About the service: Sherrick House is a respite and short breaks residential care home run by Barnet Mencap. The home is registered to accommodate up to four people and on the day of the inspection, there were two people using the service.

People’s experience of using this service:

People received personalised care. Comprehensive care plans had been developed which reflected people’s wishes on how they wanted to be supported.

People were supported by kind and caring staff who worked hard to promote their independence and sense of wellbeing.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; people's support was focused on them having as many opportunities and choices as possible.

Risks to people's health, safety and wellbeing were assessed and management plans were put in place to ensure these were reduced as much as possible. However, we found concerns with an aspect of building safety which was resolved following the inspection. People received their medicines as prescribed.

There were sufficient staff available to support people within the home and in the community. Staff were safely recruited.

Staff had received appropriate training and supervision. Staff felt supported by the management team and were encouraged to contribute ideas for improvement of the service.

We found some safety concerns in the home as there were no window restrictors to prevent falls from windows. We received confirmation following the inspection that this was addressed.

The newly employed manager was actively working to improve the service.

Rating at last inspection: Good (Report published 20 October 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect the service sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 20 September 2016. This was an unannounced inspection. We last inspected the provider on 31 July 2014 when we found the provider was meeting all the areas that we looked at.

Sherrick House is a respite care home run by Barnet Mencap. The service provides a respite care home service for adults with a learning disability or autistic spectrum disorder. Autism is a lifelong condition that affects how a person communicates with and relates to other people, and how they experience the world around them. At the time of our inspection, four people were staying at Sherrick House.

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 using the service told us they enjoyed their stay at the service and that it felt like home. Their relatives said their family members liked staying at the service and got on very well with the staff team. People’s relatives told us their family member’s health and care needs were met, and staff treated people with dignity and respect. Staff were able to demonstrate the needs and preferences of the people they cared for by giving examples of how they supported people.

People’s care plans were person-centred and recorded people’s needs, abilities, likes and dislikes. Risk assessments were individualised and gave information on safe management of the risks. Care plans and risk assessments were regularly updated and reviewed. There were clear records of care delivery. The service managed people’s medicines well and kept clear records of medicines administration.

Staff had a good understanding of the safeguarding procedure and were able to demonstrate their role in raising concerns and protecting people from harm and abuse.

The service followed safe recruitment practices and there was sufficient staffing to safely meet people’s needs. The service had people’s criminal record checks details and renewed them every three years. Staff told us they were supported well and we saw records of staff supervision and appraisal. Staff told us they attended induction training and additional training, and records confirmed this.

The service had efficient systems and procedures in place to assess, monitor and improve the quality and safety of the service delivery. There was evidence of regular monitoring checks of the service.

We considered all the evidence we had gathered under the outcomes we inspected. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?

We met with all four people who were staying in the home and spoke with three people, some relatives and three members of staff. The registered manager was not on duty at the time of our inspection.

This is a summary of what we found:

Is the service safe?

People felt involved in making decisions about their care and treatment. They were supported by skilled and experienced staff, who ensured people’s needs were being met. Staff had knowledge of each person's behaviour patterns and care needs and assisted them appropriately. The staffing level and skill mix of staff was adequate.

People were cared for in a clean and comfortable environment which was secure and well maintained. Equipment had been appropriately checked and serviced. Fire equipment had been serviced regularly.

Staff confirmed they had received training on the protection of vulnerable adults, and were able to give an account of the procedures they would follow if they had concerns about safeguarding issues.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which apply to care homes. Staff had received training and had an understanding of when an application under DoLS should be made and how to submit one to be authorised by the local authority. There had been no DoLS applications since the last inspection.

Is the service effective?

People’s personal, social and healthcare needs had been closely monitored and provided for. We observed staff interacted well with people, who understood what staff said to them. People responded positively with sign language or verbally if they were able to. Their care needs had been reviewed regularly and risk assessments had been carried out, where appropriate.

The service had worked closely with people’s relatives, the local authority and other healthcare professionals to ensure people received appropriate care and treatment.

Staff said people had been encouraged and supported to lead independent lives and staff gave support and assistance accordingly. A member of staff said, “People are encouraged to lead an independent lifestyle.” Staff had received appropriate training to enable them to meet people’s personal, health and social care needs.

Is the service caring?

All four people who were using the respite service at the time had a learning disability and some had severe speech impairment and were therefore non-verbal. However, their facial expressions and gestures indicated they were content and happy to have a short break. One person who was able to converse said, “I am fine. The staff are good.”

People were treated with respect and were made welcome when they returned from the day centre. People were given choices. We observed staff offering them a choice of drinks as they relaxed and waited for their evening meal. We observed a member of staff offering each person a choice of menu before the evening meal was prepared.

A relative said, “The staff are absolutely wonderful and I am very happy with the whole arrangement; my (relative ) is very happy and I get a break too.” Another relative said, “Staff are always polite and very supportive. We are very pleased with the service. My (relative) loves staying there.”

Is the service responsive?

People were treated with respect and dignity and were encouraged to get involved in making decisions and staff respected people’s wishes and preferences. The weekly activity records were detailed and reflected each person’s preferences and lifestyle.

People had access to a choice of community activities and holidays organised by staff. People’s and their relatives’ suggestions had been taken into consideration when activities and holidays were planned.

One relative said, “We phoned the service nearly every day whilst our (relative) was in respite care and staff were always friendly, reassuring and happy for us to phone to enquire about our relative’s welfare.”

The care records showed people’s needs had been assessed and regularly reviewed. This enabled staff to provide appropriate care and treatment when people returned for respite care. Staff signed a log book to show they had read the updated care plans.

Is the service well-led?

Staff had a good understanding of the provider’s ethos in providing a respite service. They were clear about their roles and responsibilities. Staff told us management was supportive and staff had been consulted before changes were implemented. There had been regular team meetings to discuss any issues or concerns raised about practices and any lessons to be learnt so as to improve the service.

People had been given choices and their wishes had been respected. Relatives confirmed there had been regular customer satisfaction surveys and their suggestions had been listened to and changes had been made to their satisfaction.

The provider had an effective monitoring system in place to ensure people lived in a safe environment where staff provided safe and appropriate care and treatment.

At the time of our inspection there were three people using the service. Two people were getting ready to attend a day centre. We were not able to speak to all the people who use the service because they have complex needs. We observed some good interactions between staff and people using the service. For example, one person getting ready to attend day centre appeared comfortable with staff and content. We spoke with six relatives who told us that they were happy with the quality of care provided at Sherrick House.

People’s needs were assessed and care planned and delivered in line with their individual care plan. Care plans were up to date and the care they received was reviewed. Most relatives said they felt involved in their relative’s care. Comment’s included, “I feel comfortable for him to go there.” When asked about the care and treatment a relative told us, “they’re superb, and they know him inside out.”

The service worked in cooperation with relatives and other professionals to ensure that appropriate care planning took place. One relative told us, “the social worker is very much involved in the care plan.” We spoke with a healthcare professional who told us that they were happy with the input from staff in the way their client had been cared for.

Medicines were kept securely. All medicines were stored in locked cupboards. There were arrangements in place to ensure an appropriate temperature range was maintained in areas where medicines were stored. However, the location for storage might not be suitable. Systems were in place to monitor the quality of care provided to people who use the service.

We were not able to speak to people who use the service because they have complex needs. We were able to gather evidence about the service from relatives and documents relating to people who use the service. Relatives of the people who use the service told us that they were happy with the service and felt that their relative was treated with dignity and respect.

People were given choices and the option to participate in the various activities provided by the service and we saw evidence of this in people’s records. People were involved in their care and relatives told us that they were involved in developing and reviews for care plans and risk assessments.

Relatives told us that staff were very friendly and approachable, comments such as “staff are very friendly” and “staff are brilliant and always help out” confirmed this. They told us that they were able to talk to the manager if they had a worry or concern knowing this would be acted on.

There were systems in place to ensure that people were protected from abuse and to ensure they received the care they needed. Systems were in place to gather information about the quality of the service and people had a say in how the service was run.