The Meadows Short Break Centre offers short breaks for adults with learning disabilities and/or physical disabilities. These breaks can be for a few hours (tea visit) or an overnight stay; longer stays can also be accommodated (up to two weeks). Accommodation is in four single en-suite rooms. It is registered to provide accommodation and personal care for up to a maximum of four people. The service had a contract with about 44 people who regularly used the respite facility. There were four people at the service at the time of the inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

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’s relatives told us that they were confident that people were safe when they stayed at The Meadows.

Risks to people’s health and well-being were identified, planned for and managed. There were sufficient competent and experienced staff to provide people with appropriate support when they needed it.

People received care from staff who knew them well. Staff treated people with kindness, dignity and respect. Relatives were positive about the care and support provided.

Medicines were managed safely and people received their medicines in a way they could manage.

People were supported to have 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.

People were supported to maintain good health and had access to health and social care professionals when necessary.

Relatives knew how to make a complaint and were sure they would be listened to and any concerns acted upon.

The registered manager, deputy and staff had created a warm welcoming atmosphere for people and their friends and families. There were close relations with social and healthcare professionals and the quality and safety of the service was reviewed regularly.

This inspection took place on 18 January 2016 and was unannounced. At our last inspection on 8 April 2014, the service was found to be meeting the required standards in the areas we looked at.

The Meadows Short Break Centre offers short breaks for adults with learning disabilities and/or physical disabilities. These breaks can be for a few hours (tea visit) or an overnight stay; longer stays can also be accommodated (up to two weeks). It is registered to provide accommodation and personal care for up to a maximum of four people. Accommodation is in four single en-suite rooms. The Meadows Short Break Centre has a communal sitting room /dining room, a quiet room and a garden. At the time of our inspection four people were staying for respite. The service had a contact with about 45 people who regularly used the respite facility.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

People spoken with said they felt safe, happy and well looked after at The Meadows Short Break Centre. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Flexible arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

The atmosphere in the home was welcoming and there was a warm interaction between the staff and people who used the service. People were involved in all aspects of their care and support as much as they were able.

Relatives were positive about the skills, experience and abilities of the staff who supported their family members. Care provided was good and staff were knowledgeable about people’s needs. Staff had received appropriate training and supervision. People were given choices and their privacy and dignity was respected.

A range of risk assessments had been completed for each person. They provided guidance for staff in regards to how to support people to have independence and control over their lives while promoting their safety, comfort and wellbeing. For example supporting someone with any behaviour which may challenge.

The environment and equipment used were regularly checked and well maintained to keep people safe.

Leadership and management of the home was good. There was an open culture which encouraged all involved in the home to voice their views and concerns. Staff felt valued and were encouraged to contribute any ideas they may have for improving the service. Systems were in place to monitor the quality of the service and promote continuous improvement.

At our previous inspection on 17 October 2013 we found that the service was required to make improvements in relation to safeguarding people who used the service from the risk of abuse and also with regards to cleanliness and infection control.

At our inspection on 8 April 2014 we found that the service had made the required improvements.

During this inspection we set out to answer our five key questions; Is the service caring, responsive, safe, effective and well led?

Is the service safe?

The service had robust systems in place for identifying and reporting any concerns about people’s safety and welfare. Staff had received training on protecting people who used the service from the risk of abuse and had a good awareness of their role in relation to this. People who used the service, who may not have been able to express any concerns were being supported by the service. In addition they supported by their relatives and health and social care professionals.

The environment was safe and well maintained. There were systems in place to ensure appropriate standards of cleanliness and infection control were provided. The staff we spoke with were familiar with health and safety requirements and had received regular support and training.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

We saw that where changes to a person’s needs were identified the appropriate updates were made to their care plan and the relevant professionals were contacted if needed. When issues were found through assessing and monitoring the quality of the service provided, an action plan was created a record of this action being carried out was maintained.

Is the service caring?

We observed staff with people who used the service. We saw staff to be attentive and respectful to people. Where people needed constant supervision and support due to their complex needs, staff were aware of this and assisted them in a sensitive manner. Through discussion with staff members we found that the service strived to not only support people on admission and discharge of the service, but also were keen to support their family members. This demonstrated that staff were committed to providing a high standard of care for people.

Is the service responsive?

We saw from care plans that when people arrived at the service their needs were assessed and recorded. There was evidence of people’s involvement in the planning of their care and their requests were carried out. For example, additional support which was requested was given to a person and their family through a difficult family event.

Is the service well-led?

There were regular audits completed and action plans developed from the findings of these. There was a record of these actions being completed. The views of people were taken on board and new systems of working were derived from people’s feedback and shared with the staff team.

The assistant manager works within the rota which allowed for an open and supportive approach to staff. There were regular checks on staff performance through observation and guidance when needed.

Staff meetings were held and training was provided to ensure staff were familiar with what was expected of them from the manager, assistant manager and provider.

We saw that people's ability to consent to care and treatment was assessed prior to them staying at the service. Staff told us that this was monitored during people’s stays. They told us, “If we noted any changes to capacity or needs we would report this to the social worker.”

We looked at three care plans for people who used the service and saw that these were person centred and provided staff with appropriate information to be able to meet people's needs.

The provider had not raised awareness in relation to safeguarding adults from abuse. Although staff had received training this was now past its specified renewal date. There was no guidance available for people who used the service about how to raise concerns.

Areas of the service were dirty and infection control procedures were not in place. There were no systems in place to check for cleanliness.

Staff were receiving supervision and appraisal. There were further training opportunities for staff to gain additional qualifications. We were told by staff, "I feel supported."

When we visited the home on 10 September 2012 we used a number of different methods to help us understand the experiences of people using the service, because many of them had complex needs which meant they were not able to tell us their experiences. People responded to us with smiles when we spoke with them. We observed staff engaging with people and offering them choices as to what activities they wished to undertake and what refreshment they wanted.

Care plans contained clear information on meeting people's personal and health care needs. They provided guidelines on each person’s means of communication, with information on how people with limited verbal communication showed when they were upset or in pain.

We saw the report of the last satisfaction survey in 2011. Between 94% and 100% of people and their relatives expressed satisfaction with all aspects of the service. Comments from people using the service were positive, for example, “I love it, home from home.” And, “You look after us well, all friendly and good listeners.”