About the service: Queensbridge Respite is a short break service. It offers a respite service for adults who have a learning disability or a physical disability. The service can provide care and support to up to six people at a time.

People’s experience of using this service:

People’s medicines had not always been well managed. At times people had not received their medicines as prescribed.

Risks had not always been minimised. Risks had been assessed when people started using the service and steps taken to reduce those risks. But these steps had not always been followed. When things had changed risks had not always been reassessed.

Checks to monitor the service were not robust enough to highlight the shortfalls in care delivery that we found. Accident and incidents were not always reflected on to drive improvements.

People and relatives were happy with the service they received. Relatives told us staff were friendly, people’s needs were well met and that people enjoyed their time at the service. Relatives told us they felt they could relax when people were at Queensbridge Respite as they knew they were being well cared for.

There were enough staff. Safe recruitment processes had been followed. Staff were trained and their skills and knowledge checked through competency assessments.

People’s choices were respected, and proper legal processes had been followed when people were unable to make their own decisions.

People and their relatives were very involved in the service. Care was planned around people’s choices and preferred routines. People took part in lots of activities.

Staff were proud of the service. There had been recent changes in the management structure which relatives and staff were positive about. The provider responded quickly to both the safeguarding incidents which prompted our inspection and our feedback. They put together action plans for improvement and showed us evidence of the changes they had put in place.

We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and governance. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection: Good (last report published in November 2017)

Why we inspected: The inspection was prompted in part by incidents which had occurred in the service that the provider shared with CQC and the local authority. The information indicated potential concerns about the management of risk, staffing levels and moving and handling support. This inspection examined those risks.

Follow up: We have asked the provider to send us an action plan about the steps they plan to take to make sure they are meeting all legal regulations.

The service provides short stay respite services for up to six adults who have a learning disability or a physical disability. The number of people staying at the service at any one time varied from week to week. This was the first inspection for this service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Relatives told us they were generally happy with the care provided at the service. They said there had recently been some minor issues with their family members care but these were being addressed. Relatives told said staff members were kind and caring.

Relatives told us there had recently been an unsettled period due to changes in staffing but the situation was improving. Staff confirmed there were enough staff on duty to meet people’s needs.

Staff showed a good understanding of safeguarding and knew how to report concerns. They were also aware of the provider’s whistle blowing procedure. There had been no safeguarding concerns raised at the service.

The provider had effective recruitment procedures to ensure new staff were suitable to work at the service.

Medicines were managed safely. Staff had completed relevant training and their competency to administer medicines had been verified. Accurate records were kept to account for the medicines people had been given.

Staff completed regular health and safety checks and there were procedures in place to deal with emergency situations. These were up to date when we inspected.

Staff confirmed they received good support and completed relevant training.

People were supported with nutrition in line with their individual needs. Where people required specific support or equipment to help with eating and drinking, we saw this was provided.

People’s needs had been assessed and the information used to develop detailed and personalised care plans. These were reviewed regularly to help ensure they reflected people’s needs.

People were able to take part in activities they enjoyed. However, some relatives felt there should be more opportunities for their family member to access the local community.

Previous complaints about the service had been investigated. Relatives confirmed they knew how to raise concerns if they had any issues with the service. Some relatives had complimented the service.

Opportunities for relatives to meet and share their views about the service were limited.

The service had a new manager who was intending to register with CQC. Relatives told us they had met the new manager and found them approachable.

A range of quality assurance checks were completed to help ensure people received good support.