people regularly used the service for varying lengths of stays. There were two people using the service when we visited.

A registered manager was in post. 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 registered manager was supported by a deputy manager to ensure the daily management of the service.

The service provided good care and support to people enabling them to live fulfilled and meaningful lives. People were supported by skilled and well trained staff who ensured people were safe. The registered manager and staff understood and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS).

There were sufficient numbers of staff available to meet people’s individual needs. The registered provider had effective recruitment procedures in place to protect people from the risk of avoidable harm. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. There were safe systems in place for the administration of medicines and people received their medication as prescribed.

There was a strong emphasis on person centred care. Assessments were undertaken to identify people’s care and support needs prior to them using the service. Care plans included people’s preferences and individual needs and were regularly reviewed. The service also gathered information from health and social care professionals involved in people’s care to ensure effective support and care was provided.

The service responded well to meeting people’s diverse care and support needs. People were supported to maintain their daily routines and activities during their stay at the service.

There were effective systems in place to regularly assess and monitor the quality of the service provided. The registered manager was able to demonstrate how they measured and analysed the care and support provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs. There was an effective complaints system in place.

Staff felt valued, enjoyed working at the service and were committed to providing a high quality service to people.

This was a follow up inspection as, when we inspected Eco Nights on 4 and 23 October 2013, we had minor concerns that some people were not receiving care individual to their needs. The provider wrote to us and told us the action they had taken, or would take, to address the identified shortfalls. We spoke with two staff members and the registered manager. We reviewed two people's care records. Other records viewed included staff training records and policies. We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led? This is a summary of what we found:

Is the service safe?

When we arrived at the service the staff asked to see our identification. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

We saw that the staff were provided with training in safeguarding of vulnerable adults from abuse, and the Mental Capacity Act (MCA) 2005. This meant that staff were provided with the information that they needed to recognise signs of abuse and respond to any concerns identified.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Is the service caring?

We saw that people were relaxed in the company of staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate that they knew people well. We saw that staff treated people with dignity and respect.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. We saw that when one activity was cancelled for a person without notice, the service immediately organised another activity.

Is the service well-led?

The service had a number of quality assurance measures in place. The registered manager was proactive in monitoring and looking for ways to improve the service. We saw that the quality of the service had been maintained.

At the time of our inspection to the service on 14 May 2013, we found no young people were receiving a period of respite at Eco Nights. Following our inspection we spoke with five relatives. All confirmed that they were very happy with the care and support provided for their member of family. They told us that staff rapport with the young people who used Eco Nights was positive. Comments included "The service is brilliant", "I have total confidence in the service's ability to look after and care for my relative" and "I feel that the staff team know the needs of [name of young person]."

It was apparent from our findings at this inspection that the absence of robust quality monitoring by the provider has been a contributory factor to the failure of the service to identify non-compliance, or any risk of non-compliance sooner. Improvements were required to ensure that support plans reflected the young people's care needs and any potential risks. Improvements were also required in relation to staff recruitment procedures and selection processes and ensuring that all staff received appropriate training, supervision and appraisal.

The inspection was completed on 8 July 2015, 17 July 2015 and 4 August 2015. Eco Nights provides pre-planned short term respite care for younger adults aged between 19 and 30 years of age. This may include younger adults who have a range of complex needs such as learning disability, autism and physical disability. Respite care can be arranged on a ‘one off’ or a regular basis. It can also be arranged for short periods of time (such as a few hours) or for longer stays such as a weekend or a week or longer. At the time of the inspection 36 people were using the service.

The service had a registered manager in post. 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.

Risks to people’s health and wellbeing were not appropriately assessed and required improvement.

There were insufficient numbers of staff available to meet people’s needs.

People were cared for by staff that were well trained and had the right knowledge and skills to carry out their roles. However, improvements were required to ensure that newly employed staff received a comprehensive induction.

Some aspects of care planning were not detailed and did not provide an accurate description of people’s care and support needs. The management of medicines within the service was not safe and required improvement. Appropriate assessments had not been carried out where people living at the service were not able to make decisions for themselves and to help ensure their rights were protected.

The provider’s quality assurance arrangements were not appropriate to ensure that where improvements to the quality of the service were identified, these were addressed.

Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect people. Appropriate recruitment checks were in place which helped to protect people and ensure staff were suitable to work at the service. Staff felt well supported in their role and received regular supervision.

People’s healthcare needs were supported and people had access to a range of healthcare services and professionals as required.

People were supported to be able to eat and drink sufficient amounts to meet their needs. The dining experience was positive.

People were treated with kindness and respect by staff. Staff understood people’s needs and provided care and support accordingly. Staff had a good relationship with the people they supported.

There was an effective system in place to respond to comments and complaints.

You can see what actions we told the provider to take at the back of the full version of the report.