Scarborough House offers short break accommodation for young adults with learning and physical disabilities who require assistance with personal care.

The building has been extended and adapted to provide accommodation which is suitable for the people who use it. At the time of our inspection there were four people using the service.

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.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff with the correct skill mix on duty to support people with their required needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people. 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.

Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions.

People were able to make choices about the food and drink they had, and staff gave support if and when required to enable people to eat a balanced diet.

People were supported to access a variety of health professionals when required, to make sure that they received additional healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times. Support plans were written in a person-centred way and were responsive to people’s needs. People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place which was accessible to all.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Further information is in the detailed findings below

Scarborough house provides respite and short break accommodation for people with learning disabilities and complex needs. The service has seven beds and at the time of our inspection there were five people using the service. Our inspection took place on 9 June 2016.

The service had an acting manager. There was not a registered manager in post. The previous registered manager had left their position in December 2015. 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.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.

There were sufficient numbers of staff on duty to meet people’s needs and safe recruitment processes had been followed to ensure that staff were suitable to work with people. Safe systems were in place for the administration, storage and recording of medicines. Staff received on-going training which helped them to deliver safe and effective care to people. They received formal supervisions which helped them to monitor their progress and development.

Staff were well supported by the management team and had regular one to one supervisions.

People’s consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.

People were able to choose the food and drink they wanted and staff supported people with this.

People were supported to access health appointments when necessary.

Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

People’s privacy and dignity was maintained at all times.

People were encouraged to take part in a range of activities and social interests of their choice.

Some of the people who used the service had complex needs which meant that they were not able to tell us about their experiences. We were able to talk with two people about their service. In addition to this we used other methods to help us understand people’s experiences. For example we directly observed people working with staff and listened to their interactions. These indicated that people were relaxed and comfortable and enjoyed their experience in the respite service. One person said, “I love coming here.”

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plans. Care plans were very detailed and provided staff with information about how to communicate with people who did not communicate verbally. They also provided information about people’s health needs and their personal preferences.

Staff had a good understanding of their responsibilities with regard to keeping people safe from abuse. People’s possessions were safeguarded during their stay at the service. There were also arrangements to assist people with managing their monies.

Staff were well trained and supported to care for people. They were well supervised and encouraged in their personal development.

There were measures in place to ensure that the views of people who used the service and the staff were heard. The quality of the service was monitored and any perceived failures were addressed promptly.

During our inspection of Scarborough House on 17 May 2013, we looked at care records and spoke with staff and a healthcare professional. On 20 May we spoke on the telephone with relatives of people who used the service about their experience.

We found evidence that staff made every effort to identify and act on the wishes of people who used the service. A relative we spoke with told us, “They listen and never make them do anything. They are allowed to make their own decisions wherever possible.”

However, suitable arrangements in line with published guidance relating to the Mental Capacity Act (MCA) 2005 were not in place where necessary to properly assess people’s ability to make decisions when they started using the service.

Care plans we looked at showed that people’s needs and preferences were thoroughly assessed, documented and reviewed. A relative told us, “The care is absolutely fantastic and [name] always goes off and comes back smiling. We are very happy with the care provided.”

We saw evidence that people were provided with a good choice of food and drink in a way that both encouraged and promoted a healthy balanced diet.

The premises were safe, suitable and fit for purpose. Adequate emergency procedures were in place and the safety equipment we saw had been regularly checked and well maintained.

We saw that a complaints policy and procedure had been put in place and that people’s comments, feedback and suggestions were regularly sought.