Harelands House offers short-term support accommodation to people over the age of 18 who have a learning disability. They provide respite to parents and carers of people who are cared for in their own home. Harelands House is adapted to meet the needs of profoundly disabled individuals. Admissions to the home are usually planned but the service can also be provided if an emergency arises. There are a number of communal areas including a lounge, a dining room and a garden. Parking is available to the side of the property. The service has 82 people who have access to the service. Three people were accommodated at the home on the days of the inspection.

At our last inspection 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. However, the service improved to outstanding in well-led.

The inspection took place on 16 and 17 January 2018 and was announced in line with our guidance to ensure staff were present at the service.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 manager had been in post since October 2014.

Staff were consistently kind, caring and supportive and although most often they only supported people for a short period of time had developed positive relationships with people who used the service and their families.

The views of people who used the service were sought regularly using people’s own individual communication methods.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff also supported family members, for instance the service could take people if there was an emergency to ensure their care was maintained. Staff tried as much as possible to ensure that when people came into the service they followed their routines and activities they normally did at home.

The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and worked to ensure people's rights were respected.

Staff were supported to undertake their roles and had incentives to perform better. Staff also received induction, training and supervision relevant to their roles. This ensured they had sufficient knowledge to meet people’s needs.

Managers at the home and head office audited systems to help maintain and improve performance.

There were safe systems in place for the storage and disposal of medicines. Staff received training in how to administer medicines and had their competency in this area assessed.

People received individual care packages which took account of their needs which were mainly a learning disability or Autism. Staff were trained in the care of people with these conditions and how to safely de-escalate any behaviours that challenge. There was also the provision of equipment such as track hoists for people with mobility issues.

This was an unannounced inspection which took place on 08 July 2015. The service was last inspected on 17 July 2014 when we found it to be meeting all the regulations we reviewed.

Harelands House offers short-term support accommodation to people over the age of 18 who have a learning disability. They provide respite to parents and carers of people who are cared for in their own home. Harelands House is adapted to meet the needs of profoundly disabled individuals. There are a number of communal areas including a lounge area, a dining room and a garden. There were three people staying for a short break at the service on the day of our inspection.

The service had a registered manager in place at the time of our inspection. 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 this inspection we found that temperature checks of the medicine cupboard were not being undertaken to ensure that medicines were being stored at or below the recommended temperature. The registered manager and senior staff member were not aware these temperature checks were required. We have confidence that the provider would undertake this task.

We found that temperature checks of hot water outlets were not being undertaken to reduce the risk of scalding from hot water. We were informed that the thermometer had recently broken and was being replaced as soon as possible.

Supervisions were not being undertaken within timeframes identified by the senior member of staff. However, the senior member of staff informed us they planned to increase the frequency of supervisions for staff.

Fridge and freezer temperature checks that the service required staff to undertake were not being completed. The senior member of staff told us they would be addressing this with the staff.

We noted that redecoration was required in some parts of the service. This was being addressed by the registered manager and refurbishment plans were underway.

We found the service was in the process of renewing and updating their policies and procedures. On the day of our inspection some of these had been completed and others were work in progress.

Staff had received training in safeguarding and was able to tell us what they would do if they had concerns.

The service had a safeguarding and whistleblowing policy in place. This helped to ensure staff would know how to respond if they had concerns about the safety of people using the service.

There was an easy read leaflet readily available for people who used the service in relation to abuse.

The service had a nominated lead person and two safeguarding champions who were available to support and advise staff members about safeguarding concerns.

Risk assessments were in place throughout the service. These included risk assessments relating to the health and safety of people who used the service and risks in relation to the environment.

Moving and handling equipment was available throughout the serve which had been checked on an annual basis by an external contractor and deemed safe. Staff also visually checked this equipment twice daily.

The service had procedures in place for the reporting of incidents, accidents and dangerous occurrences.

Robust recruitment processes were followed by the registered manager to ensure the suitability of people working in the service.

People who used the service were involved in the recruiting of new staff members and were given the opportunity to decide if people were suitable for the role.

People who used the service had personal emergency evacuation plans in place. This would help to ensure that people were safely evacuated in an emergency situation.

Policies and procedures were in place in relation to medicine management and these were accessible to staff members.

We found the service was clean, tidy and free from offensive odours. Staff had received training in relation to infection control and knew their responsibilities in relation to this.

People who used the service and relatives we spoke with told us they were cared for by people who knew them well. Staff told us extra staff were put on duty when someone new came into the service for the first time, until they got to know each other.

Staff completed mandatory training in various areas such as moving and handling and safeguarding. Further training was available in relation to specific needs, such as autism and dementia.

The service had training champions (people with enhanced knowledge in specific areas) such as communication and moving and handling.

People who used the service were supported to access healthcare appointments as and when necessary.

All the care files we looked at included a ‘traffic light hospital assessment’. This is a system by which important information is readily available should a person be admitted to hospital.

The kitchen was accessible to all the people who used the service to access drinks and food when they liked. Menus within the service were pictorial to support all people who used the service to make choices.

People who used the service told us staff were caring. We observed people who used the service were treated with dignity and respect. Care records we looked at showed staff wrote about people in a compassionate and respectful manner.

People who used the service told us that staff respected their privacy and would always knock on their door before entering.

We saw that verbal handovers were undertaken to ensure changes regarding people who used the service were communicated and understood.

We saw people who used the service were offered a variety of activities to choose from throughout the week. People were encouraged to inform staff what activities they would like to undertake on a daily basis.

People who used the service were offered the opportunity to go on holiday. This included caravan holidays and to a centre where they could undertake arts and crafts during their stay.

Prior to using the service people’s needs were assessed. This helped to ensure the service could meet their needs prior to them staying.

Care plans we looked at showed people’s likes and dislikes were documented and reflected the current needs of people.

Staff has received specific training in relation to the management of behaviours that challenge.

People who used the service told us they were encouraged to make choices about many things including what they wanted eat or how they wanted to spend their day.

The service had a compliments and complaints policy in place. Forms were readily available in communal areas should anyone have wanted to give a compliment or make a complaint.

People who used the service, relatives and staff members told us the registered manager was approachable and they were able to talk to them.

Robust quality assurance systems were in place within the service to identify where improvements were required.

The service sent out feedback forms to relatives annually in order to improve the service.

We saw thank you cards the service had received from people who used the service and/or their relatives.