Archived: Creative Support - Trafford Respite Service

At our last inspection in April 2016 we rated the service as good overall, with the safe domain rated as required improvement. At our last inspection we found a fault in the fire alarm had not been rectified in a timely manner. At this inspection all equipment was maintained and serviced in line with national guidelines. The service was well maintained and clean throughout.

At this unannounced inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going 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.

The care 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.

.

At this inspection we found the service remained Good.

Why the service is rated good.

People enjoyed staying at the respite service and said they felt safe when staying there. Relatives were also complimentary about the service. Positive interactions between the people at the service and staff were observed during our inspection.

Staff received the training and support, through supervisions and team meetings, to effectively meet people’s needs. Annual observations of staff competencies were completed.

A safe system for recruiting new staff was in place. The number of staff on duty varied depending on the needs of the people staying at the respite service. More staff worked at a weekend to support people to participate in activities.

Person centred care plans and risk assessments were in place to guide staff on the support people needed and how to reduce any identified risks. Where applicable positive behaviour and epilepsy support plans were in place.

Information about people’s preferences, culture, likes and dislikes was recorded. A description of people’s daily routines was in people’s care files.

Medicines were administered as prescribed. People’s health and nutritional needs were met by the service. People told us the food was good and they had a choice of meals.

People are supported to have choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

At our last inspection we found a fault in the fire alarm had not been rectified in a timely manner. At this inspection all equipment was maintained and serviced in line with national guidelines. The service was well maintained and clean throughout.

Emergency evacuation plans were in place for each person in their care files. We have made a recommendation that these plans are easily accessible to staff in the event of an emergency.

The registered manager had an auditing system in place to monitor the quality of the service. All incidents and accidents were reviewed to reduce the likelihood of a re-occurrence. The provider, through the area manager, also undertook quality checks and audits at the service.

Surveys were used to gain feedback from people and their relatives about the service.

Further information is in the detailed findings below.

Creative Support – Trafford Respite was last inspected in January 2013 when it was found to be meeting all of the standards reviewed.

Creative Support – Trafford Respite Services is registered to provide short break and respite services for a maximum of seven adults who have a learning disability. Some people may also have a physical disability. At the time of our inspection 31 people used the respite service. Some people visited for 1 or 2 nights each week, others accessed the service for a week at a time, several times throughout the year.

There was a registered manager in place at the service. 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 this inspection we found one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

We found that the monitoring of the fire alarm and emergency light systems had improved however the visual light fire alarms for people who are hard of hearing had been identified as not working on more than one occasion when tested. This meant that people who used the service and staff who are hard of hearing may not be safe in the event of a fire due to the visual fire alarms not working correctly.

People told us that they felt safe in the service. Their relatives also told us that they thought that the service was safe. Staff had received training in safeguarding vulnerable adults and could clearly describe the action they would take if they suspected any abuse had taken place. People told us that the staff were always kind and caring.

The service had a safe system in place for the recruitment of staff. We saw that the number of staff on duty varied depending on the number of people accessing the service and their needs. This was assessed by the registered manager, however two staff we spoke with said that there were not always enough staff on duty in the evenings when there were two or three people who needed two staff for support staying at the service at the same time.

We found that medicines were safely administered and staff received training in the administration of medicines. Clear guidelines were in place for any ‘as required’ medication that had been prescribed.

People’s care records and risk assessments contained personalised information about an individual’s needs and provided guidance for staff as to the support people needed and the routines they followed. However we found that one person did not have their risk assessment and management plan completed.

If people’s needs changed a system was in place to liaise with the person, their family and other professionals to update care plans and risk assessments. Where required people’s health and medical needs were met, with access to GP’s and health professionals.

We saw that the service had facilities to support people with a range of needs, including the availability of track hoists and a sensory room.

The home was clean and tidy throughout and staff used personal protective equipment (PPE) such as gloves and aprons when undertaking personal care tasks.

Plans were in place in the event of an emergency, such as a utility failure. All equipment was found to be maintained to the manufacturer’s instructions. Weekly Health and safety checks had started to be completed in December 2015.

We found that the service was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards. These provide legal safeguards for people who may be unable to make their own decisions. People’s respite support was assessed and agreed with the person, their families and the local authority commissioning team prior to a referral being made to Creative Support – Trafford Respite Services.

An induction programme was in place for new staff to complete required training courses and shadow existing staff. Staff training was available and staff confirmed that they had completed training courses relevant to their role. However not all staff had received refresher training in infection control and food hygiene. As per the company’s policy.

People told us that staff members respected their privacy and dignity. Staff we spoke with could provide examples of how they did this. We also saw that staff knew the people they were supporting well.

We saw that activities within the service and in the community were available for people if they wanted. Art and craft resources, a sensory room and a large garden area were available. Trips were arranged, especially at weekends.

Staff told us that they felt supported by the registered manager. Formal supervisions had been restarted in January 2016 after a gap of six months. Regular team meetings were also held and staff were able to raise any issues or concerns at these meetings.

A system was in place for responding to complaints. We were told by relatives and staff that the registered manager was approachable and would listen to their concerns.

We saw that an internal audit had been completed in November 2015. A system of manager’s audits and health and safety checks had been implemented following the audit. We will check in our next inspection that these have continued to be carried out.

We were told during the inspection that the registered manager had left and a new manager would be appointed within 6 weeks.

We found correct records were being kept which monitored fluid and food intake and people were protected from the risks of inadequate nutrition and dehydration.

There were guidelines specific to individual needs and medication checking in and out sheets specific to short term respite placements. The information we saw was up to date.

There was a complaints system available and complaints people made were responded to in line with policy.

One person told us that they received the right amount of care and support to meet their needs. They showed us their room and confirmed that they enjoyed spending time there.

We saw that appropriate policies and procedures had been put in place to protect people using the service from abuse. Support staff had received training in how to recognise the signs and symptoms of abuse and what action to take if they suspected that a person using the service was at risk of abuse. Support staff had also been trained in the safe management of behaviours that challenged the provision of care and support. The two people we spoke with had no concerns about their safety while using the service. Important information was available to people using the service in alternative formats, such audio, easy read and other languages.

The provider had put suitable arrangements in place to ensure that staff received the training and support needed to deliver safe care and support to people using the service.

A robust system was in place to assess and monitor the quality of outcomes experienced by people using the respite service.