This inspection took place on 23 and 29 August 2017. The first day of the inspection was unannounced. West Lancashire Short Break Service is registered to provide accommodation for up to six people over the age of 18 with a diagnosis of a learning disability, autistic spectrum, physical disability and older people on a short term basis. At the time of our inspection 70 people were accessing the service and six people were in receipt of care at the home during our inspection. People who used the service were referred to as ‘guests’ in the home.
The service had a registered manager in post. 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.
At the last comprehensive inspection on 9 January 2015 the service was rated as good overall with outstanding in effective and was meeting the regulatory requirements relevant at that time. During this inspection we found the service was meeting the requirements of the current legislation. The home had successfully retained an outstanding rating in effective and had improved its rating for responsive to outstanding.
There was an exceptional training programme in place that provided in depth and relevant knowledge and skills to fully equip staff to meet the individual needs of guests.
Professionals were exceptionally positive in their feedback about the home and the quality of the care they provided ensuring the guest’s individual health needs were met.
The care delivered to guests was exceptional and we observed multiple examples of this during our inspection. Relatives regarded the care guest’s received as the highest quality. There was a collaborative approach to the delivery of care. Discussions regularly took place that ensured care was relevant up to date and continuous in the high quality delivered.
Guests and family members confirmed they had been involved in the development and reviews of the care files. Records we looked at had detailed and exceptional information in them about how to support guests individual needs, likes and choices.
Activities were tailored around guest’s likes and choices and the programme of activities available for guests was excellent and met their needs. Staff supported guests to engage in meaningful activities both in the home as well as out in the community.
There was an excellent system to deal with complaints in place and records we looked at confirmed the actions taken as a response to concerns or complaints. The feedback about the service was exceptional. Guests and relatives confirmed the home regularly asked for their feedback about the service that was delivered to them.
Systems to protect guests from the risks of abuse were comprehensive and detailed. Investigations had been thoroughly completed and included evidence of the actions taken to ensure that the guest’s safety was maintained. Staff demonstrated a detailed understanding of the principles of safeguarding and how to protect guest’s from the risks of abuse.
There was a detailed recruitment programme in place that ensured guests received quality care from a very skilled staff team. Staffing levels ensured that guests received high standards of care that protected their welfare and safety.
The building had been purpose built and offered excellent well maintained facilities that supported safety and quality in the care that guests received. All bedrooms had excellent facilities available to guest’s which included ensuite showers, flat screen televisions and internet access.
Thorough risk assessments were in place to protect guests from any identified risks enabling them to take positive risks. Records of regular environmental checks and service certificates demonstrated that the home was maintained to a very high standard.
The management of medicines clearly met the needs of guests in the home. Staff demonstrated excellent knowledge and skills during administration of medicines, Records and procedures identified effective systems were in place to ensure medicines were managed safely.
People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff had a detailed understanding by staff of Deprivation of Liberty Safeguarding (DoLS) and of the Mental Capacity Act 2005 (MCA) and its relation to protecting guests from unlawful restrictions.
The privacy, respect and dignity of guests was an essential competent of the experience of the guests in receipt of care. Guidance, up to date policies and regular training provided up to date information on how to meet guest’s diverse needs.
We received exceptional feedback about the management and oversight of the home. Audits and quality checks were in place and demonstrated the ongoing oversight and development to ensure guests received a high standard of care whilst in the home.