Encompass Care Respite Accommodation and Outreach Service

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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There were enough staff to keep people safe and meet people’s needs. Staff had received training in how to safeguard people from harm and abuse and were confident in how they would raise concerns internally or externally. There were processes in place to ensure safe recruitment of staff who were suitable to work with vulnerable people.

People’s needs were thoroughly assessed prior to them coming to respite with their input sought wherever possible alongside involvement from their relatives, regular support staff and health professionals. People were supported by staff with the skills, experience and attitude to meet their individual needs and help them relax and enjoy their stay. Most people were non-verbal but the staff’s in-depth knowledge of each person’s preferred means of communication meant that they were given the opportunity to express their views and make decisions about what they wanted to happen while there.

People were supported by staff who were consistently kind, caring and attentive. Relatives told us they felt their family members were safe and well looked after. When people required reassurance or emotional support this was provided in a timely and respectful way. We observed people relaxed and smiling in the presence of staff. Interactions were person-centred and respectful. People were supported to have maximum choice and control, as their abilities allowed, and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There was a strong emphasis on maintaining continuity for people on respite so that they could continue enjoying activities that they usually enjoyed in the community. This included attending local day centres, listening to their favourite music, trips to the cinema, and baking. The home conducted annual surveys to ensure that people and those important to them had an opportunity to provide feedback on the quality of the service. Relatives told us that they were happy with the service and felt consulted and listened to. Health professionals praised the home’s responsiveness and adaptability when people needed emergency respite and viewed the home as an integral contributor to reviews of risks people faced. This meant people and their family members received maximum benefit from respite stays ensuring that placements at home were sustained.

The home had a homely and relaxed atmosphere. Staff, relatives and health professionals expressed confidence in the management of the home. Staff said that they felt supported and were praised for their achievements. This helped to motivate them. Staff were encouraged to raise issues or concerns. They said they felt able to do this as the management were approachable and listened to them. There were systems in place to measure quality and performance and these were used to drive improvements.

The home 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.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. The registered manager is also the registered provider. Registered providers 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.

5 Prince of Wales Road only provides respite care, this means people stay for different lengths of time. For example people stayed one or two nights or for longer periods including weekends or for a week’s holiday. A thank you card recorded; “Thank you so much for all your care and kindness towards […], also for making his stay an enjoyable one.” A relative said; “They go above and beyond-brilliant service.”

We met and spoke with all five people during our visits. We observed people and staff were relaxed in each other’s company and there was a calm atmosphere. Most of the people who stayed for respite care were not able to fully verbalise their views. People responded positively when asked if they liked staying for respite care. Staff agreed that they felt people were safe when they stayed. Staff knew people well and had the knowledge to be able to support people effectively.

People did not all have full capacity to make all decisions for themselves, therefore staff made sure people had their legal rights protected and worked with others in their best interest. People’s safety and liberty were promoted. Staff understood their role with regards to ensuring people’s human rights and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by staff. Staff had undertaken training on safeguarding adults from abuse, they displayed good knowledge about how to report any concerns and described what action they would take to protect people against harm. Staff felt confident any allegations or concerns would be fully investigated.

People’s medicines were managed safely. People received their medicines as prescribed and received them on time. Staff were trained in the management and administration of medicines.

People were unable to respond when asked about the care they received. However a thank you card recorded; “Thank you to all the staff who took such good care of our son.” Care records were comprehensive and personalised to meet each person’s needs. Staff understood people’s individual complex care needs and responded quickly when people needed support. People were involved as much as possible with their care and records documented how people liked to be supported. People were offered choice and their preferences were respected.

People’s risks were well managed and documented. People were supported to try a wide range of activities while staying for respite care. Activities were planned with people’s interests in mind.

People enjoyed the meals provided and they had access to snacks and drinks at all times. People were involved in planning of menus and preparing meals.

Staff said the registered manager was very supportive and approachable and worked in the home regularly. Staff talked positively about their roles.

People were protected by safe recruitment procedures. There were sufficient numbers of staff on duty to support people safely and ensure everyone had opportunities to take part in activities of their choice. Staff received an induction programme when they started working for Encompass. Staff had completed training and had the right skills and knowledge to meet people’s needs.

People had access to healthcare if needed during their stay, for example GP services. Staff acted on the information provided by professionals to ensure people received the care they needed.

There were effective quality assurance systems in place. Any significant events were appropriately recorded, analysed and discussed at staff meetings. Evaluations of incidents were used to help make improvements and ensure positive progress was made in the delivery of care and support provided by the service. Feedback was sought from people who stayed for respite care, relatives, professionals and staff.

During our visit we spoke with three people staying there, four relatives, the registered manager, and two members of staff. People staying at Encombe told us they liked it there. A relative said, 'I feel relaxed that she's in good hands.' Another told us, 'staff keep him safe and well.'

People using the service received personalised care and support that met their needs. Their privacy and dignity was respected and they were supported to make decisions about their care.

The service provided a choice of meals, snacks and drinks, and support for people who needed assistance. Special diets and supplements were provided where appropriate.

People who used wheelchairs brought their own to use during their stay. In addition, the service provided a range of specialist beds, bathing and lifting equipment that met individual needs.

We found that there were enough appropriately trained staff to meet the needs of people using the service.

The service had a formal system for dealing with comments and complaints. At the time of the visit it was in the process of reviewing this.

During our visit we spoke with a relative whose family member had just completed their respite stay, the registered manager and two members of staff.

People using the service received personalised care and support that met their needs. Risks relating to the provision of care and support were identified and managed, taking into account safety and people's right to make choices.

The service had training and support systems in place to ensure that people who use the service were protected from abuse, or the risk of abuse.

People using the service were supported by sufficient numbers of staff, who received regular supervision and ongoing training to ensure they had the knowledge and skills to meet people's needs.

Systems were in place to monitor the quality and safety of the service that people received and to make improvements where necessary.