The unannounced inspection took place on 29 March and 5 April 2017. We last inspected the Calvert Trust Kielder in May 2016. At that inspection we found the service was in breach of Regulation 12 in connection with the safe management of medicines.

The provider sent us an action plan to show us how they were going to address the concerns we had found and we returned to check they now met all of the regulations. We also visited to follow up on a safeguarding concern which had been raised although the investigation was not yet complete. We will report on this in due course.

We found that the provider had improved their medicines procedures and were now meeting Regulation 12. Medicines were managed safely. Only trained staff administered medicines. People confirmed they received their medicines at the correct time.

The Calvert Trust Kielder complex is set up to provide residential respite care with the main focus being on adventure activities for up to 20 people with various healthcare needs. At the time of our inspection there were six people who had a range of physical and learning disabilities using the service.

The service is based in the Kielder forest area with people staying for one or two weeks, with some choosing to stay longer. The service is used by people from all areas of the country and because the service is part of a larger complex, accommodation and activities is extended to other people and their families on the same site including those who are both able bodied and those less so.

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.

People said they received good care from kind, caring and considerate staff. They also confirmed they felt safe while visiting and staying at the service. Relatives and staff also told us the service was safe for people to stay at.

Staff knew how to report safeguarding concerns and we found the provider had dealt with previous safeguarding concerns appropriately.

Where potential risks had been identified an assessment had been completed. The benefits of people taking risks and the measures needed to keep them safe were considered as part of the assessment.

Accidents and incidents were logged and investigated with appropriate action taken to help keep people safe. Health and safety checks were completed and procedures were in place to deal with emergency situations.

We found there were sufficient staff deployed to provide people’s care in a timely manner. People, relatives and staff felt staffing levels were appropriate. There were effective recruitment checks in place to help ensure staff were suitable to be employed at the service. Staff received the support and training they required and records confirmed training, supervisions and appraisals were up to date.

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 in the service supported this practice and were currently being reviewed.

People gave positive feedback about the meals and refreshments available to them. We saw people received the support they needed with eating and drinking.

The service was adapted to suit the needs of people with a range of disabilities, with an emphasis on enabling people to participate in the wide range of outdoor and indoor activities by providing specialist assistance and equipment.

People’s needs were assessed to enable personalised care plans to be developed. Care records contained details of their preferences. Care plans were in the process of being fully reviewed to keep them up to date.

Meetings were held so that people could share t

The unannounced inspection took place on 13 and 17 May 2016. We last inspected Calvert Trust Kielder in January 2014. At that inspection we found the service was meeting all the regulations that we inspected.

Part of the Calvert Trust Kielder is set up to provided residential respite care with a focus on activities, for up to 20 people with a range of disabilities. At the time of our inspection there were 12 people who had a range of physical and learning disabilities using the service. The service is based in the Kielder forest area and people are able to use the service from any location in the country and usually stay for one to two weeks, but can stay longer if they wish. The service is part of a larger facility on the same site which provides holiday accommodation/activities to people and their families and day activity breaks to a variety of groups including those who are not disabled. This part of the service is outside of the scope of our regulations.

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.

We found some areas of the management of medicines needed to be improved. For example, there was not always information regarding 'as required' medicines, staff did not fully detail individual medicines on people's medicines administration record and risk assessments were not always in place. The provider sent us an updated version of their medicines policy but we were not able to see the new practices and audits in place and will return to check this at a future date.

Staff were aware of safeguarding responsibilities and knew how to implement safeguarding and whistleblowing procedures. The provider took safety seriously and risks identified were assessed and reviewed and people were kept as safe as possible. Accidents were recorded, reported and monitored by the provider.

We found the provider had already undertaken some refurbishment work within the hydro pool area but that there was more to complete. The provider told us that this was due to be completed in the near future.

There were enough staff employed at the service who had been recruited safely, who received appropriate support and who were continually trained to meet the needs of the people using the service.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. We found the provider was complying with its legal responsibilities.

People were able to enjoy enough food and refreshments to meet their needs and if people needed additional support from staff, this was provided. Special dietary needs were also catered for.

We observed staff speaking with people in kind, respectful and reassuring ways. People told us they felt their dignity and privacy were respected by staff. They also told us staff encouraged them to be as independent as possible and involved them with the running of the service and to be fully informed as to what was happening.

People’s had been assessed for their needs and their care records were detailed and had been updated as the need arose.

The provider had a large range of outdoor and indoor activities for people to participate in. People told us that this was the main reason for coming to stay at the service.

The provider had in place a complaints policy and people were aware of how to use it. We found

We spoke with people who were in the accommodation for a lunch break between activities.

People spoken with said they were happy at the service. People said they chose exactly how they spent their day. One person said “I have decided not to go sailing, it’s not my thing so I’m staying here reading a book”. Another person told us “I might try the ‘Go Wild’ week next time I come. You can choose not to do the activities, let’s face it, this is my holiday, if I didn’t like it I wouldn’t come back".

People confirmed that they enjoyed the food and they felt well looked after. One person said “nothing is too much trouble here, the staff are fantastic”.

People confirmed that they were consulted by the service and encouraged to give their opinion. One person said “you get a questionnaire to fill in when you finish your stay or you can go on the website when you get home”.

During our inspection we spoke with two people who had used the service recently and two relatives. We examined the care records for three people.

People told us that consent was gained before care was delivered.

We found people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plans. One relative said, “I absolutely trust them to care for X, I know I can go on holiday and they will do anything and everything to support X.”

Records were available to show that the manager monitored the administration records of medication. This meant that people’s medicines were checked regularly by the manager to see that staff were administering and disposing of them properly.

People were cared for by staff who were supported to delivered care and treatment safely and to an appropriate standard. One relative said, “The consistency of the staff is a brilliant thing, they are all so knowledgeable. They have a solid staff group and to me that is a real indicator of the service.”

We found that the provider had an effective complaints procedure in place and this was advertised clearly throughout the service. All staff we spoke with told us they were aware of the complaints procedure and would support any one who wished to raise any concerns.