This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. The inspection was carried out by one inspector on the 27 November 2018.

Fairburn provides short breaks to people with a learning disability. The service is registered to provide accommodation, nursing and personal care for seven people. Presently 42 people access the service for short breaks throughout the year. The service is jointly commissioned by Bristol City Council and South Gloucestershire Council.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has 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.

There was 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.

At our last inspection in 2016 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.

Why the service is rated Good.

People received the care that had been commissioned by the local authorities. Relatives commended the service in relation to the planning, flexibility and delivery of care. Relatives told us they usually got the dates they requested and they knew in advance when their relative would be staying at Fairburn. The service also responded to emergencies such as ill health of the main carer.

People received a safe service. Staff ensured that people got on well and they were compatible with each other. Risks had been assessed and safe systems of work were in place to ensure people’s safety whilst not curtailing their independence. Staff had been through a thorough recruitment process to ensure they were suitable to work at Fairburn.

People were receiving care that was responsive and effective and tailored to their needs. Care plans were in place that clearly described how each person would like to be supported. People had been consulted about their care and support. The care plans provided staff with information to support the person effectively. Other health and social professionals were involved in the care of the people and there was very much joint working with them and family. Safe systems were in place to ensure that people received their medicines as prescribed.

People were supported by suitable numbers of staff, with the right skills and knowledge. Staff had received training and were supported in their roles. They regularly received supervision and team meetings were organised monthly.

People were valued and supported to be as independent as possible. People’s rights were upheld, consent was always sought before any support was given. Staff were aware of the legislation that ensured people were protected in respect of decision making and any restrictions and how this impacted on their day to day roles.

People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice.

People were provided with a safe, effective, caring and responsive service that was wel

This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. The inspection was carried out by one inspector on the 20 and 23 September 2016.

Fairburn provides short breaks to people with a learning disability. The service is registered to provide accommodation, nursing and personal care for seven people. Presently 35 people access the service for short breaks throughout the year. The service is jointly commissioned by Bristol City Council and South Gloucestershire Council.

There was a registered manager in post; they were also responsible for another short break service operated by Milestones Trust. 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 were receiving care that was responsive and effective and tailored to their needs. Care plans were in place that clearly described how each person would like to be supported. People had been consulted about their care and support. The care plans provided staff with information to support the person effectively. Other health and social professionals were involved in the care of the people and there was joint working with them and family. Safe systems were in place to ensure that people received their medicines as prescribed.

People received the care that had been commissioned by the local authorities. Relatives commended the service in relation to the planning, flexibility and delivery of care. Examples were given where the service had responded to emergencies such as a carer being admitted into hospital or a family bereavement. Relatives told us they usually got the dates they requested and they knew in advance when their relative would be staying at Fairburn. Some of the people had been using the service for many years.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management and safe recruitment processes.

Staff were genuinely caring and supportive and demonstrated a good understanding of their roles in supporting people. Staff received training and support that was relevant to their roles and the people they supported. Systems were in place to ensure open communication including team meetings and one to one meetings with their manager. Staff were committed to providing a service that was tailored to each person they supported. Relatives were complimentary about the staff. Many of the staff had worked at Fairburn for a long time.

People’s rights were upheld, consent was always sought before any support was given. Staff were aware of the legislation that ensured people were protected in respect of decision making and any restrictions and how this impacted on their day to day roles.

People’s views were sought through care reviews and surveys. The results of these were analysed and had outcomes. Systems were in place to ensure that complaints were responded to and, learnt from to improve the service provided. The service was committed to involving relatives in the delivery of care with good communication in place to ensure care was consistent when people moved from one service to home or to another service. Staff and the registered manager understood the importance of working closely with relatives and other professionals.

People were provided with a safe, effective, caring and responsive service that was well led. The registered provider was aware of the importance of reviewing the quality of the service and was aware of the improvements that were needed to enhance the service.

At the time of this unannounced inspection four people were staying at the home for a short respite break.

People were not able to tell us about their experiences. We gathered evidence by observing care, reviewing records, and speaking with the manager and five staff. We also spoke with a visiting health care professional. We viewed recent survey results that the provider had sent to parents and carers of people who stayed at Fairburn. These indicated good levels of satisfaction with the service.

People experienced care, treatment and support that met their needs and protected their rights. We found that people's needs were assessed and care was planned and delivered in line with individual care plans.

People were supported to eat well and nutritional needs were met.

People stayed in a place that was clean and had been maintained to minimise the risk of infection.

Generally records were detailed, well maintained, kept up to date and provided information to inform and guide staff practice.

We did not consult people who use the services of Fairburn for respite break on this occasion.

Some people were unable to tell us how they were cared for due to their learning disability and some people have non verbal communication skills. We were therefore only able to talk with some people to hear their views of their care and support. For these people we carried out observations of their care and interaction with staff in the communal areas of home. We observed the staffs' interaction with people in the home and saw that their approach was calm and attentive in supporting people with their needs. We saw peoples' individualised preferences being respected.

During our visit to the home we saw that people looked content and happy and interacted with the staff who were looking after them. We saw that the staff communicated with those with limited or no verbal communication and interpreted signs and behaviours.

During our visit to the home we observed interactions between the people that used the service and the staff to help us understand their experiences. This helped us to see that they were being involved in their care. It also helped us to see that they were being respected and that relationships had been established. Staffs communication with people was positive and clearly showed that they knew people and their needs well.

We asked the people who had experience of short term care about their stay and one person agreed to give feedback.

We were told that they could make decisions about what to wear and about what to eat. We were told that although bedroom doors were lockable and there were keys to bedrooms, the keys were held in the office for security, people were not able to hold the key to their own bedrooms.

We asked the people if the staff had asked them about the way they wanted to be supported with their care. They told us that although the staff were “ok” and that they helped them, we were told that staff not discuss with them the support they needed.

We asked about feeling safe at the home. The person we spoke with told us that they felt they would be safer living independently.

The way people kept themselves occupied was discussed with people. We were told that people generally went to day care centres or had one to one time with day care staff.