This inspection took place on 23 February 2017. This was an unannounced inspection.

At the time of our last inspection in February 2015, the provider was rated as ‘good’ over-all with a rating of ‘requires improvement’ in one of the areas we looked at; whether the service was safe. This was because risk assessments were not always sufficiently detailed to ensure staff had all of the information they needed to keep people safe. At this inspection, we found that improvements had been made.

Silver Birch Road provides respite accommodation and personal care for people who require specialist support relating to their learning and physical disabilities. ‘Respite’ is the term used for when people receive care and support at a location for a short period of time. The provider is registered to provide accommodation and personal care for up to four people at any one time. At the time of our inspection, there were two people staying at the service.

There was a registered manager in post. 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 were supported by enough members of staff who had been safely recruited and received adequate training to ensure they had the knowledge and skills they required to do their job effectively.

People received care and support with their consent and people’s rights were protected because processes had been fully followed to ensure people were not unlawfully restricted. They were also supported by staff who protected their privacy and dignity.

People’s nutritional needs were assessed and monitored to identify any risks associated with nutrition and hydration.

People were supported to maintain good health because staff worked closely with other health and social care professionals when necessary. People received support to take their prescribed medicines as required.

People were supported by staff that were kind and caring and that were dedicated and committed to getting to know people well. This meant that people received the care they wanted based on their personal preferences, likes and dislikes.

People were encouraged to be as independent as possible and were supported to express their views in all aspects of their lives. Staff were respectful of people’s diverse needs and the importance of promoting equality.

The provider was very responsive because people felt involved in the planning and review of their care because staff communicated with them in ways they could understand.

People were encouraged to engage in activities that they enjoyed and were supported to maintain positive relationships with their friends and relatives.

The service was not always well led because systems and processes in place to monitor the quality of the service were not always effective and staff felt that the organisation and the communication within the service could be improved. People were encouraged to offer feedback on the quality of the service and knew how to complain.

The inspection took place on 6 February 2015 and was unannounced. At the last inspection carried out on 21 August 2013 we found that the provider was meeting all of the requirements of the regulations inspected.

The home is registered to provide accommodation and personal care to up to four people at any time. The home provides short residential respite stays to people with physical disabilities and / or learning disabilities and / or autism. We were told that the home provided respite care to 22 people that received varying lengths of short stays at the home. On the day of our visit one person had gone home following their short stay and three people were due to arrive for their respite stay.

The location is required to have a registered manager in post. 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 and associated Regulations about how the service is run. At the time of this inspection a registered manager was in post.

All of the relatives that we spoke with all told us that they felt their family member was safe at the home during their respite stay.

We found people’s risk assessments were not detailed and had either not been completed as required or had not been updated to reflect changes.

Appropriate numbers of sufficient and suitable staff were planned for different people’s respite stays which were reflective of their needs.

A medication policy was in place and staff were trained to support people with their prescribed medicines.

Staff had the skills and knowledge to care and support people that had respite stays at the home.

The Mental Capacity Act 2005 (MCA) states what must be done to ensure the rights of people who may lack mental capacity to make decisions are protected. We found that the provider was meeting the requirements set out in the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards.

Relatives told us that staff were caring and kind toward their family member.

Relatives told us that staff responded to their family member’s needs.

Systems were in place to monitor and improve the quality of service people received.

At this inspection we reviewed records and spoke to both people who were at the service at the time. We also spoke to all five staff. We found that people were involved in the planning of the care they received. People told us that they were asked their opinions and were actively involved in planning their days.

Care and treatment was well planned and delivered. People and families were involved in the care and it met people’s needs. Activities were maintained as they would be at people’s homes whilst staying at this respite service.

Food and drink met people’s nutritional needs and there was variety and choice so people could have what they wanted. Fresh fruit and vegetables were available daily. Where people wanted to maintain a restricted diet, encouragement was given to explore other food choices.

People were protected from abuse; by having a staff team that was well trained and able to recognise signs of abuse and report it. One person told us: “I feel safe here.”

The premises were adapted to ensure that people who were using the services could access all the areas such as the garden and bedrooms. It was in a good state of repair, and staff were supported by outside contractors to maintain it.

This service offers respite care to people, it is registered to accommodate four people at a time. There are currently 21 people using the service at different times. People stay for varying length of times. At the time of our inspection two people were using the service.

The two people using the service were not present when we visited. We were told they could become distressed if they saw us. Therefore, we ensured that we spoke with people who would be able to share with us their views about the the service provided. We spoke with six relatives / carers of people who used the service and three staff. We looked at two sets of care documents.

We found that people consented prior to support being given. People's needs were met, one relative told us, “Brilliant, it is a perfect place”. The service endeavoured to ensure the environment and activities were similar to what people were used to.

The provider understood its roles as part of the multidisciplinary team and shared appropriately information about people. They sought and acted on best advice from external healthcare professionals.

The equipment used was serviced regularly and was appropriate for the needs of people. Staff were given training in its use, if it was new to them.

The provider conducted auditing and monitoring of the service. They used the information to improve the experience for people. One relative when asked about the service said, “it’s like home, and very calm”.

We visited the service on 27 February 2012. There were three people staying at the service that night for a few days. This included a person who had not used the service before. Everyone was out at their usual day time occupation. We did not meet anyone who used the service on this occasion.

We followed the care of one person who was using the service that week. We looked at their care records, their accommodation and talked to workers on duty. This person had complex and changing needs. They had a care file with a recently updated assessment. There was a detailed care plan that was individual to them and written in a 'person centred' way. There were assessments and agreed management plans for the risks presented by the person's condition. The care plan was was not just a list of tasks for workers to do to look after them. Workers made daily and nightly records of their welfare while they stayed at the service.

We saw that the home was clean, tidy and had enough space for people to gather together or be away from each other as they wished. Bedrooms had sufficient furniture for a short stay and contained the specialist equipment that people needed.

We saw that there were sufficient workers on duty to meet the needs of the people that were staying at the service that day.

Workers on duty understood people's needs and knew their care plans. They spoke about people who used the service with warmth and respect. They knew what were their responsibilities under the provider organisation's policy and procedures for protecting people from the risk of abuse. Workers were given the training that they needed to support people's particular needs and to obtain professional qualification in health and social care.

The service had an updated statement of purpose that the provider sent to us.