This inspection visit took place on 15 August 2017 and was announced to assist us speaking with people who used the service and their representatives.

Preston Short Break Services can accommodate up to six people with a learning disability and/or a physical disability at any time for a short stay. Showers, bathrooms and four of the bedrooms are designed to meet the needs of people with a physical disability, having specific equipment and overhead tracking. As well as the main kitchen, lounge, dining area and conservatory, there is an area which includes a smaller kitchen with a lounge and dining area, that can be separated from the main part of the building should this better meet people’s needs.

At the last comprehensive inspection on 25 November 2014 the service was rated overall as good.

At this inspection we found the service remained good.

At this inspection visit there were six people staying at the service. Approximately 60 people used the service for short stays throughout the year. There have been occasions where people have stayed for an extended period of time which had reduced the capacity of the service for short stays and had caused some short stays to be cancelled by the service.

As part of the inspection we spoke with seven people who had short stays at Preston Short Break Services and twelve relatives.

People told us staff were caring and helpful. They said they felt safe at Preston Short Break Services and enjoyed going there.

There were procedures in place to protect people from abuse and unsafe care. Staff were familiar with these and had received training in safeguarding adults. We saw risk assessments were in place which provided guidance for staff. These measures minimised risks to people.

Recruitment was safe. There were sufficient staff available to provide people with personal care and social and leisure activities.

Staff received training to support and care for people. They had the skills, knowledge and experience to provide safe and effective support.

Staff managed medicines safely. Medicines were stored securely, administered as prescribed and disposed of appropriately.

The service was clean and hygienic and staff used appropriate protective clothing to reduce the risk of infection to people.

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.

People told us they were happy with the variety and choice of meals available to them. Staff knew people’s food likes, dislikes and any health or cultural requirements people had.

Care plans were personalised detailing how people wished to be supported. Their consent and agreement had been sought before providing care.

People who received support or where appropriate their representatives had been involved in making decisions about their care. Where people were unable to make their own decisions independent advocates were available.

People knew how to raise a concern or to make a complaint. The complaints procedure was available in text and easy read formats. People said they were encouraged to raise any concerns.

Senior staff monitored the support staff provided to people. Audits of care and support records and risk assessments were carried out regularly. People were encouraged to give their views informally. They and where appropriate their relatives were invited to complete surveys about the quality of their care.

The three people staying at the home had specific communication needs which made it difficult for them to express their views. Staff clearly knew people well and had developed communication skills to overcome this. People appeared comfortable and relaxed in the company of staff.

During our inspection we spoke with two relatives. Comments included; “We are very happy with the service.” And “The communication is good. We are kept informed.”

Each person had a medication profile and risk assessment. Medicines were securely kept, handled appropriately and safely administered.

There were safeguards in place to protect people's finances. Robust recruitment checks were conducted before new staff commenced work. Staff training, written guidance and good practice helped to safeguard people against the risk of abuse.

Staff received appropriate training and supervision, which helped to ensure they delivered care safely and to an appropriate standard.

Feedback surveys, completed by people using the service or their representative, contained many positive comments including; “The level of care is outstanding.”

There were 4 people staying at the home at the time of our visit. Due to communication difficulties, only one person was able to tell us their views about the service provided. We did spend some time with another individual, who appeared to be happy and relaxed.

The person we spoke to told us that they were staying at the home for two nights and that staff would be supporting them to attend their regular social activities the following evening, as they still liked to go to these events and keep in contact with their friends, even when staying away from home. They also told us that they enjoyed helping in the kitchen and were looking forward to doing some baking that evening. We were told that they looked forward to their short breaks at the home and they liked to telephone beforehand to discuss their plans and see who would be on duty. They were happy with the support provided by staff, who were helping this person to develop their independence, community networks and personal relationships.

Staff were observed to be welcoming when greeting people coming to stay at the home. Staff appeared to know people well and the interaction was warm and friendly, creating a relaxed atmosphere. We looked at feedback from surveys which had been sent to people who use the service/or their relative. These contained much positive feedback about the staff team and the quality of service provided. We were told that staff were helpful and kind.

People were able to request their preferred bedroom when they stayed at the home and staff told us that as far as possible these preferences were met. We saw that soft furnishings and accessories had been removed from one bedroom, to meet the needs of an individual staying at the home.

The relative we spoke to was very happy with the support provided at the home telling us they were invited to reviews and found staff to be approachable.

We found that people were receiving personalised care and support.

This inspection took place over two days on 25 and 28 November 2014. It was unannounced on 25 November 2014 and announced on 28 November 2014.

The last inspection of this service took place on 25 July 2013 when the service was found to be compliant with all regulations inspected.

Preston Short Break Service is registered with the Care Quality Commission (CQC) to provide accommodation for persons who require personal care. The home is a purpose built bungalow which can accommodate up to six people with a learning disability and/or a physical disability on a short term basis. Showers, bathrooms and bedrooms were designed to meet the needs of people with a learning or physical disability. One area could be divided off into a separate annexe, allowing for people to be supported in two groups, should this better meet their needs.

A registered manager had been in post since November 2011. 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 who stayed at Preston Short Breaks Service told us that they felt safe and well looked after. Relatives/carers we spoke with also confirmed this. All believed the service was unique and that their relative/friend was safe from abuse.

Policies and procedures were in place to protect people. Staff we spoke with told us they had all received training in in the safeguarding of vulnerable adults and were able to explain to us how they would deal with and report suggestion of abuse.

We saw that the service operated a system of ‘staff matching’. This ensured that the correct numbers and most appropriately trained members of staff were on duty to support each particular person who stayed there in order to keep them safe. Robust recruitment and selection procedures were in place. Records we looked at confirmed this.

The service did not store medication and people brought their own medication with them. We did see that procedures were in place to make sure people received their medicines in a safe way whilst using the service.

We were shown around the whole building as part of the inspection. The home had been purpose built and each room was fitted with a wide range of specialised innovative equipment to cater for any number of disabilities and conditions to keep people safe from harm.

People who used the service and their relatives/carers told us they felt staff had the skills and knowledge to support them. Staff told us they had received a comprehensive induction to the service which included essential mandatory training such as moving and handling, infection control and health and safety. Specialist training around more complex medical conditions had been received in order to support them and improve their skills.

Staff received regular supervision which included one to one meetings with their line manager as well as annual staff appraisals. Staff meetings took place and staff told us they liked working there and felt listened to.

Relatives/carers told us that with peoples’ consent they were consulted as part of the process of decision making relating to the care and support of their relative/friend.

Where people lacked the capacity to consent to their care and support we saw that Preston Short Break Service had policies and procedures in place around the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This legislation is designed to protect people who are unable to make decisions for themselves. It was clear from talking to staff that staff they fully understood the principles of the MCA and DoLS.

As people used this service for breaks or holidays, people chose their own food and drink. Staff informed us that they tried to encourage healthy eating but in the end people made their own choices.

People, their relatives/cares and health and social care professionals we spoke with all confirmed that people who stayed at the service were able to see doctors, dentists and other health people if needed.

People we spoke with told us they were happy with the care and support received. We were told care was provided from familiar and consistent care staff that were kind and caring. Staff demonstrated a good understanding of the needs of people who stayed at the home. We saw staff respect people’s privacy.

People’s records were updated by way of conversations with relatives/carers and professionals before a person returned. People who used the service and their relatives/carers were actively encouraged to share their views. One of the relatives/carers we spoke with said that they had been involved and consulted about the building since day one.

Documents and forms were available with pictures and symbols, to aid the understanding of people with learning disabilities. Relatives/carers we spoke with both praised the unit and the staff, one person told us her relative was terminally ill and the staff did a tremendous job caring for her.

We saw that support plans for people were person centred and included preferences, routines, likes, dislikes and how best to provide the necessary support. Initial referral to the service was followed up by a home visit. This involved the person concerned, family friends and professionals from other services to obtain as much information as possible.

Before a person arrived the registered manager or team manager matched the support workers to the individual’s needs and each person had a key worker responsible for them. This meant that people received consistent support during their stay from care staff who knew them.

Activities at the service were dictated by the wishes to the individuals who stayed. People we spoke with told us there was enough for them to do.

We saw that Preston Short Breaks Service had policies and procedures in place to deal with any complaints made about the service. Information for people was produced in an easy to read format and gave details of how to complain and to whom. There were no outstanding complaints at the time of our inspection.

Staff we spoke with told us they liked working at Preston Short Break service. Staff told us they were able to air their views and were listened to. All the people we spoke with told us how the management and registered manager created an informal, approachable and atmosphere.

The business support officer for the service was able to tell us about a range of surveys completed to ensure the service met the needs of people who stayed there. People we spoke with who stayed there told us: “Yes I get a yearly survey and you get phone calls”.

Regular audits and checks were carried out by the registered manager and team manager for the home. These helped to ensure that high standards were maintained. Records evidenced that safety checks took place.

The home was also subject to internal inspections and audits by the organisation, for instance the regional manager visited the home on a frequent basis.