This inspection visit took place on 17 May 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service to people. We needed to be sure that we could access the office premises.

At the last inspection in November 2015 we asked the provider to take action to make improvements because of recommendations we made about the service. This was in relation to recruitment practices and induction training for new staff. In addition we found gaps in their auditing systems to monitor the service. During our inspection visit on 17 May we found the provider had addressed all the concerns and was now meeting the recommendations.

Holidays with Care Ltd is a personal care service supporting people with a range of disabilities and special needs whilst staying at the Bond Hotel in Blackpool. The agency will support people with their personal or social care needs during their stay.

There was a registered manager in place. 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.

No new staff had been recruited since the previous inspection. However we looked at recruitment of two staff currently going through the process. We found appropriate checks were being followed through. Also they had reviewed their policies for recruitment and improved their procedures to ensure suitable staff were employed. In addition all checks were to be completed prior to personnel starting employment at the service.

We found medication procedures at the service were safe. Staff who would be responsible for the administration of medicines had received training to ensure they had the competency and skills required.

Risk assessments had been developed to minimise potential risk of harm to people during their stay at The Bond Hotel.

Induction training for staff was now in place and updated to ensure new staff were trained well to start their role at the agency.

The registered manager and provider had improved their range of audits recommended from the last inspection so they could monitor the service better. For example regular audits took place such as, medication, care plans and staff training. This ensured the quality of the service could be measured and improvements made where required.

We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to provide safe care for people

The service had a complaints procedure which was made available to people when they received a service. People we spoke with told us they were happy and had no complaints.

Staff, people who received a service and relatives told us the registered manager was supportive and approachable. The management team met with people and provided opportunities for them to comment about the quality of their care.

We carried out this review to check The Bond Hotel had taken action in relation to: -

Outcome 4 – Care and welfare of people who use services

Outcome 14 – Supporting Staff

This was because the service was not compliant at the previous inspection.

We spoke with a range of people about The Bond Hotel. They included the manager, staff and people who received support. We also had responses from external agencies including the local authority contracts team. This helped us to gain a balanced overview of what people experienced whilst accessing the service.

We saw people were relaxed and happy during our inspection. The service had introduced new pre-assessment and risk assessment documents. These ensured people who accessed The Bond Hotel received safe and appropriate care and support. Records we checked demonstrated that staff had received training and supervision on a regular basis. This meant staff were able to carry out their duties effectively.

During our inspection we looked at how people were being supported by the agency during their holiday at The Bond Hotel which provides the regulated activity, personal care. We also looked at what systems were in place to protect people from harm or abuse. What support systems were in place for staff. How the service monitored quality and how complaints were managed.

This helped us gather sufficient evidence to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, staff supporting them, relatives and from looking at records. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced when using Holidays with Care Ltd.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us that they felt safe. We were told that staff were kind and caring. People also told us that they felt respected by the people that supported them and that their dignity was protected.

Not all records for risk management had been completed which had the potential to affect people’s level of care and pose risk. For example a risk assessment record for moving and handling, as well as using equipment had not been completed in full to show the level of risk for the person. This also had the potential to put staff at risk by not knowing the level of risk for that person. In another instance there was no instruction for staff to know what level of support people required when taking medication or applying creams. For example, some people self- medicated, others required staff to administer their medication and in other instances staff prompted people to take their medication.

Is the service effective?

By speaking with people and looking at records we could see that each person’s health and care needs had been assessed prior to the service commencing. This was to make sure that the agency could provide the level of care and support required.

People were receiving care and support from the same staff who understood their needs so that it was delivered at the right time, usually by the same people and in ways they wanted. One person told us, “It’s lovely to have the same staff. They get to know what I like and don’t like”.

Is the service caring?

We spoke with the three people currently receiving support from Holidays with Care Ltd at The Bond Hotel. This also included a relative of one person being supported. They all spoke positively of the care and support provided by the staff team. One person told us, “I can’t fault the staff at all. They are brilliant”. Another person said, “I think I made the right decision coming here for a holiday. It’s more than that because the staff are so caring and support me every day”. Another person had limited communication. However we were able to see by their responses and smiles that they were happy with the care and support they were receiving”.

When speaking with staff they demonstrated their commitment in providing good quality care for people they supported. One staff member said, “It’s a job I love doing. It’s nice to want to come to work everyday”. Another told us, “Every week is different. You meet such lovely people and its nice supporting them to have a lovely holiday”.

Is the service responsive?

We saw that people had been provided with a copy of the agency’s brochure and complaint procedure when they made their bookings. This informed them of what service were available to them when they stayed at The Bond Hotel.

The service was able to demonstrate how they responded to complaints and act on the areas raised with them, in order to determine the outcome and review practices if necessary.

The agency listened to what people’s choices were in order to respond to the level of care and support identified. One person told us, “The staff are always there when you need them”.

Is the service well led?

There were quality audit systems in place however they were currently being reviewed and therefore information was limited. However, comments we received from people using the service and by talking with staff, confirmed their views on the service were regularly sought. Staff told us the manager constantly communicated with them and informed them of changes where necessary.

People we spoke with said they received a good quality service at all times. Comments included, “It’s an important lifeline for me. I can’t fault it”.

The manager supported staff in their roles through regular communication. However there were no records to support supervision or appraisal had taken place. This meant the provider could not demonstrate staff support had taken place and what was included in the support.

We spoke with people who used the agency. People told us,” It is a well organised caring service.” A second person told us, “The carers did seem well informed and experienced.” A third person told us, “I was very pleased with the whole attitude of the care staff. It is much harder on holiday than at home because the facilities at home are specific to meet our needs.”

A pre assessment and care planning was undertaken by phone. This was because many people were not local and used the agency to support them to participate on holiday. Each time people used the agency their care plans and risk assessments were reviewed. People were fully involved and consulted regarding their care and support.

There were contingency measures in place regarding emergency care people may require. The agency used the local walk in health centre, hospital, pharmacy and District Nurse team. There was an emergency on call system available for staff for advice and guidance.

We looked at three staff files to see if the agency had safe recruitment processes in place. There were application forms, references checks and the agency had undertaken Disclosure and Barring checks (DBS) for all three staff.

There were a range of audits and systems in place to monitor the quality of the service being provided. We noted that access to offices where information was stored was always locked and information stored on the computer was password protected.

This inspection visit at The Bond Hotel took place on 05 and 06 November 2015 and was announced. 48 hours’ notice of the inspection was given because the service is small and we wanted to ensure people were staying at The Bond Hotel.

The Bond Hotel provides a personal care service supporting people with a range of disabilities whilst staying at The Bond Hotel in Blackpool. The service supports people with their personal or social care needs during their stay. At the time of our inspection there were three people receiving personal care.

There was no registered manager in place. 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. The previous registered manager had resigned in October 2015. The provider was in the process of recruiting a new registered manager to the vacant position.

During this inspection, feedback from people who used the service was very positive. Two people told us the level of care they received was as good a standard as the care they received at home. People told us they felt safe when using the service. Staff demonstrated they had a good understanding of the needs of people they supported.

Staff employment, induction and training records in their files were incomplete. This meant we were unable to confirm if staff had been recruited safely and been supported through a formal process of induction. With the exception of a recently recruited staff member, records viewed confirmed other staff had received safeguarding vulnerable adults training. The provider had identified there were some shortfalls in their record keeping. One director had recently initiated developing a training matrix; although this had not been completed. An up to date training matrix would assist the provider to monitor the training they provided and address any gaps. We have made a recommendation about the safe recruitment and induction training for new staff.

People told us staff were friendly and caring. We found members of the staff team were welcoming and there was a friendly atmosphere in the hotel. People were supported to comment about the support they received, by completing a questionnaire at the end of their holiday.

We found there were safe staffing levels to meet people`s needs and contingencies in place in case of an emergency.

Care plan records showed us people were involved in their care and had discussed and consented to their care support. We found staff had a received training regarding the Mental Capacity Act 2005 (MCA). We have made a recommendation about the assessment of people’s mental capacity.

Since the last inspection, the provider had undergone a major restructure in the management and operation of the business. A new management team was in place, who accepted there had been shortfalls in the services they provided. They had arranged to attend training to support them with their responsibilities in relation to recent changes in Health and Social Care. Although there were quality monitoring systems in place we did identify some gaps in their monitoring systems.