This inspection took place on 15 November 2018. We let the service know on the morning of our inspection visit that we would be arriving because we did not want people using the service to be anxious when we arrived. Also, we needed to be sure that the registered manager or a member of the senior care staff would be in.

The service is a short breaks service that supports up to 70 people at various times throughout the year. Short breaks last between one and 21 nights. At the time of our inspection five people were using the service.

The 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.

At our last inspection on 12 May 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of Good overall. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments associated with a person’s care and support were reviewed before they began their latest stay and, if necessary, during their stay. People were involved in the planning of their care which was person centred and updated before they came to the service . People were supported to access relevant health and social care professionals if they needed to during their stay. They were supported to take their medicines as prescribed by their GP.

Safe recruitment processes were in place. People received care from staff that had received training and support to carry out their roles. There were enough staff to meet people’s needs.

Staff understood their responsibilities under the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were supported with their nutritional needs. Special dietary and cultural requirements were met. People had a choice of healthy meals that were freshly prepared by a cook.

People stayed in rooms they had used before unless they requested otherwise. They had use of spacious communal areas where they socialised with other people and participated in activities. Other facilities included People had use of a sensory room where they could relax and a garden.

Staff respected people’s privacy and dignity. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to express themselves, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred. People using the service and their relatives knew how to raise a concern or make a complaint.

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 and associated Regulations about how the service is run.

The registered manager was supported by the provider’s operations manager. Both monitored the quality of the service. People’s feedback about their experience of the service was consistently positive. Feedback from a staff survey was acted upon to improve staff experience of working at the service.

Further information is in the detailed findings below.

We carried out an unannounced inspection of the service on 12 May 2016. Wynhill Lodge Short Breaks Services provides a short break service for up to 10 people who live with a learning and/or physical disability.

On the day of our inspection eight people were using the service and there was a registered manager in place.

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.

During our previous inspection we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to a lack of mental capacity assessments being completed for people who were unable to make decisions for themselves. Additionally, there were limited quality assurance processes in place to identify and act on risks to people using the service. During this inspection we saw improvements had been made in both areas.

People’s relatives told us they felt their family members were safe when they stayed at the home. People were supported by staff who could identify the different types of abuse and who to report concerns to. Assessments of the risks to people’s safety, including how to evacuate them safely in an emergency, were in place and regularly reviewed. There were sufficient numbers of suitably qualified and experienced staff in place to keep people safe. Safe recruitment processes were in place. People’s medicines were managed safely.

Staff were well trained, received regular supervision and felt supported by the registered manager. Improvements had been made in the way the principles of the Mental Capacity Act 2005 (MCA) were used when supporting people. People received the food and drink they wanted and were supported and encouraged to follow a healthy and balanced diet. People’s day to day health needs were met effectively by the staff.

People’s relatives told us they felt the staff were kind and caring and treated their family members with respect and dignity. The views of people and their relatives on the care and support provided were regularly discussed with them. People were supported to live as independently as they were able to.

People’s relatives felt their family members were supported to take part in the activities that were important to them. People’s care records were person centred and focussed on what was important to each person when they stayed at the home. Adaptations to the environment had been made to support people living with a physical disability. Complaints and concerns were responded to in a timely manner.

Improvements had been made to the way the registered manager monitored the risks to people’s safety and the service as whole. Relatives and staff spoke highly of the registered manager. The registered manager welcomed people’s views on developing the service and they also understood their roles and responsibilities required of them as a registered manager.

We carried out an unannounced inspection of the service on 30 April 2015. Wynhill Lodge Short Breaks Services provides a short break for up to 10 people who have a learning disability and additional complex needs. On the day of our inspection four people were using the service.

On the day of our inspection there was a registered manager in place.

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 did not always have the appropriate risk assessments completed in order for staff to be aware of the risks posed to people’s safety and how they should reduce that risk.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. Where people did not have the capacity to consent to decisions about their care the registered manager did not always ensure that the appropriate assessments had been completed to support the decisions made for people.

The registered manager conducted audits to assess the quality of the service that people received, however they did not identify the issues that were raised within this report.

Relatives of people who used the service felt their family members were safe. The risk to people experiencing abuse at the home was reduced because the staff had received training on safeguarding of adults, could identify the different types of abuse and knew who to report concerns to. There were enough staff to meet people’s needs. People’s medicines were managed in a safe way. Accidents and incidents were investigated. The environment people lived in and the equipment they used was monitored to reduce the risk to people’s safety.

People were supported by staff who were well trained, knowledgeable and understood how to communicate with people. Relatives spoke positively about the staff and the way they supported their family members. People were supported to maintain a balanced diet and the staff were aware of people’s specific dietary requirements. People were able to access their GP and dentists and other external healthcare professionals.

Staff treated people with respect and supported people in a dignified and caring way. When people became distressed, staff responded to them in a timely manner. People were provided with the information they need to access independent advice if the needed it. Relatives were involved with decisions relating to their family member’s care although people’s records did not always reflect this. People’s privacy and dignity was maintained at all times. There were no restrictions on people’s friends or relatives attending the home.

Before people attended the home the care they required was discussed with them and/or their relative. People were encouraged and supported to do the things that were important to them. People were supported to practise their religion. People’s care plans were not always reviewed in a timely manner. A complaints procedure was available for people and staff responded to complaints raised by people in a timely manner.

Relatives and staff spoke highly of the registered manager. People, relatives and staff were encouraged to contribute to the development of the service. Staff understood their role and how the risks to the service were explained to them by the registered manager.

You can see what action we told the provider to take at the back of the full version of the report.

As part of the inspection we spoke with two people who used the service and a relative who was visiting the service for their views. We also used observation because some people had communication needs and were unable to share their experiences and views. We spoke with the registered manager, two team leaders, the cook, domestic assistant / handy person and three care workers. We looked at service information, care plan files for three people and did a tour of the building.

People were involved and consulted in the development of their care plans. Where people did not have capacity to consent to care and support, the provider had followed the correct procedures to ensure people’s human rights were protected.

We saw that people were provided with varied, appetising and nutritionally balanced meals and any specialist diets that were required due to pre-existing medical conditions or cultural needs could be supplied.

We saw the cleanliness of the home was well managed and there was an effective system in place for the prevention and control of infections.

We saw the staff rota and the daily ‘hand over’ document, clearly identified how staff were deployed according to their experience and skills. We saw there were sufficient numbers of staff employed at the service.

We saw the provider’s records were stored securely, fit for purpose and confidentiality was maintained to protect people who used the service and staff employed at the service.

As part of our inspection we spoke with two relatives of people who used the service. We used observation to help us understand the experiences of people using the service, because some of the people had communication needs which meant they were not all able to tell us their experiences. We also spoke with the registered manager and four members of staff and looked at service information and records.

We spoke with two relatives of people who used the service. One person told us, “I have no concerns about the place and staff that work there. I’m 100 percent happy.” And “My daughter loves it, I drop her off and she gets really excited when she arrives, she shows me she wants me to leave her. I would know and the staff would too if she was unhappy.”

Another relative said, “I have no concerns, my son returns home after a short stay happy, if he wasn’t happy we would know and he wouldn’t use the service if that was the case.”

There were three people receiving a short break when we visited. We observed positive interactions between staff and people who used the service. We saw people were supported and encouraged to participate in various activities.