Archived: Short Term Breaks - April Cottage

Updated 25 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 March 2017 and was unannounced. The inspection team consisted of one inspector. This inspection was completed to check whether sufficient improvements to meet legal requirements after our comprehensive inspection in June 2016 had been made. We inspected the service against one of the five questions we ask about services: “Is the service effective?”. The focus of the inspection was narrowed down to this domain because on the last inspection the service had failed to meet legal requirements only in relation to this question.

Before the inspection we reviewed the information we held about the service and the service provider. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.

We looked at three people’s care records. We spoke with the registered manager, the deputy manager and one member of care staff. We reviewed records relating to the management of the home which included staff training files.

Updated 25 April 2017

We inspected Short Term Breaks-April Cottage on 17 and 18 June 2016. The inspection was unannounced. Short Term Breaks-April Cottage is a respite care home in Witney that provides care to people in and around Oxfordshire. At the time of this inspection, the home was supporting five people.

There was 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. The registered manager worked closely with a director of operations.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework to assess people’s capacity to make certain decisions, at a certain time. However, the registered manager was not clear on their responsibilities to ensure the service completed their own mental capacity assessments if it was thought a person may lack the capacity to make certain decisions. Where people were thought to lack capacity, assessments in relation to their capacity assessments had not been completed in line with the principles of MCA.

Staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be restricted of their liberty for their safety.

People who used the service felt safe. Staff had a clear understanding of how to safeguard people and protect them from harm. Staff had a good understanding of their responsibilities to report any suspected abuse. The home had sufficient numbers of suitably qualified staff to meet people’s needs. People and staff were confident they could raise any concerns and these would be dealt with. The provider had systems in place to manage and support safe administration of medicines.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where required, staff involved a range of other professionals in people’s care.

People’s needs were assessed and care plans enabled staff to understand how to support people. Changes in people’s needs were identified through regular reviews. People's interests and preferences were discussed during assessments and these were used to plan their care. The service was flexible and responded positively to people’s requests.

People felt supported by competent staff. Staff benefitted from regular supervision (one to one meetings with their line manager) and yearly appraisals to reflect on their practice and develop their skills. Staff received training specific to people’s needs.

People and their relatives described the staff as good and providing very good care. People felt they were treated with kindness and their privacy and dignity were always respected. Staff had developed positive relationships with people.

The registered manager informed us of all notifiable incidents. The service had good quality assurances in place. The registered manager had a clear plan to develop and improve the service. Staff spoke positively about the management and direction they had from the registered manager.

The registered manager had a clear vision for the service which was shared throughout the staff team. This was embedded within staff practices and evidenced through people’s care plans. Staff felt supported by the registered manager and the provider.

Leadership within the service was open and transparent at all levels. The provider had systems to enable people and their relatives to provide feedback on the support they received. The feedback was acted upon when required.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we have required the provider to take at the end of this report.