The inspection took place at Hyndburn Short Breaks service on the 19 and 20 October 2016 and was completed by contacting relatives by telephone on the 26 October 2016. The first day was unannounced.

Hyndburn Short Break Service is a Lancashire County Council funded short breaks service that provides respite to families by offering short term care, support and accommodation for up to five people living with a learning disability. The home does not provide nursing care.

At the last inspection on the 13 May 2014 the service was found to be meeting the regulations applicable at that time.

At the time of the inspection there was a registered manager at the service. 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 received positive feedback from people using the service, their families and staff members. Everybody we spoke with indicated that staff were caring, respectful and understood people’s needs well. Relatives voiced their confidence in the service and its ability to support their relatives safely and effectively whilst allowing a period of respite.

The provider had processes in place to maintain a protected and suitable environment for all people using the service and visitors. Risk assessments were established to identify any risks associated with areas such as the use of bath hoists, wheelchairs, sharps and substances hazardous to health (COSHH).

Suitable training was offered to staff to ensure they were competent in recognising the signs of abuse and could appropriately and confidently respond to any safeguarding concerns. Staff were aware of how to notify the relevant authorities when required.

The service had satisfactory staffing levels to support the operation of the service and provide people with safe and personalised support. Comments from people using the service, their relatives and staff supported this. Staff were expected to access a variety of mandatory and additional training which ensured they were skilled and experienced in safely and effectively supporting all people using the service.

Recruitment procedures were in place to ensure appropriate steps were taken to verify new employee's character and fitness to work. New employee induction processes were robust and staff were required to complete an additional Lancashire County Council induction prior to commencing employment. This process ensured the correct amount of detail to provide them with the knowledge to carry out their support role effectively. People spoken with and their relatives felt that staff knew their needs well. Staff demonstrated a good understanding of their role and how to support people based on individual need and in a person centred way.

The provider had appropriate processes in place for the safe administration of medicines; this was in line with best practice guidance from the National Institute for Health and Care Excellence. Staff were adequately trained in the administration of medicines and all medicines were stored securely and safely.

Each person had their own individual care file containing documents such as support plans and risk assessments and a personal profile. These records gave clear information about people's needs, wishes, feelings and health conditions. Changes to people’s needs and requirements were communicated well which meant staff were kept up to date with any changes.

Staff were aware of the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These provided legal safeguards for people who may be unable to make their own decisions. The management team also demonstrated their knowledge about what process they needed to follow should it be necessary to place any rest

The inspection was undertaken by the lead Inspector and we met with the Registered Manager of the service. We gathered evidence against the outcomes we inspected to help us answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection and discussions with people who used the service. We also spoke with the team leader, staff members and we looked at records.

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

Is the service safe?

Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to record and review complaints, accidents and incidents. This should help reduce the risk to people and help the service to continually improve.

The home had policies in place in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff understood the need to seek consent from people before they provided any care. This should help ensure people’s rights were safeguarded.

Recruitment procedures were safe and thorough. Staff were supported to gain appropriate skills and knowledge for their role. This should help ensure people received safe and appropriate care.

Is the service effective?

It was clear from our observations and discussions with staff that they knew people well and had a good understanding of their care and support needs.Staff had received training to meet the needs of people who used the service.

Specialist dietary, mobility and equipment needs had been identified in care plans where required. Risk assessments were regularly reviewed and care plans amended to reflect people’s changing needs.

Is the service caring?

People were supported by kind and attentive staff. We observed staff took care to support and protect people.

Is the service responsive?

People’s needs had been assessed before they arrived at the service. Records we looked at showed us people had the opportunity to meet with their key worker to review their care.

Systems were in place to ensure staff had access to up to date information regarding people’s needs. This should help ensure they were supported to respond appropriately to any changes to a person’s condition.

Is the service well led?

The service worked well with other agencies to make sure people received the care they needed. This information helped to ensure the person was provided with the care they required during their planned stay.

Quality assurance processes were in place in the home. Records we looked at showed us people had completed a satisfaction survey. People who used the service were regularly asked their opinion about the service. Regular meetings were held with staff. These provided the opportunity for staff to discuss any concerns or practice issues in the home.

From our discussions with relatives of people who used the service we were assured that staff treated people with respect and communicated with them regularly.

We reviewed information about two people's care and found that their care needs were being planned for. We found that the staff understood people's care needs and how to protect them from risk and harm.

Records we looked at did not demonstrate that people's needs and risk assessments were updated and care and treatment was not planned prior to every visit to the service using up to date assessments. Information held in the care plans was not current and relied on historical risk assessments undertaken at the time the person used the service.

The lay out of the care plans were not person centred and would benefit from an easy read format to enable greater accessibility to the people who use the service.

We found that there were effective systems in place for the safe storage and administration of medicines.

We saw that there were effective recruitment procedures in place to ensure that people who used the service were protected from harm through good staff recruitment.

There were no people who use the service available to meet with us when we visited. We did review records including details of the last survey conducted with relatives of people who had used the service previously. These indicated that there was a good satisfaction response from all of those contacted.

By reviewing records we found that people were given a choice about what care and support they received. Staff had been trained in assessing people's mental capacity and people's right to make decisions about their care and support for themselves.

Medical and personal needs for each individual were noted in their care plans. Staff were trained in handling medical emergencies and were briefed on the specific medical needs of individuals using the service.

Appropriate numbers of skilled staff were assigned to each shift to meet the particular needs to the individuals using the service. Staff received appropriate training in providing care and support, as well as specific training in caring for people with learning disabilities.

Accurate records were kept of what medications people had taken and when. Care plans contained full details of people's medical and personal needs, their preferences for how they wanted to be cared for and supported, as well as what care and support had been provided during a respite stay.