This inspection took place on 8 and 13 November 2018, and 7 and 12 December 2018. The inspection was unannounced on the first day and the we advised the provider of our intention to return on the subsequent dates. The registered manager was not available on the first two visits as she was leading a group of people who used the service and their relatives on a visit to South Africa to undertake voluntary work. Therefore, we returned to the service on 7 December to meet with the registered manager and gather additional evidence in relation to the management of the service. As full recruitment records are administered by the provider’s human resources department and are not ordinarily held at the premises, we visited on 12 December to check this information and provide inspection feedback. Inspection activity was completed on 31 December 2018 when we completed our telephone contact with people who used the service and/or their relatives.

Rivercourt Short Breaks Service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during the inspection. The service provides personal care for people with a learning disability and/or autistic spectrum disorder. 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. The service is registered to accommodate up to five people and approximately 40 people used the service for flexible periods each year.

The registered manager also managed Options, a nearby day services centre for people with a learning disability. This report also refers to Linking Hands, which is a social enterprise that the registered manager supported the relatives of people who used the respite service to set up. Some of the people who used Rivercourt Short Breaks Service also used Options. The ‘Linking Hands Choir’ consists of people who used the respite and/or day services centre and their relatives. Options and the Linking Hands social enterprise and choir are not within our scope of regulation.

At our previous inspection we rated the service Outstanding. We had rated safe, effective and responsive as Good, and caring and well-led as Outstanding. At this inspection we found the evidence continued to support the rating of Outstanding in caring and well-led and we have also rated responsive as Outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

The service continued to deliver outstanding care and support to provide people with an enjoyable and safe respite experience, and offered opportunities to learn new skills, develop and maintain friendships and participate in fulfilling social activities within the service and in the community. The provider ensured that people’s respite stays positively impacted on their daily wellbeing.

People were protected from harm or abuse by staff who understood how to protect people. Staff had attended safeguarding training and local health and social care professionals commented very favourably about the service’s ability to safely support people and provide stability during difficult periods in their lives. Risk assessments were thorough and provided relevant guidance for staff about how to mitigate identified risks. These assessments demonstrated a balanced approach to enabling people to live as independently as possible and take carefully considered risks. Medicines were safely managed. Sufficient staff were deployed to meet people’s needs and wishes, and staff were recruited via robust procedures. People who used the service and r

This inspection took place on 31 December 2015 and 5 January 2016. The first day of the inspection was unannounced and we told the registered manager we were returning on the second day. At our previous inspection in May 2014 we found the provider was meeting regulations in relation to the outcomes we inspected.

Rivercourt Project Short Breaks Service is a five bedded respite care home for adults with a learning disability who ordinarily live with their families, and respite is also offered to people who live with a partner or friend, or live alone. At the time of this inspection 30 people used the service for varying length of stays and five people were using the service on the two days we visited. The service can be accessed for day care only, if required. More than half of the people who use the service are living with autism, and two of the bedrooms are equipped with ceiling hoists to support people with mobility needs.

There was a registered manager in post, who has managed the service for over fourteen years. 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 delivered outstanding care and support in order to provide people with an enjoyable and safe respite experience, and offered opportunities to learn new skills, develop and maintain friendships and participate in fulfilling social activities within the service and in the community. Although people ordinarily attended the service for a maximum of 12 short visits each year, the provider ensured that these respite stays positively impacted on people's daily wellbeing. For example, people were supported by staff to express their views about difficult events in their lives through the use of therapeutic life story work. A person who used the service told us that staff provided the emotional support and encouragement they needed to cope with their health care concerns, which made it easier to manage at home. The provider supported people to access other health and social care services, and created additional local leisure facilities through setting up a social enterprise and disco evenings. The provider supported the relatives of people who used the service through quarterly relatives meetings, which were used for peer support and a chance to socialise with other family carers, in addition to discussions about the service.

There were policies and procedures in place to protect people from harm or abuse and staff were able to explain the actions they would take to protect people. Records confirmed that staff had attended relevant safeguarding training and external health and social care professionals had praised the registered manager and the staff team for their thoughtful work with people at risk of abuse.

Up-to-date risk assessments were found in the care plans we checked. The risk assessments were individualised and addressed a range of issues, including guidance about how to support people to maintain their safety when out in the community for activities, and how to support people with behaviour that may challenge the service. The registered manager and the staff team supported people to live as independently as possible, and the risk assessments demonstrated a balanced approach to considering the possible benefits and risks associated with various choices and activities.

The registered manager and the staff team were passionate about providing an outstanding standard of care and support that was compassionate, creative and personalised. There was sufficient staff available to provide people with individual support as required, and to take people out to places of their choice including restaurants, pubs, leisure centres, the cinema and parks. People were also supported

People who were at Rivercourt Project Short Breaks on the of this inspection described it as "very nice" and "I like it here". Appropriate care plan records were in place with all of the relevant and up to date relevant information for all people that used the service. Staff had been trained in what to do in a medical emergency and would contact the emergency services.

The dietary requirements for all people staying at the home were recorded as part of the assessment and care plan records. People were asked what they chose to eat.

Medication bought with an individual staying at the service was checked and recorded on medication records. Medication was kept securely in a lockable medicine cupboard in the staff room.

When staff started at the service they received an induction. Staff undertook mandatory training on an annual basis, including safeguarding and what to do in a medical emergency. All staff attend team meetings and received annual appraisals where their performance would be discussed and targets set for the coming year.

The service conducted audits to monitor the quality of the service it was providing. Regular feedback questionnaires were completed. Records showed that there had been no incidents at the service in the last two years. We looked at the complaints log and there had been no complaints made in the last twelve months.

All records looked at were relevant and up to date and stored securely.

The people went spent time with have been visiting Rivercourt Road Project for a number of years and told us that they were happy with the service provided. We saw that staff knew the people well and spent time with each person communicating at a pace that each individual could understand. The people visiting the service were asked what they wanted to do by staff. For instance one person wanted to go out into the community and go to the libary. Staff arranged it so that everyone went out daily with the relevant support. We observed staff treating people with dignity and respect.

This section was not completed for this inspection. More information about what we found during the inspection is available in the report below.

During this inspection we spoke with three people using the service and the relatives of ten people. We also spoke with the manager, members of the staff team and attended a meeting for the relatives and friends of people using the service. People told us they liked visiting the service for short breaks. One person said, "I like it when we go out to the park and then we have a pizza. I make cards with staff and I am good at making things." Another person told us, "I always have fun. I am best at cooking and playing games." The relatives of people using the service told us it was a "special place" and staff were "magnificent, so kind and caring."

A single inspector carried out this inspection. The focus of the inspection was to answer our five questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

There were enough staff on duty to meet the needs of people using the service and a member of the management team was always available. Systems were in place to make sure that staff could learn from events such as accidents and incidents, complaints and concerns.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The relevant staff were aware of the policies and procedures relating to the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards and understood when an application should be made.

Is the service effective?

People using the service told us they were happy with the care and support they received. One person told us, "I like coming here, it's always good. I go bowling and I help [staff member] with washing up." Relatives told us they were pleased with the how the service planned and delivered care. One relative said, "They have introduced [my relative] to new interests and experiences and given them confidence. The staff understand that each person is a unique individual."

Is the service caring?

We observed people being spoken with in a kind and encouraging way by staff. For example, people were encouraged and supported to participate in the inspection by speaking with us about their experiences of using the service or by showing us around the garden. There were policies and procedures in place to inform people of their rights and these were available in large print and/or pictorial formats, to meet the needs of people who use the service.

Is the service responsive?

People's needs were assessed before they used the service, which included information from people, their families, and other professionals and services involved. People were provided with written and pictorial information about the service, which included a service users guide, newsletters and guidance about how to make a complaint. We saw that complaints were responded to within the agreed timescales. Staff had received training in order to understand the use of Best Interests decisions.

Is the service well led?

A range of quality assurance processes were in place to make sure that people's feedback was used to improve the quality of the service. For example, people using the service and their relatives were sent annual surveys and the manager held quarterly meetings for relatives. People using the service had contributed their views to the quarterly newsletter. The manager monitored the needs of people using the service to ensure that the correct staffing levels were in place. Complaints were analysed and the subsequent learning was used for making improvements. People using the service said they liked the manager and the relatives spoke highly of the manager's leadership and managerial skills.