Archived: Alison House Short Breaks Service

Updated 14 January 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

Prior to the inspection we asked the provider to complete a Provider Information Return (PIR). The PIR is an important element of our new inspection process. It helps us plan our inspections by asking the provider to submit data, and some written information under the five key questions: Is the service safe? Is it effective? Is it caring? Is it responsive? And is it well led? We received this information and were able to review this and other information we held about the service before we carried out the inspection. We also spoke to the local authority commissioning team who provided us with information about recent contract monitoring visits and safeguarding investigations.

We carried out an unannounced inspection on 17, 18 and 20 October 2014. The inspection was carried out by a single inspector.

At the time of our inspection the service did not have a registered manager. During our visit we spoke with four support workers, a team leader, a contracts manager and an operations manager. We were unable to speak to people who use the service at the time of our inspection but we did undertake general observations in communal areas as people were getting ready to attend day services or activities in the community. We spoke to the relatives of four people who use the service. We reviewed the care records of three people who use the service and records relating to the management of the service such as audits, meeting minutes, accident and incident records and letters of complaints.

After the inspection we spoke with two health and social care professionals from a local authority learning disability service involved in the care of people who use the service.

Updated 14 January 2015

We carried out an inspection on 17, 18 and 20 October 2014. The inspection was unannounced. At our last inspection on 25 November the service met the regulations inspected.

Alison House Short Breaks Service provides short term respite accommodation and support to adults with physical and/or learning disabilities aged 18-65 years. The service has five bedrooms which are all wheelchair accessible. The service is staffed 24 hours and provides personal care but not nursing care. At the time of our inspection three people were using the service.

The service did not have a registered manager. 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 and associated Regulations about how the service is run.

Staffing levels were determined according to the needs and dependency levels of people who use the service. Staff had qualifications in health and social care and/or previous experience of working in care settings. We were told new staff were required to complete a five day induction programme prior to working with people who use the service.

We found that some staff had not completed relevant training prior to working with people using the service. As a result some staff were not familiar with service policy and procedure regarding emergency response particularly in the case of what to do if someone was choking or having an epileptic seizure. This meant there was a breach of the relevant legal regulation and you can see what action we told the provider to take at the back of the full version of the report.

People’s needs were assessed and care plans were developed to identify what type of care and support people required. People were involved in making decisions about their care wherever possible. If people were unable to contribute to the care planning process, staff worked with people’s relatives and sought the advice of healthcare professionals to assess the care they needed. Some of the care plans we looked at had not been signed or dated making it difficult to confirm whether plans had been reviewed as per the service’s policies and procedures.

Medicines were not always managed safely. We saw that staff were not always following the correct procedures regarding the logging, storage, administration and recording of medicines. This meant there was a breach of the relevant legal regulation and you can see what action we told the provider to take at the back of the full version of the report.

We saw that incidents and accidents were logged appropriately but it was not always clear what steps were taken to reduce the risk of incidents reoccurring.

There were processes in place to monitor the quality of the service and action points were used to identify required improvements.  However, audit records we looked at often lacked any clear indication as to who was responsible for actioning recommendations and the timescales required for this action.

We observed staff supporting people to engage in activities and prepare for attendance at day centres. A range of activities were on offer at the service. However, people indicated via written feedback forms that they would like more access to the local community and more indoor games, computer facilities and activities.

Staff were patient and polite when supporting people who used the service. Staff supported people to maintain their dignity and were respectful of their right to privacy. Relatives of people using the service told us they felt their family members were well looked after and safe.

Staff were knowledgeable about how to recognise the signs of potential abuse and aware of the appropriate reporting procedures. We found the provider was meeting the requirements of the Deprivation of Liberty Safeguards. Staff had been trained to understand when an application should be made, and how to submit one.

Staff felt supported by their team leaders and were open to suggestions on how to improve the service from people who use the service, their relatives and visiting professionals.