We carried out a review of the data available to us about Breakaway Short Breaks on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Breakaway Short Breaks, you can give feedback on this service.
Breakaway Short Breaks is a care home and provides respite care for adults with learning disabilities. Some people may also have sensory or physical impairments. The London Borough of Camden provides the service. People stay for varying periods and the service also offers emergency placement, which had been needed for a few people living at the home over the last few years. Breakaway Short Breaks accommodates up to eight people in one adapted bungalow-style building. Five people were using the service at the time of the inspection.
People’s experience of using this service and what we found
Breakaway Short Breaks had improved the management of medicines because the storage and documentation related to medicines management now followed current national guidelines and the provider's policy. The provider’s quality assurance system had also improved to ensure that any emerging issues could be more speedily recognised and responded to. The previous breaches of regulation in respect of this had been addressed.
Risk assessment and management plans and care plans, had improved to include suitable detail and guidance for staff to ensure they had precise information on how to provide safe and personalised care to people.
The provider had systems and policies to help ensure people were protected from the risk of abuse. The provider managed the recruitment process and carried out appropriate checks, which we verified at this inspection, to ensure people were supported by suitable staff. Staff had undergone training about safeguarding people and working with people with learning disabilities and / or autistic spectrum disorder.
People told us, and we observed, that there were positive relationships with the staff supporting them. Staff spoke encouragingly about people who had gone through difficult times and about working supportively and positively with people in making plans for their future.
People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing Support to people with a learning disability and/or autism.
This service was able to demonstrate how they were meeting the underpinning principles of Right Support, right care, right culture.
Right Support:
• Model of care and setting maximised people's choice, control and independence. Staff offered people meaningful choices about how they lived their daily life and helped participate in activities that developed people’s interests, whether through educational courses and activities of interest to them.
Right care:
• Care was person-centred and promoted people's dignity, privacy and human rights. People’s privacy was maintained when providing personal care and we observed staff respecting people’s privacy when they wanted to spend time alone in their own room.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. Staff and managers spoke with a great deal of positivity about what they did to recognise how life events affected people and the support provided to encourage and assist people to move forward with their lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was requires improvement (published 9 July 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that the provider seek further training and guidance on effective risk assessment and risk management planning and the service seeks further training and guidance on comprehensive care planning. At this inspection we found that risk assessments and management, as well as care planning, were much improved and safe and the provider had acted on our recommendations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led and contains the requirements and recommendations. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Breakaway Short Breaks on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Breakaway Short Breaks is a care home and provides respite care for adults with learning disabilities. Some people may also have sensory or physical impairments. The London Borough of Camden provides the service. People stay for varying periods and the service also offers emergency placement. Breakaway Short Breaks accommodates up to eight people in one adapted bungalow-style building. Four people were using the service at the time of the inspection.
People’s experience of using this service and what we found
Breakaway Short Breaks had not always managed medicines safely because the storage and documentation related to medicines management had not always adhered to current national guidelines and the provider's policy , this posed a risk to people. The provider’s quality assurance system had failed to highlight these shortfalls. We found a breach of regulation in respect of this.
Risk assessment and management plans and care plans, at times, lacked sufficient detail and guidance for staff to ensure they had precise information on how to provide safe and personalised care to people. We made recommendations in respect of that.
The provider had systems and policies to help ensure people were protected from the risk of abuse. The provider managed the recruitment process and carried out appropriate checks to ensure people were supported by suitable staff. Staff received or were scheduled to attend training on safeguarding people and working with people with learning disabilities.
Overall, family members told us the service provided care and support that was required for their relatives. Staff spoke kindly about people they supported. The staff took proactive action to seek the best ways of working with people to ensure the support they provided was safe, effective and enriched people's lives in and outside the service. Staff supported people to have a nutritious diet of people's choice, engage in meaningful activities, and access a health professional when needed.
People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing Support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right Support, right care, right culture.
Right Support:
• Model of care and setting maximised people's choice, control and independence. Staff offered people choices about daily life and helped participate in activities that developed people, for example attending a college.
Right care:
• Care was person-centred and promoted people's dignity, privacy and human rights. People’s privacy was maintained when providing persona care. People looked well looked after and groomed ensuring their dignity was maintained.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. Staff and managers spoke kindly about people and ensured they had sufficient knowledge to support people well.
External health and social care professionals gave positive feedback about the staff and the management at the service. They told us the service communicated well about people and their needs and staff followed professional guidance on how to support people and ensured people participated in activities they enjoyed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 21/11/2019 and this was the first comprehensive inspection of this location.
Why we inspected
We inspected Breakaway Short Breaks as part of our inspection prioritisation programme. We carried out a comprehensive inspection to take an in-depth and holistic view across the whole service, looking at all five key questions to consider if the service is safe, effective, caring, responsive and well-led.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We have identified a breach in relation to management of medicines at this inspection. We made two recommendation about risk assessment and care planning.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
The service has identified which people were in the clinically extremely vulnerable group and whether shielding measures needed to be implemented. Staff wore appropriate PPE and we observed 2 meters of social distancing. Cohorting of exposed and unexposed to COVID-19 people using the service had been risk assessed within the zoned building plan.
There were separate designated areas for donning/doffing PPE. Signage on donning/doffing PPE was visible helping staff to remember where to dispose of PPE.
Weekly COVID-19 tests for both people using the service and staff were carried out as well as instant testing for staff twice per week. Risk assessments had been carried out for people using the service and staff belonging to higher risk groups.
Rooms designated for specific activities such as for visitors were subject to regular enhanced cleaning. Communal areas such as outdoor spaces and garden areas had been used creatively to help with infection prevention and control process. There was good ventilation in all areas.
Only four people were using the service which is half the usual maximum capacity of eight. Therefore the number of people in and out of the home was minimised. There was a process in place to ensure personal items and toiletries were not mixed up or shared across. Each person had ensuite facilities.
The manager liaised with cleaning staff to review processes and make sure they were in line with national guidance. There was a designated room for storage and managing laundry.