Driftwood Lodge

The service provides care to five children and young people. The primarily aim of the service is to provide respite care for children with complex physical disabilities who have associated health conditions. The length of stay varies from two to ten days, although two young people lived at the service on a permanent basis. In total the service supported 17 children and young people. A domiciliary care service also operated from the location to assist the transition for children being discharged from hospital with complex needs and we looked at this as part of the inspection. At the time of our inspection one child was being supported by the domiciliary care agency.

There was a registered manager in post on the day of our 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.

Relatives and professionals spoke very positively about the service and the quality of care that was provided. They told us that this was well managed service were staff genuinely cared for the young people and went "the extra mile."

Staff had received training in safeguarding and knew what actions to take should they have concerns. Risks were identified and there were management plans in place which set out the steps that should be taken to reduce the likelihood of harm. There were systems in place to ensure that equipment was working effectively and safe to use. Staff were aware of their responsibility to report safety incidents.

There were robust systems in place to recruit staff and check their suitability prior to employment. The service employed both nursing and care staff and while nursing staff were not always on site there were clear on call arrangements in place should they be required to attend the service.

All staff received an induction when they first started to work at the service on subjects such as moving and handling, infection control, first aid, equality and diversity. Additional training was undertaken to ensure that they had the skills to enable them to support young people with complex health conditions such as epilepsy, breathing or feeding difficulties. Competency assessments were undertaken to check the staff's understanding of what they had learnt.

Medicines were well managed and there were clear arrangements in place to book medicines into the

service and clarify any anomalies at the beginning of each period of respite. Staff worked alongside community health professionals to ensure that young people's health conditions were managed.

Young people had access to healthy meals which promoted their wellbeing. Nutritional needs were identified and monitored.

The manager was aware of the Mental Capacity Act 2005 (MCA) and related Deprivation of Liberty Safeguards and the different legal requirements for adults and children. One young person had best interest documentation in place but it was agreed that this would be extended further to ensure their best interests were fully considered in the delivery of personal care. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes is called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the Act. We saw the service had correctly identified that one person may require a DoLS and had made the necessary applications to the local authority.

The service had a strong person centred culture that focused on the needs of young people. Staff knew the young people they supported, their skills, communication and preferences. The care and support was underpinned by detailed care plans and regular reviews. Families were welcomed and seen as partners in the care delivery. The registered manager was aware of the need to develop palliative care pathways but was sensitive to the issues and was working closely with families on how best to meet young people's needs.

Young people were supported to access the community and lead full lives.

The management of the service had a clear vision which focused on the wellbeing of young people and providing good quality care. Staff were clear about the aims of the service and their roles and responsibilities. The culture was positive and staff morale was high.

There was an effective quality assurance system in place to identify shortfalls and to drive improvement. Independent oversight was provided by an external individual who provided reports to the provider on how the service was operating on a day to day basis.

The five questions we ask about services and what we found