About the service: Stibbs House is a respite care home that provides personal and nursing care to up to 10 people at a time. The service offers short breaks for people with learning disabilities, allowing people and their carers to have a break when needed. At the time of the inspection there were five people using the service.

We undertook an unannounced focused inspection on 6 March 2019. This inspection was undertaken due to whistleblowing concerns we had received. This report only covers our findings in relation to those concerns.

People’s experience of using this service:

People were supported for by a consistent staff team who were kind and caring. Staff had good relationships with people and knew them well. People were encouraged and supported to maintain their independence.

The provider and senior staff had completed audits on the home to support quality checks. However, for some areas these checks had not prevented shortfalls in the quality of service provision. This was in respect of safe care and treatment and good governance.

Rating at last inspection: Good (report published March 2017)

Why we inspected: We inspected following concerns raised to us by staff who worked at the service.

Enforcement: We found one breach of The Health and Social Care Act Regulations (2014). Further information is at the end of the report.

Follow up: We will ask the provider to send us a report setting out how they will improve.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Stibbs House provides short break accommodation and personal care for up to ten people with learning disabilities. At the time of our inspection there were seven people staying at the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

Staffing levels were safe to meet people’s needs and were adapted to meet the changing amount of people staying at the service. Medicines were stored and administered safely. Risk assessments were in place to support people safely whilst promoting independence.

Staff had effective induction, training and supervision. People’s health needs were met and people had benefited from input from health and social care professionals. People were supported with their nutrition and hydration. Staff were skilled in how assist people in this area of care.

Staff were kind and caring. The staff team were well established and had developed good relationships with people. Staff knew people well.

Care plans were person centred, accessible to people and gave clear guidance to staff of how people preferred to be supported.

Systems were in place to monitor and improve the quality of the service. The service was well run and managed. Staff worked effectively as a team and were supported by a senior staff member and the registered manager.

People’s capacity had been considered and documented in care records However, best interest decisions were not always completed where appropriate. We made a recommendation in regards to working in accordance with the Mental Capacity Act Code of Practice.

Stibbs House provides accommodation for up to 10 people who require personal care. The service provides short breaks for people with learning disabilities. This was an unannounced inspection, which meant that the staff and provider did not know we were visiting.

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 and has the legal responsibility for meeting the requirements of the law; as does the provider.

Formal staff support systems were in place. There were team meetings where support and staff supervision part of the agenda. We also saw nurses were supporting staff while they were assisting people. However individual supervision meetings had not been taking place as regularly as the provider’s policy said they should for all staff. This meant staff may not always get enough formal guidance to do their job effectively.

Care and support was provided by staff with an attentive approach, they were caring and supportive. People staying at the service and their relatives said they were happy with their care and support.

There was animated communication between people and the staff. Staff engaged people in games, household tasks and conversations.  

People were included and consulted about what mattered to them in their daily life and were encouraged to maintain important relationships.

People were supported by enough suitably qualified, skilled and experienced staff to provide them with effective care. They were also protected by robust recruitment and staff selection procedures.

People were provided with a choice of healthy food and drink during their stay. This ensured their nutritional needs were met.

People’s physical health was monitored and they were supported to stay healthy. Where people had health conditions or symptoms referrals to the relevant health professionals were made.

Staff were suitably trained and knew how to provide effective care. The staff team had been provided with a comprehensive induction when they began employment. Staff knew in detail what their roles and responsibilities were. The staff also understood the values and philosophy of the organisation they worked for.

The registered manager and the provider used a range of methods to assess and monitored the quality of care and service people received. Feedback from people and their families was encouraged. This information was used to improve and develop the quality of the service.   

During our inspection of 16 June 2013 we had found that care and support was delivered in a way that was intended to ensure people's safety and welfare. However care planning processes failed to fully show how to meet people’s range of current needs.

We had found that some care plans had not been regularly reviewed or updated. This meant care plans did not accurately reflect all of people’s current needs.

The provider wrote to us and told us the action they would take and that they would be compliant in the area we had identified by 1 December 2013.

At this inspection we met four people who used the service. We spoke with one person about the home and they told us the staff were “really nice”. We also observed how staff assisted people who were not able to make their views known.

We found that care and support was delivered in a way that was intended to ensure people's safety and welfare. We also found that care planning processes now showed how to effectively meet people’s range of needs.

We spoke with six people who used the service to find out it was like staying at Stibbs House. We asked people what they thought of the staff who assisted them at the home.

Every person we met had positive views about their stay and the quality of care and support they were receiving. One person told us, “the staff are nice”. Examples of the comments people made included, “the staff help me get up and take me out when I want to go shopping” Another person said, "all the staff help me and I can talk to them about anything ".

People who used the service were being supported to live an independent life while they stayed at the home. People were assisted to maintain their regular routines and to attend their regular community activities during their stay at Stibbs House.

Peoples care plans were not all up to date and did not fully reflect their range of current needs. This meant people were at risk of receiving unsafe and unsuitable care during their stay at Stibbs House.

People were provided with a varied and nutritious diet. Menus were planned based on peoples’ likes and dislikes.

People felt safe staying at Stibbs House. There were systems in place to safeguard people from abuse.

The provider’s recruitment procedures ensured safe and suitable staff were employed to assist people.

The quality of service people received and its suitability was being checked and monitored.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We observed staff working with people, looked at records and reviewed the results of a recent satisfaction survey which was sent out by the home.

We met ten people who were staying at the home, only one person spoke with us. This person said that they liked coming to Stibbs House and liked the staff. All the people we met looked settled and comfortable in the environment of Stibbs House.

We spoke with four staff who all said that they were well supported in their role and received regular training. All the staff said that they enjoyed working at Stibbs House.

We reviewed a compliance action that was set in regards to record keeping at the home following our last inspection. The records we reviewed demonstrated that record keeping in the home has improved and the homes records were fit for purpose.

One person gave us information about the home. They told us that the staff are good, they regularly stay at the home for respite but they were unaware of care plans.

We spoke to a relative about their experiences of the care at the home. We were told that their main concern is that their relative is safe at the home during their respite care and they were happy with the way care is delivered at the home.

This relative also told us that an introductory visit was arranged in advance of any respite stays. Information was provided about the service; a care plan was devised and provided by the social worker to the home’s staff. It was further stated that the home corresponds well with other agencies involved with the care of the person. Where people had mobility needs, staff would use the correct equipment and staff were pleasant and knew how to meet the needs of the people accommodated. This relative confirmed that they would feel confident to approach staff with complaints and that it would be resolved to a satisfactory level.

When we observed staff interacting with people we saw that they engaged with people. There were opportunities for 1 to 1 time and staff were observed giving people time to make choices.