Natural Breaks Limited

Updated 13 August 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The team consisted of one adult social care inspector.

Service and service type: Natural Breaks is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides services to people living with dementia, physical disabilities, mental health, older people and younger adults.

The service had a manager registered with the CQC. This means they and the provider are legally responsible for how the service is run for the quality and safety of the care provided.

Notice of inspection: The inspection was announced. We gave the service two days' notice of the inspection site visit because we needed to be sure someone would be present. We visited the office location on 23 and 28 May 2019 to see the registered manager and office staff; and to review care records and policies and procedures. We visited the homes of people who used the service on 28 May 2019. We also contacted relatives of people who used the service by telephone.

What we did: Before the inspection, we reviewed information we had received about the service since the last inspection. This included details about incidents the provider must let us know about, such as safeguarding events and statutory notifications sent by the provider. A notification is information about important events which the provider is required to tell us by law, like a death or a serious injury. We sought feedback about the service from the local authority and other professionals involved with the service. The provider had completed a Provider Information Return (PIR). This is a document that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help inform our inspection.

During our inspection we looked at four people’s care records and elements of another two people’s records, records relating to the management of the service, including staff training records, audits, medication records and meetings. As part of the inspection we spoke with five people using the service, three relatives, four support staff, the registered manager and chief executive officer.

Details are in the Key Questions below.

Updated 13 August 2019

About the service: Natural Breaks is an organisation which provides support services to people with a range of needs such as a learning disability, mental health needs, physical disability or an acquired brain injury. The service has two strands offering both a domiciliary care service to people living in their own home and support for people to access social and leisure activities within their local community. At the time of the inspection 29 people were being supported with personal care.

People’s experience of using this service: People were positive about the care and support they received from Natural Breaks.

People received medicine when they should, and medicines were stored safely in people’s homes. There were some issues with one person's MAR chart as these had not always been completed appropriately in line with national guidance. However, the provider had processes in place that had identified these issues and the registered manager had taken appropriate action.

We found the service had completed mental capacity assessments as required. Decisions about people's care had been taken in their best interests when they did not have the capacity to do so.

Not all staff had completed mandatory training. The registered manager told us this would be addressed immediately.

People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life history, and their communication needs. They used this information to develop positive and meaningful relationships with people.

Sufficient numbers of staff were employed to meet people’s needs and support people to access the community. Staff were caring and always promoted people’s dignity and independence.

People we spoke with told us they felt safe being supported by the staff, and staff were able to describe the course of action they would take if they felt someone was being harmed or was at risk of harm.

Risks which compromised people’s health and well-being were appropriately assessed, reviewed when needed, and contained a high level of detailed information.

Safe recruitment procedures were in place. Appropriate checks were carried out on staff before they started working at the service to ensure they were suitable to work in the role.

There was a clear complaints policy for the service. Complaints we saw had been responded to appropriately.

Staff understood their role and had confidence in the manager. We were told the management team were approachable and responsive to any issues. Systems were in place to gather feedback from people.

People and their relatives were highly complimentary about the service. People told us the service was “excellent” and met people’s needs.

Rating at last inspection: Good (Report published 30th December 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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