This inspection was carried out on 24 August 2018 and was announced.

Creative Support Respite, Thyme Lodge is a care home offering respite to adults with a learning disability. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. The home has five bedrooms over two floors. Rooms have ensuite facilities and ground floor rooms had full wet rooms with ceiling track hoists.

The home 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The home has 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 a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Everyone we spoke with talked positively about the activities undertaken. People had the opportunity to participate in a wide range of activities of their choice. This reduced the risk of people experiencing social isolation.

The registered manager and staff team had undertaken some very good pieces of work to support people to achieve their very personal goals. Staff had developed excellent relationships with people and treated each person individually. Everyone spoke positively about the staff and management team.

The registered provider continued to have safe recruitment practices in place. All staff had completed an induction at the start of their employment and undertaken shadow shifts with an experienced team member. Mandatory training was consistently completed along with refresher training when required in accordance with good practice guidelines. Staff received support through supervision and team meetings. Staff told us they felt well supported.

People’s needs were assessed before they commenced periods of respite at the home. This information was used to create person centred care plans and risk assessments. These documents included clear guidance for staff on how to meet individual people’s needs. People’s needs that related to age, disability, religion and other characteristics were considered throughout the assessment and care planning process.

The registered provider had safeguarding policies and procedures in place. Staff demonstrated a good level of understanding and had all received training. Staff felt confident that any concerns they had would be promptly acted upon. Staff had their knowledge assessed through supervision. The registered provider had developed a ‘Keeping you safe’ document in an easy read and pictorial format.

People had developed positive relationships with the regular and consistent staff that supported them. Privacy and dignity of people was respected and people’s independence was promoted through documentation and interactions observed between people and staff.

Medicines were managed safely in accordance with best practice guidelines. There were medicines policies and procedures in place, staff had all received training and had their competency regularly assessed.

People were supported by staff with their nutrition and hydration needs. When people had specific assessed dietary needs staff had guidance available to meet these. People spoke positively about the food and drink available. We observed a mealtime experience that included many positive staff interactions, comfortable conversation and practical support which was offered as required.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and

The inspection was announced and took place on 31 December 2015. The registered provider was given 48 hours’ notice because the residential service is small. We needed to be sure that the registered manager would be available for the inspection.

Creative Support Respite is a residential care home which offers support to younger adults with learning disabilities, physical disabilities and mental health conditions for respite (short stay). The service provided personal care and support for up to 5 people.

The last inspection of Creative Support Respite was carried out on 22 October 2013 and we found that the service was meeting all the regulations reviewed.

There was 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 told us they felt safe when they stayed at Creative Support Respite [Thyme Lodge]. Comments from relatives included “[Name] is always happy to stay at Creative Support Respite [Thyme Lodge] and the staff understand them well” and “Nothing is too much trouble, it is brilliant”.

Staff had received training in how to recognise and report abuse. All staff were clear about how to report concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were sufficient numbers of suitably qualified staff to meet the needs of the people who used the service.

People were supported to take their medicines by staff that were appropriately trained. People received care and support from regular staff that knew them very well, and had the knowledge and skills to meet people’s individual needs. People and their relatives spoke very positively about staff; their comments included; “The staff are very friendly” and ”Staff are always calm and nothing is too much trouble for them”.

Before people started using the service the registered manager visited them to assess their needs and discuss how the service could meet their support needs. From these assessments individualised care plans were developed with the person and where appropriate, with their relatives to agree how the care and support would be provided.

Care plans provided staff with clear direction and guidance about how to meet people’s individual needs. People told us that the manager was approachable and had always been open to feedback.

People said they would not hesitate to speak to the manager or any staff member if they had any concerns about the service they received. People and their relatives knew how to make a formal complaint if they needed to. One relative said, “I had one small issue but it was resolved promptly and efficiently by the manager”.

There was a positive culture and strong leadership within the service and staff said the manager led by example. Staff said, “The whole staff team and all the management are great” and “I idolise my job and always look forward to work”.

There were quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

Creative Support- St Helens Respite is a recently created service. The service was previously provided by another organisation and as a result the staff and people they supported had been transferred to Creative Support.

The service was less than two months old and a number of areas of improvement had been identified by the management in Creative Support. There were clear plans in place that included staff training and support to make sure that the service increased and maintained quality.

People using the service told us that they felt safe and were supported by sufficient levels of staff to meet their needs. We observed that staff were available in sufficient numbers to meet people’s social needs such as going to a social event. Records showed that staffing levels varied with the assessed needs of people using the service in order to make sure that staff available matched the needs of people staying in the service.

Care plans (also known as support plans) were available. It was explained by the area manager and manager that additional support would be made available to the staff to write care plans specific to people’s individual needs. There were also plans in place from the service in different formats such as pictures in order to fully involve people in their own care/support plans.

During our inspection we observed staff interact with people in a manner that suited their needs and to support people to make choices about the support they were receiving. Examples of this included what food they wished to eat and if they wanted to go out for the evening.