We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 December 2016 and was unannounced. Our inspection team consisted of one inspector.

We checked the information we held about the service and provider. This included the notifications that the provider had sent to us about incidents at the service and information we had received from the public. We used this information to formulate our inspection plan.

On this occasion we did not ask the provider to send us a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However we offered the provider the opportunity to share information they felt relevant with us.

Some people who used the service had complex needs and were unable to communicate verbally with us. We spent time observing how staff provided cared for people to help us better understand their experiences of the care and support they received. We spoke with two relatives and three members of care staff. We did this to gain people’s views about the care and to check that standards of care were being met.

We observed how the staff interacted with people who used the service.

We looked at three people’s care records to see if their records were accurate and up to date. We also looked at records relating to the management of the service including quality checks. We reviewed information from commissioners of the service and quality reports.

This inspection took place on 14 November 2015 and was unannounced. The inspection was carried out by one inspector.

Silver Birch is registered to provide accommodation for up to five people with a learning and physical disability for respite care. At the time of our inspection, four people were using the service. This was the first inspection of this service.

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 2008 and associated Regulations about how the service is run.

People chose how to spend their time and staff sought people’s consent before they provided care and support. Some people did not have capacity to make certain decisions. It was not clear how some decisions had been made and whether people should make the decision for themselves. We saw some people may have restrictions placed upon them as they were not able to go out alone and may not have the capacity to make a decision about their safety. Applications to ensure these restrictions were lawful had not been made. You can see what action we told the provider to take at the back of the full version of the report

People told us they felt safe at the home and when out. People were supported by staff who knew how to reduce avoidable risk to prevent harm and understood how to recognise and report any abuse.

Staffing levels were sufficient and flexible to support people when they received respite care and to provide them with opportunities to pursue their interests. People had opportunities to develop their living skills in the home as well as engage in activities of their choosing. People could help to prepare their meals and received support where necessary and could choose to eat out.

People were supported with their medicines safely and systems were in place to make sure that at the beginning of each stay, correct information about people’s support and the medicines they needed was available.

Staff knew people well and were trained and competent to meet people’s needs. Staff were supported and supervised in their roles by the manager and senior staff. When new staff started working in the service, they were able to get to know people and supported by the staff team.

People had developed good relationships with staff. The staff were kind and caring in their approach and people’s privacy and dignity were respected. People were supported to be as independent as possible during their respite stay.

People were involved in the planning and review of their care and support and family members continued to play an important role. Where people had any concerns they were able to make a complaint and this was responded to.

Systems were in place to assess and monitor the quality of the service. People and staff were encouraged to raise any views about the service to review how improvements could be made. The manager promoted an open culture which put people at the heart of the service.