We carried out an unannounced inspection of the service on 18 and 26 January 2018. Helmsley Road Short Breaks Service a is a ‘care home’. 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. This service supports people who have a learning and/or physical disability.

Helmsley Road Short Breaks Service accommodates 12 people across three separate units, each of which have separate adapted facilities. People do not live at this home, they attend this service for short, pre-arranged breaks, some as short as one night with other stays lasting up to two weeks. During our inspection on the 18 January two people were staying at the home, during our inspection on 26 January, eight people were staying at the home.

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.

At the last inspection on 17 November 2015 the service was rated Good overall, however it was rated Requires Improvement for the question, ‘Is the service Effective?’ After this inspection the service maintained its overall rating of Good and the rating for the question ‘Is the service Effective?’ improved to Good.

People continued to receive safe care and the risks to people’s safety were continually assessed and reviewed. Staff were recruited safely and there were enough staff in place to support people. People's medicines continued to be managed safely and effectively. Relationships with other health and social care agencies to offer further support for people. Accidents and incidents were monitored, reviewed and where needed measures put in place to reduce the risk of reoccurrence.

People’s physical, mental health and social needs were assessed and provided in line with current legislation and best practice guidelines. Staff received a detailed induction and training programme. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice. People were supported to lead a healthy lifestyle. People’s day to day health needs were met by the staff and other healthcare agencies where needed.

Staff and the registered managers treated people with respect, dignity and compassion which led to people forming positive and meaningful relationships with them. People were encouraged to do as much for themselves as possible. People were provided with information about advocacy services and were supported to make decisions about their health and care needs where able. There were no restrictions on people’s friends or relatives visiting them during their stay.

People’s needs were assessed each time they came to stay at the home. People’s personal preferences and likes and dislikes were recorded within their care records. They were used by staff to communicate effectively with them and to provide them with a stay at the home that was personal to them. Processes were in place that ensured people’s cultural and religious choices were respected and people were provided with information in a way that reduced the risk of discrimination. People felt able to make a complaint if they needed to and that it would be acted on.

The service was well-led by two registered managers who were well liked by relatives, staff and the people they supported. There was a positive atmosphere at the home. People and staff were encouraged to contribute to the development of the service. Effective auditing processes were in place to monitor the quality of the service. The registered managers carried out their role in line

We carried out an unannounced inspection of the service on 17 November 2015. Helmsley Road Short Break Services is registered to accommodate up to twelve people and specialises in providing short breaks, care and support for people who live with a learning disability. The service is split into three bungalows with a fourth used as the base for administration. At the time of the inspection there were four people using the service.

On the day of our inspection there were two newly appointed registered managers in place. 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 risk to people’s safety was reduced because staff had attended safeguarding adults training, could identify the different types of abuse, and knew the procedure for reporting concerns. People were given the freedom to live their lives as they choose to and no unnecessary restrictions were placed on them. Where appropriate people’s relatives and other healthcare professionals were involved in discussions about the care and support provided.

Accidents and incidents were investigated and used to reduce the risk to people’s safety. Regular assessments of the environment people lived in and the equipment used to support them were carried out and people had personal emergency evacuation plans (PEEPs) in place.

People were supported by an appropriate number of staff. Appropriate checks of staff suitability to work at the service had been conducted prior to them commencing their role. People were supported by staff who understood the risks associated with medicines. People’s medicines were stored, handled and administered safely.

People were supported by staff who completed an induction prior to commencing their role and had the skills needed to support them effectively. Regular reviews of the quality of staff members’ work were conducted and staff felt supported in carrying out their role effectively. Staff were well trained although there were a small number of areas where some staff required refresher training.

The registered managers had not always ensured they had recorded how the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. The appropriate processes had been followed when applications for Deprivation of Liberty Safeguards had been made.

People spoke highly of the food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.

Staff supported people in a kind and caring way. Staff understood people’s needs and listened to and acted upon their views. Staff responded quickly to people who had become distressed.

People told us they were provided with the information they needed that enabled them to contribute to decisions about their support however this was not always recorded within their care records. People were provided with information about how they could access independent advocates to support them with decisions about their care, although where this information was positioned, could make it difficult for some people to access. Staff understood how to maintain people’s dignity. People’s friends and relatives were able to visit whenever they wanted to.

People were involved with planning the support they wanted to receive from staff. People’s care records were reviewed although there were some parts of the records that required more regular review. People’s support plan records were written in a person centred way and staff knew people’s likes and dislikes and what interested them. People were encouraged to do the things that were important to them and they w

As part of the inspection we spoke with four people who used the service and a relative who was visiting the service for their views. We also spoke with the registered manager, a team leader, the cook, domestic assistant and three care workers. We looked at service information, care plan files for three people and did a tour of the buildings.

Systems were in place to ensure that consent was sought from people who used the service. Where people did not have capacity to consent to care and support, the provider had followed the correct procedures to ensure people’s human rights were protected.

We saw that people were provided with varied, appetising and nutritionally balanced meals and any specialist diets that were required due to pre-existing medical conditions or cultural needs could be supplied. A person told us, “The food is fantastic, I had a cooked breakfast today, and there are always choices.”

We saw the cleanliness of the home was well managed and there was an effective system in place for the prevention and control of infections.

People who used the service and relatives told us they felt there were sufficient numbers of staff available to meet people’s needs and keep them safe. Comments included, “I like it here, and the staff are a good bunch. I feel safe and well looked after.”

We saw the provider had internal quality assurance audits in place to monitor the service and that people were asked for their views and wishes.

Helmsley Road is a short breaks service. There were nine people using the service when we visited. They had made a choice of when to come for a holiday. The length of stay could be anything from two days to two weeks, or in an emergency.We spoke with three people who used the service and they told us that they were able to express their views and were involved in making decisions about their support at Helmsley Road. One person told us, “I like it here, I like horses, the disco and I have my own room.”

People staying at Helmsley Road told us they were happy there and that they felt involved in their care. Everyone told us the staff cared for them well and they supported them in a way they preferred. However we found that people may be at risk of poor care because some risks to their health and safety were not assessed and planned for.

Everyone we spoke with said they felt safe living at the home and they could tell staff if they were unhappy in anyway. One person said, “I feel safe here and I trust the staff.”

People who used the service were asked for their views about their care and treatment and they were acted on. Records we saw showed that each person using the service received an opportunity to discuss how their holiday had gone and if they were satisfied with the service they received. We found that there were systems in place to monitor the quality of the service but not enough was done to make sure that improvements took place in a timely way.