Greenwood is a purpose built unit providing short stay and respite care to 16 younger adults. People using this service have a learning disability and may also have a physical disability, sensory impairment or mental health issues. There were at total 130 people using the service throughout the year for short stays and respite. The period of stay depended on the needs of the individual person and their relatives.

The service was last inspected on 29 August 2013. At that time we found the service was meeting the requirements of the regulations we inspected at that time.

This inspection took place on 1 November 2016. There were 10 people using the service at the time of this inspection.

There was an experienced and qualified manager at the service who was registered with CQC. 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 service had made a difference to the lives of people who used it and their family. One person said, “I know that when I come here, people at home are cared for too and people of my own age are here as well.” We received positive feedback from family members who said their relatives were well supported, safe and treated with dignity and respect when they stayed at the service. A relative commented, “We know we are lucky to have access to this service and the care is safe as well and respectful.” Another said, “The staff are supportive and helpful, they understand the impact of transitions and how people need to be with peers to develop and feel comfortable.” A health professional told us, “We work closely with parents who feedback to us how valuable the service is…”

The registered manager and staff explained they referred to people using the service as “guests” and they intended to provide a ‘hotel’ style service, which was safe, flexible and fun to use.

Staff communicated skilfully with people using their preferred methods and displayed a warm and caring attitude. People appeared comfortable in their surroundings and quickly made themselves at home when they arrived at the service or returned from day time activities.

The service had been completely refurbished to a very high standard since the last inspection. All bedrooms were single occupancy rooms and they were spacious and had en-suite facilities. There were various aids and adaptations to support people with their mobility needs such as overhead hoist tracking, specialist bathing facilities, dining space for wheelchairs and beds specific to people’s needs. All areas were tastefully decorated and furnished to a high standard.

There were systems in place to protect people from the risk of abuse and harm. The registered manager and staff were knowledgeable about safeguarding people and were aware of the procedures to follow should an allegation of abuse be suspected. Assessments identified risks to people and management plans to reduce the risks were in place to ensure people's safety.

There was a sufficient number of staff deployed to meet people's needs and preferences. Thorough recruitment procedures were in place to ensure staff were suitable to work in a care environment.

Medicines were stored, administered, and disposed of safely and staff were trained in the safe management of medicines. We recommended that the service follow the guidance issued by the National Institute for Health and Care Excellence (NICE) in relation to record keeping. The registered manager took immediate action during the inspection to improve the recording of medicines received by the service.

The service was meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding and knowledge of the Act, and

We brought forward our inspection of this service because we saw that there had been an escalation in the number of incidents that the service had experienced and reported on in recent months.

To help us understand why this was happening and to assess that people using the service were safe, we met nine of the people staying on respite at the service. In addition, we met with, nine staff of varying roles and responsibilities. We listened to what people had to say and we also reviewed some documentation in respect of the people staying there and staff. We reviewed information collated about incidents.

We were satisfied that people using the service received a good standard of care and were safe. We found the service was well led. We found there were enough skilled and trained staff to support people. Staff were proactive in identifying and escalating incidents and these were managed well to minimise disruption to others. People and staff were happy with the service but indicated that resource issues regarding transport and activities could be improved, and we passed this to the manager to look into.

When we visited, we spoke with four people who were using the service for respite. Three people said that they had visited the home previously and liked to come there. They said they liked to carry on with their usual day time activities when they visited.

One person said this was their first visit. They said that they did not think that it was the right place for them. However, they understood this was an interim placement whilst other arrangements were made for their accommodation. They said that they had as much freedom as they wanted but found the need to be back by a certain time a nuisance.

When we visited the majority of people using the service had left to attend day time activities. However, we spoke with one person who was waiting to go out, they told us they had not used the service before. They said they were enjoying being in the service, and that staff were to accompany them to an appointment. They confirmed that they had enjoyed some recent activities. For example, going to the pub, which they had enjoyed.