36a Birling Avenue

36a Birling Avenue is a residential care home providing respite care for up to seven people with a learning disability or autistic spectrum disorder. A respite care service provides care and support for people who do not require a permanent stay in a care home. For example, people stayed at 36a Birling Avenue where they could receive the care and support they required when their families or carers (carers) planned time to go on holiday or a weekend away. Many people saw their stay in respite care as their holiday too. Bedrooms were available on the ground and the first floor. People who were able to use the stairs independently could use the upstairs bedrooms. One double bedroom was available if two people chose to share, such as siblings or friends, but was also used for emergency accommodation at times. The service was in a residential location with easy access to shops and public transport so that people who were able to go out into the community independently could continue to do so while staying at the service. Due to the nature of the support needs of people, two members of staff slept at the premises each night and a bedroom was set aside for this purpose. Three people were staying for respite care at the time of our inspection.

At the last inspection on 18 November 2015 the service was rated Good. However, we did find one breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider did not have systems and processes in place to ensure they could identify, assess and monitor quality and safety within the service.

At this inspection we found the service remained Good and improvements had been made to the quality auditing systems.

A registered manager was employed at the service and had been in the position since before the last inspection. 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.

Staff continued to be aware of their responsibilities in keeping people safe and reporting any suspicions of abuse. Staff knew what the reporting procedures were and were confident their concerns would be listened to.

Individual risks were identified and steps continued to be taken to reduce and control risk, making sure people and staff had the guidance they needed to prevent harm while at the same time supporting independence. Accidents and incidents were recorded by staff, action was taken and followed up by the registered manager.

The processes for the administration of people's prescribed medicines was still managed and recorded well

so people received their medicines as intended. Regular audits of medicines were now undertaken to ensure safe procedures were followed and action was taken when errors were made.

The registered manager continued to undertake a comprehensive initial assessment with people when they applied for a respite care service which fully included the involvement of the person and their carer's. Care plans were developed and regularly updated and reviewed to take into account people's changing needs between visits to the service. People's specific needs were taken account of and addressed in care planning and in planning people's respite care visits to ensure equality of access to services.

People were supported to make their own choices and decisions. The registered manager and staff continued to have a good understanding of the basic principles of the Mental Capacity Act 2005 (MCA) and promoted people's rights.

People were given plenty of choice at mealtimes and staff were flexible, often planning meals around the food they knew people liked. Staff were aware of people's specific dietary needs and planned for this before people arrived for their respite visit.

Although people's carers supported them with their health needs, staff were kept fully informed and knew what help people needed if the circumstances arose.

People had access to many different activities of their choice outside of the service and were supported to pursue and maintain these if they wished while staying at the service. Within the service, people could take part in activities they wanted to do individually or together. People and their carer's were asked their views of the service and action was taken to make improvements where necessary.

There continued to be clear evidence of the caring approach of staff. People and their carer's were positive about the staff who supported them, describing them as caring and saying they were very happy staying at the service. Staff knew people well and were able to respond to people's needs on an individual basis. Support to maintain independence was a key theme in the service.

Suitable numbers of staff were available to provide the support individual people required during their stay. The provider continued to make sure safe recruitment practices were followed so only suitable staff were employed to work with people who required respite care and support.

Staff were still supported well by the management team. Staff told us they were approachable and listened to their views and suggestions. Training was up to date and staff were encouraged to pursue their personal development. Staff continued to have the opportunity to take part in one to one supervision meetings to support their success in their role. Regular staff meetings were held to aid communication within the team and to provide updates and feedback.

Quality auditing processes were now in place to check the safety and quality of the service provided. A senior manager now checked the completed audits and countersigned them to show they had done this.

The carers we spoke with thought the respite care service was well run and their loved ones were very happy with the service provided.

Further information is in the detailed findings below.

The five questions we ask about services and what we found