We considered all the evidence we had gathered under the outcomes we inspected. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?We met with all four people who were staying in the home and spoke with three people, some relatives and three members of staff. The registered manager was not on duty at the time of our inspection.
This is a summary of what we found:
Is the service safe?
People felt involved in making decisions about their care and treatment. They were supported by skilled and experienced staff, who ensured people's needs were being met. Staff had knowledge of each person's behaviour patterns and care needs and assisted them appropriately. The staffing level and skill mix of staff was adequate.
People were cared for in a clean and comfortable environment which was secure and well maintained. Equipment had been appropriately checked and serviced. Fire equipment had been serviced regularly.
Staff confirmed they had received training on the protection of vulnerable adults, and were able to give an account of the procedures they would follow if they had concerns about safeguarding issues.
The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which apply to care homes. Staff had received training and had an understanding of when an application under DoLS should be made and how to submit one to be authorised by the local authority. There had been no DoLS applications since the last inspection.
Is the service effective?
People's personal, social and healthcare needs had been closely monitored and provided for. We observed staff interacted well with people, who understood what staff said to them. People responded positively with sign language or verbally if they were able to. Their care needs had been reviewed regularly and risk assessments had been carried out, where appropriate.
The service had worked closely with people's relatives, the local authority and other healthcare professionals to ensure people received appropriate care and treatment.
Staff said people had been encouraged and supported to lead independent lives and staff gave support and assistance accordingly. A member of staff said, 'People are encouraged to lead an independent lifestyle.' Staff had received appropriate training to enable them to meet people's personal, health and social care needs.
Is the service caring?
All four people who were using the respite service at the time had a learning disability and some had severe speech impairment and were therefore non-verbal. However, their facial expressions and gestures indicated they were content and happy to have a short break. One person who was able to converse said, 'I am fine. The staff are good.'
People were treated with respect and were made welcome when they returned from the day centre. People were given choices. We observed staff offering them a choice of drinks as they relaxed and waited for their evening meal. We observed a member of staff offering each person a choice of menu before the evening meal was prepared.
A relative said, 'The staff are absolutely wonderful and I am very happy with the whole arrangement; my (relative ) is very happy and I get a break too.' Another relative said, 'Staff are always polite and very supportive. We are very pleased with the service. My (relative) loves staying there.'
Is the service responsive?
People were treated with respect and dignity and were encouraged to get involved in making decisions and staff respected people's wishes and preferences. The weekly activity records were detailed and reflected each person's preferences and lifestyle.
People had access to a choice of community activities and holidays organised by staff. People's and their relatives' suggestions had been taken into consideration when activities and holidays were planned.
One relative said, 'We phoned the service nearly every day whilst our (relative) was in respite care and staff were always friendly, reassuring and happy for us to phone to enquire about our relative's welfare.'
The care records showed people's needs had been assessed and regularly reviewed. This enabled staff to provide appropriate care and treatment when people returned for respite care. Staff signed a log book to show they had read the updated care plans.
Is the service well-led?
Staff had a good understanding of the provider's ethos in providing a respite service. They were clear about their roles and responsibilities. Staff told us management was supportive and staff had been consulted before changes were implemented. There had been regular team meetings to discuss any issues or concerns raised about practices and any lessons to be learnt so as to improve the service.
People had been given choices and their wishes had been respected. Relatives confirmed there had been regular customer satisfaction surveys and their suggestions had been listened to and changes had been made to their satisfaction.
The provider had an effective monitoring system in place to ensure people lived in a safe environment where staff provided safe and appropriate care and treatment.