The Short Break Respite Unit provides accommodation and care on a planned or urgent basis for people with a learning disabilities or autistic spectrum disorder. The service provides overnight stays and longer periods usually for up to four people for people at a time. At the time of this announced inspection there were four people using the service.

At our last inspection of 8 April 2016, 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.

The service had a registered manager. 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 21008 and associated Regulations about how the service is run. People, relative and staff described the registered manager as supportive and approachable.

Staff continued to promote people’s safety. The staff had received training and were aware of procedures to safeguard people from abuse and manage risks to their health. Each person had a detailed support plan and staff were aware of people’s individual needs. People’s care plans were updated at each respite stay.

There were robust recruitment procedures in place. There were sufficient numbers of staff on duty to support with their needs throughout the day and night. People received their medicines as prescribed and information about their medicines had been recorded and medicine audits were carried out. There were infection control procedures in place to guide the staff in how to minimise the risks of cross infection. The registered manager met with other members of staff regularly to determine if any lessons could be learnt from events.

Staff continued to receive training and supervision to enable to them to provide the support to people with regard to their assessed needs. People gave consent to the support they received. People were given support to manage their nutrition and access healthcare services should the need arise when staying at the 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.

The staff continued to be caring and treated people with dignity and respect.

People continued to receive support which met their individual needs and preferences. People using the service and their relatives knew how to raise a complaint and were confident any concerns raised would be addressed and resolved. The service had worked with other professionals to support people at the end of their lives.

An open and positive culture was maintained by the service. The registered manager led and supported the staff team to focus upon person-centred support. Quality checks and audits remained in place so that issues were identified and resolutions for improvements put in place. The service operated an on-call system to support the staff providing support and also to cover any care visits that the usual member of staff was unable to attend.

The inspection took place on 08 April 2016 and was announced. We gave the service a few hours’ notice as we wanted to make sure that people would be there when we visited the service.

The Short Break Service supports adults with a Learning disability and provides a short break or respite care service for up to four people at any one time. In total there were 34 people being supported by this service and the length of stay varied depending on peoples individual requirements. On the day of our inspection there were three people using the service and following our visit we spoke with a number of relatives about the care provided.

There was a registered manager in post at the time of the 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.

The feedback we received from relatives about the service was very positive and they told us that their relatives looked forward to their stays and staff were very caring. There were systems in place to protect people from potential harm. Staff were clear about the reporting mechanisms and were confident that concerns would be taken seriously. Risks were identified and there were plans in place which provided clear guidance to staff about how they should be managed and risks minimised.

There were clear procedures in place to ensure that staff who were recruited had been subject to checks and were suitable for the role. Staffing was organised to meet people’s needs and ensure continuity of care. New staff received a comprehensive induction which gave them the knowledge they needed to perform their role. Existing staff received regular updates and were supported to keep up to date with practice and changes. Staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DOLS) and the implications for the people using the service. Further training on this area was planned. Individuals were supported to have food and drink of their choice and there were clear systems in place to identify and support people with allergies. Relatives told us that staff were alert to changes in their relatives health needs and sought medical advice appropriately during their stay.

Staff were caring and knew the individuals they supported and how they communicated. Care plans were informative and detailed. Incidents were recorded and reviewed to identify learning and how best to support individuals. Relatives told us that they were kept up to date with changes and what activities individuals had participated in during their stay. Concerns were dealt with in an open way and relatives told us that staff and management were approachable.

There had been some recent staff changes and some relatives expressed concerns about potential changes as the service had worked so well in the past. However, staff morale was good and staff were optimistic about the future and the service they delivered. There were clear arrangements in place to oversee and monitor the quality of the service which included audits and surveys where the views of peoples who used the service and their relatives were obtained.

One person told us while we inspected, they were happy when they used the service because they liked the staff. We communicated with two other people who used the service, although they were not able to speak with us, they were able to make us understand they were happy with the service. We also spoke with two relatives, the manager and two members of staff. We looked at five people's care records and service policies.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were greeted by a member of staff. We were asked for our identification and were asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

We reviewed staffing records regarding the Mental Capacity Act (MCA) 2005 in relation to Deprivation of Liberty Safeguards (DoLS) and saw this training was up to date. The CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager demonstrated a knowledge and understanding of the MCA and DoLS and arrangements were in place for staff training. The manager informed us that no DoLS were in operation at the time of our inspection. While no applications have needed to be submitted, correct policies and procedures were in place.

The service held weekly fire safety checks and had systems in place for routine maintenance and unexpected premise emergencies.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were reviewed for each respite occasion and updated as required. This meant that staff provided information that was up to date about how people's needs were met.

Is the service caring?

We saw that the staff interacted with people who used the service in a caring, respectful and professional manner. We saw staff offering people choices regarding meals and drinks. We also observed staff taking time to allow people to clearly communicate with them. The service carried out an inventory of people’s belongings to ensure that when they left the service their belongings were accounted for.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. We saw people enjoying the garden area, reading books, watching television and planning future events. People's choices were taken into account and listened to.

A relative told us that they knew how to make a complaint if they were unhappy. They had no complaints to make and complimented the service on how well it responded to their relatives changing needs.

We saw that allergies had been recorded and the medication policy instructed people what to do in an emergency.

Is the service well-led?

The service worked with people to provide as best as possible respite throughout the year at convenient times. Staff training was organised and the system for the safe keeping of people’s money was documented and provided access to their money as required. The service had a quality assurance system in place and robust recruitment arrangements.

We spoke with relative as part of our inspection. One person who used the service communicated to us they were happy when they used the service, viewed their stay as a short holiday and enjoyed trips out into the community.

We inspected five outcomes during our inspection and found there was a safeguarding process in place and also a robust complaints policy and procedure. The service had undergone a major refurbishment working with volunteers of the local community, families and involved people who used the service to select fixtures and fittings. One relative said, “We all look forward to this respite and I cannot speak highly enough of the staff.” People stayed at the service for long and short weekend periods and weekday stays and the care plans were updated at each visit. The service provides for up to four people at any one time and had thirty-eight people registered with the service.

The manager explained how the staff worked with people during their stay to purchase, prepare and cook meals. The service had a saying that was ‘If it is not good enough, it will not do.’ During our inspection we saw people used a Karaoke machine and looked through a book with staff. The service had a process in place to support staff with supervision and yearly appraisals.