We inspected the service on 25 January 2017 and the visit was unannounced.

Smith Crescent Care Home is a short break service and provides care and support for up to six people with learning disabilities or autism at any one time. The service currently supports 30 people when they require the service. At the time of our inspection one person was using the service.

There was a registered manager in place. It is a requirement that the service has 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 and their relatives told us that the service was safe. Staff understood their responsibilities to protect people from avoidable harm and abuse. The provider had a system to manage accidents and incidents and staff were trained to respond to these. Risks to people’s health and well-being were assessed. For example, where people could show behaviours that could cause injury to themselves and others, staff knew about the guidance to follow to support people to remain safe.

The provider had a safe recruitment process in place for prospective staff including undertaking relevant checks. People and staff were satisfied with the number of staff recruited by the provider to offer them care and support. Some staff told us that more staff would help them to offer activities to people when the service was full. The provider said they would consider this feedback. We found that staffing numbers were suitable to support the person currently using the service.

People received their prescribed medicines safely. Staff received training and guidance and understood their responsibilities to handle people’s medicines safely. Medicines were stored appropriately and guidance was available to staff about how people preferred to take them.

People were supported by staff members who had the required skills and knowledge. New staff received an induction when they started to work for the provider. Staff received guidance and training about their role in topic areas such as epilepsy and health and safety.

People were supported in line with the Mental Capacity Act 2005 and were supported to make their own decisions. Where there were concerns about a person’s mental capacity to make decisions, the provider undertook assessments. Any decision made in a person’s best interest included involving significant others such as their family members. Staff understood their responsibilities under the Act. The registered manager had made applications to the appropriate body where they had sought to deprive a person of their liberties.

People and their relatives were satisfied with the food available. Staff knew people’s food preferences and support requirements. Staff followed specialist advice when they supported a person to eat.

Staff had guidance on people’s health conditions so they knew how to promote their well-being. Information about people’s health was available to share with health care professionals, should care and treatment be undertaken in other services that people accessed.

Staff supported people in a kind and compassionate way. Staff protected people’s dignity and privacy. For example, they stored people’s sensitive and private care records securely. People’s relatives could visit when they chose to.

Staff knew the people they supported including their preferences. Some staff told us that improvements could be made to people’s care records to include more information on people’s life histories. The provider told us they would consider this when reviewing people’s care records.

People were supported to be as independent as they wanted to be in order to retain their skills. People were, where they could be, involved in decisions about their

We inspected the service on 10 and 14 December 2015; the first visit was unannounced.

Smith Crescent Care Home offers short stay accommodation for six younger adults (under 65 years of age) who have a learning disability. The service offers people a break from their usual place of residence as well as providing support for full-time carers. There are six single bedrooms without en suite facilities. Accommodation is provided over two floors, access is via stairs or passenger lift. The home has a rear garden which is well maintained that is accessible to people living in the home. At the time of our inspection four people were using the service.

It is a requirement that the home has 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. At the time of our inspection there was a new manager in place who was applying to be registered with CQC.

People told us they felt safe. There were systems in place to protect people from abuse and staff knew their responsibilities in relation to safeguarding adults. There were regular checks on the equipment being used and the provider had a plan of what to do if there was an emergency.

There were environmental risks to people who used the service that had not been fully risk assessed or considered. For example, the storage of chemicals was not safe.

People and their relatives felt that the staffing levels were adequate. On the day of our visit we found this to be the case. The staff records we viewed showed us that the manager had made the relevant checks before new staff started employment with the service.

Medicines were safely managed. We saw that there were safe systems in place to make sure that medicines were stored properly. Staff were checked regularly to make sure they were handling medicines safely.

Staff had received an induction and told us they felt supported by the manager. We found that staff were not having regular individual meetings with their manager. This meant that the manager may not have been fully aware of the development needs of staff in order to support people well.

Staff had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff told us how they offered choices to people and how they could not restrict people without the correct authority. We found that records did not show how or if people had consented to their care.

People told us that they were satisfied with the food and drink offered. We were told there was choice available and staff were aware of people’s likes and dislikes. This was important as some people could not express this for themselves.

People had access to see healthcare professionals when they needed to. The staff team updated people’s records on their health needs when this was required.

We found that staff were caring and offered support that was friendly and pleasant. Staff worked positively with people when they were anxious and used information from support plans to offer consistent support.

We saw that staff worked with people in a dignified and professional way.

Staff knew about what was important to people and we saw this in practice during our visit. However, records did not show how people had been involved in decisions about their care. There was not any information about advocacy available to people.

Staff worked with people in a person-centred way. People received care that was based on what they could and wanted to do. There was detailed information for staff to follow to provide the right support to people.

There were opportunities for people to take part in activities that were important to them. We saw that these were happening when we visited.

Reviews of people’s

As this visit was to follow up on outstanding compliance action linked to support plans and records not reflecting people's current care needs we did not speak with people using the service on this occasion. We looked at two support plans for people who were having respite care or who had just finished their stay. We saw that plans were now reviewed and where necessary relatives were consulted to obtain their views. The provider has taken the necessary action to make the improvements required.

During the course of this inspection we were unable to speak to any person using the service as they were attending their day service.

We saw from written records how people were respected and involved in their care.

We found that although support plans were in place they did not always reflect people's current needs and risk assessments were not always in place where risk was identified.

We saw that people's nutritional needs were met during their respite stays with choice and a variety of nutritional meals available.

Medication was handled appropriately ensuring that people received the medication they needed and it was stored safely.

The building was well maintained and the kitchen had recently undergone a refurbishment ensuring that people using the service were able to access it and be involved in all aspects of their care.

Recruitment was carried out by the local authority human resource department and followed legal procedures to ensure that only people suitable to work with vulnerable adults were recruited.

We looked at records kept by the service to ensure they were up to date and fit for purpose, although the majority of the information was suitable, we saw that some support plans were not up to date and did not provide staff with the necessary information they needed to provide support to people using the service.

We spoke with one of the two people using the service on the day of our inspection visit. The person told us the service was meeting their needs. Comments included, “I like living here.” and “It’s alright. The staff are nice to me.” We found the provider had appropriate systems for assessing people’s needs and planning care and treatment.

We saw that people were routinely offered choice in their daily lives. Care workers listened to people’s views and took them into account when planning care. The provider told people how they could complain about the service. Care workers supported people to complain if necessary.

We asked people about staff at the service. Comments included, “The staff’s okay.” and “They’re alright.” There were sufficient staff on each shift to meet the needs of people using the service and the provider had systems in place to ensure people's stays were reviewed and any changes necessary were then made for the future short stay.