Archived: Ribble Valley Short Break Service

People's experience of using this service: We observed people were relaxed and content in the company of staff and managers. Relatives told us they felt people were safe at the service. Staff had received training on positively responding to people’s behaviours and safeguarding and protection matters. Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns.

Processes were in place to make sure all appropriate checks were carried out before staff started working at the service. There were enough staff available to provide care and support; staffing arrangements were kept under review.

Arrangements were in place to promote the safety of the premises, this included maintenance, servicing and checking systems. There was a good standard of décor and furnishings to provide for people's individual needs, comfort and wellbeing.

Staff followed some good processes to manage people's medicines safely. Some improvements were needed with safe storage of medicines, the registered manager acted on this.

People's needs were assessed, planned for and reviewed. Each person had a support plan which was designed to meet their needs and choices. People were supported with their health and well-being. Where necessary, people received appropriate medical attention.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems at the service supported this practice. People had opportunity to develop their independence skills.

People and their relatives made positive comments about the caring attitude of staff. We observed staff interacting with people in a kind, pleasant and friendly manner. Staff knew people well and were respectful of their choices and preferred routines. People’s privacy and dignity was respected.

There were opportunities for people to engage in a wide range of community and in-house activities. People were supported to keep in touch with their families. Relatives said they were made welcome at the service.

People were offered a variety of meals and drinks; healthy eating was promoted and monitored. Individual needs and choices were known and catered for.

Relatives had an awareness of the service's complaints procedure and processes and were confident in raising concerns. Some complaints records were unclear and didn't properly show how they were investigated and managed. The registered manager confirmed to us, action had been taken to make improvements.

The provider had arrangements to encourage people to express their views and be consulted about Ribble Valley Short Break Service. They had opportunities to give feedback on their experience of the service and make suggestions for improvements.

The provider used a variety of systems, to regularly monitor and improve the service.

Management and leadership arrangements supported the effective day to day running of the service.

Rating at last inspection: Good (published 29 October 2016)

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

Follow up: We will plan a follow up inspection as per our inspection programme. We will continue to monitor the service and if we receive any concerning information we may bring the inspection forward.

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

Ribble Valley Short Break Service provides short term accommodation and support, for up to six people with a learning disability. The house is a detached property in a residential area, towards the outskirts of Clitheroe. Accommodation is provided in six single bedrooms. The two bedrooms on the ground floor are equipped with overhead ceiling hoists and specialist bathing equipment. There is an enclosed private garden area to the rear of the property. At the time of the inspection there were four people accommodated 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 (CQC) 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 inspection on 21 August 2014, the service was found to be meeting the regulations applicable at that time.

During this inspection, people using the service told us they felt safe and staff treated them well. There were enough staff on duty in the home to meet people's care and support needs. Safeguarding adults’ procedures were in place and staff understood how to safeguard people from abuse. Risks associated with care were identified and assessed. There was a whistle-blowing procedure available and staff said they would use it if they needed to. People's medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Staff had completed an induction programme when they started work and they were up to date with the provider's mandatory training. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. There were appropriate arrangements in place to support people to have a varied and healthy diet. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and people's privacy was respected. We observed people were happy, comfortable and relaxed with staff. Support plans and risk assessments provided guidance for staff on how to meet people’s needs and were reviewed annually or in line with any changes in need or circumstance. People were encouraged to remain as independent as possible and supported to participate in a variety of daily activities.

Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care. Regular checks were undertaken on all aspects of care provision and actions were taken to continuously improve people's experience of care.

During the inspection we spent time in the company of people using the service. We spoke with two people who used the service, a relative, four members of staff, the designated manager and a team leader. We considered all the evidence we had gathered under the outcomes we inspected. We have used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found:

Is the service safe?

Processes and practices were in place to safeguard people from abuse and neglect. However, there was a lack of information for people on abuse and protection matters, which would help promote awareness of their rights to be safe from abuse.

There were appropriate arrangements in place to manage people's medicines safely. However we found some improvements were needed with reviews and specific dosage instructions.

Staff recruitment practices were in place to protect people from unsuitable staff. We found the required clearance checks had been thoroughly carried out for the safety and well- being of people who used the service.

Is the service effective?

We found arrangements were in place to assess people's needs and abilities prior to accessing the service. This meant individual needs and choices would be considered and planned for before they used the service.

Records and discussion showed people's health and wellbeing was monitored and they were getting support as appropriate, for healthcare appointments.

Processes were in place for staff to attain nationally recognised qualifications. Staff spoken with, told us of the training they had received.

Is the service caring?

During the inspection we observed staff considerately supporting people with their chosen activities and individual needs. A family member told us 'Their hearts and minds are in it; [my relative] is valued and respected'.

People indicated they were satisfied with various activities and community involvement. Arrangements were in place to offer a range of individual and group activities.

Care plan records were sensitively written in a person centred way; they identified people's needs, abilities and choices. There were actions for staff to follow to respond to people's support needs and preferred routines.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Policies, procedures and a code of practice were available to support appropriate practice around DoLS and the Mental Capacity Act 2005. However, we found the care planning process was lacking in screening and highlighting people's capacity to make their own choices and decisions.

Is the service responsive?

Arrangements were in place to review people's needs, choices and abilities when they returned to the service. A relative commented, 'They are quite responsive. As much as possible, they accommodate outings and stimulation'.

Risks to people's wellbeing and safety were identified and managed, taking account of enabling their choices and their right to take risks.

Is the service well-led?

The service did not have a registered manager. There was a new manager in post who had designated responsibility for the service. There was also a team leader and administrator. Support and expertise was also provided by external management within the organisation.

We found people using the service were involved as far as possible with decisions which affected them personally, both on an informal daily basis, during reviews and through questionnaires.

People who used the service indicated they were satisfied with the care and support they experienced at Ribble Valley Short Break Service. One person said, 'Yes I like it'. In a questionnaire, one relative had commented 'The service received is excellent'.

Regular audit checks were being carried out on various processes and practices. This meant there were systems in place to assess and monitor how the home was operating and to evaluate the quality of the service. However, we found there was a lack of action planning for future developments and on-going compliance with the regulations.

People were being involved in planning and consenting to their support and were enabled to make decisions about matters which affected them.

We found some care records could be made easier to understand, so people could be more involved with planning and agreeing their support.

People were supported to access resources and activities within the community. They were supported to make choices, try new experiences and develop independence skills.

People were getting support with personal care and healthcare needs; they had access as necessary, to health care professionals.

People were provided with a good standard of accommodation which was well kept for their comfort and well-being.

We found the staffing arrangements were sufficient in ensuring people received suitable care and support.

There were systems in place to help support people to make complaints and raise concerns.

People were being involved as far as possible in planning their support and were enabled to make decisions about matters which affected them. We found some information in care plans was lacking in detail. However, arrangements had been made to include more specific instructions for staff to follow.

People were treated with respect and valued as individuals, they were supported to make choices and continue their independence skills.

People were supported to access resources and activities within the community and keep in touch with friends and relatives.

People were getting support with healthcare needs and they had access to health care services.

We found the staffing arrangements were sufficient in ensuring people received effective care and support. Arrangements were in place for staff to receive appropriate training and development.

People were being consulted about their experience of service. We found some checks of the services' various systems and practises had been carried out. We were told further monitoring processes were to be introduced.