This was an announced inspection, carried out on 7 February 2017. As the service provides respite support to people we gave short notice of the inspection visit to ensure staff were available.

The service was last inspected on 2 March 2016. At that inspection we found breaches of regulations. This was because some people’s risk assessments had not been updated to reflect a change in a person’s health needs. The environment had not been maintained by not improving paintwork where equipment had damaged walls and doors. Some bathrooms were too small to accommodate equipment for people who required it. Restrictions of movement had not been responded to, to meet the requirements of the Mental Capacity Act 2005. Systems to assess and monitor the quality of the service provided to people were not effective. Risks associated with the environment and equipment had not been assessed, or action taken to mitigate risk. There was a lack of clear leadership within the service. The service did not actively seek the views of people about their experience of using the service. Following the inspection the service provided the commission with an action plan telling us what actions they were taking to meet the regulations. At this inspection we found improvements had been made in these areas and the service was now meeting the relevant requirements.

The Bungalow is a respite service that provides care and support for guests who have learning and/or physical disabilities and other complex needs. The Bungalow can accommodate up to a maximum of 10 guests. The length of stay varied depending on their individual requirements. On the day of our inspection there were two people using the service and following our visit we spoke with a number of relatives about the care provided. The service is owned and operated by Cornwall Council.

Staff referred to people using the service as guests throughout the inspection. This term will be used throughout the report to represent people using the service.

The manager was currently going through the process of registration with the Care Quality Commission. 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.

The feedback we received from families about the service was very positive and they told us that their relatives looked forward to their stays and staff were very caring. Relatives were confident in the skills, experience and abilities of the staff who supported their family members. They said, I don’t know where we would be without this service. Very good all round” and “Staff very competent.” There were systems in place to protect people from potential harm. Staff were clear about the reporting mechanisms and were confident that concerns would be taken seriously.

The service had reviewed and developed how risks were identified and managed. The records provided guidance for staff in how guests should be supported to reach their individual potential. This included the level of independence and control over their lives while promoting their safety, comfort and wellbeing. For example, supporting someone to cook, bake and use the kitchen appliances with support.

Staff training had been developed since the previous inspection to ensure training which required updates was taking place. Staff were trained in a range of subjects which were relevant to the needs of the people they supported. New employees undertook a structured induction programme which prepared them well for their role.

There were clear procedures in place to ensure that staff who were recruited had been subject to checks and were suitable for the role. Staffing was organised to meet people’s needs and ensure continuity of care. Due to the nature of the service st

This was an announced inspection, carried out on 2 March 2016. As the service provides respite support to people we gave short notice of the inspection visit to ensure staff were available. This is the first Comprehensive inspection since the service was registered with the Care Quality Commission in January 2016.

The Bungalow is a respite service that provides care and support for people who have a learning disabilities and other complex needs. The Bungalow can accommodate up to a maximum of 10 people, although due to the nature of the service this fluctuates on a daily basis. The service is owned and operated by Cornwall Council.

The service is required to have a registered manager and at the time of the inspection visit a registered manager was in post. However, the registered manager was also registered for another service and was not always working at The Bungalow. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run. In November 2015 a deputy manager had been appointed to manage the day-to-day running of the service with overview from the registered manager.

People using the service had a range of learning, sensory and physical disabilities and there were a range of aids and adaptations in place which met those needs. Rooms and lounge areas incorporated a range of seating and equipment to support people with physical disabilities. However a bath and shower room could not be used for people with specific mobility needs as there was not enough room to accommodate the necessary equipment.

A concern had been raised at a staff meeting in November 2015 about the regulation of water temperature when using showers. Shower heads now had temperature monitors which alerted staff when they rose above a safe level.

All care plans were being reviewed and updated. However, two of the four care plans we looked at contained the previous provider’s information. In those files there was no evidence of reviews taking place from January 2015 to November 2015. Since then where reviews had taken place not all the information had been added to the care plan review section. Staff told us it had been a difficult twelve months when there had been specific staffing problems resulting in agency staff being used to support the core staff team. Comments from staff included, “It has been a really difficult time. We have just got on with the job of supporting guests” and “It has calmed down a lot since Christmas because we have got the staffing right”.

Where staff had been recruited there was limited information to show if they had had the necessary safety checks to work in the service. The deputy manager had requested the information from Cornwall Councils Human Resource department. It was confirmed all checks were in place but evidence of this had not yet been sent to the service.

The general maintenance of the building since registration in January 2015 had been limited. Woodwork was damaged and chipped throughout the service due to the use of equipment to support people. Paintwork was damaged in some of the rooms. Furniture did no match in most rooms.

Where people required specific equipment to support them, for example track hoists and bathing facilities they used the same rooms when using the respite service. A relative said, “(Persons name) likes a certain room and staff try and make sure they get that room when they stay”. People brought their own personal items to make their rooms more familiar to them.

The service complaints procedure had been made available to relatives. One relative told us “I have the information and would know who to speak with. I have never had to make a complaint but think I am confident they would listen. A document called ‘Have Your Say’ was available to