We carried out this inspection on 30 December 2014. The inspection was unannounced. During our last inspection on 26 September 2013 we found the provider to be in breach of Regulation 10, Assessing and monitoring the quality of service provision. The provider wrote to us with an action plan of improvements that would be made to their monitoring processes. During this inspection we found the provider had taken steps to make the necessary improvements.
Bembridge House is run by the White Horse Care Trust, which has a number of care homes in Swindon and Wiltshire. The home provides care and support to adults with a learning and physical disability and associated health needs. The property is a detached bungalow, which has been designed to meet the needs of up to eight people.
At the time of our inspection the home did not have a registered manager. The management of the service was being overseen by a manager of another service provided by the White Horse Care Trust. They were supported by the home’s two deputy managers. Recruitment for a new manager was being undertaken. 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.
We found that records relating to the planning of people’s care required improvement in some areas. People’s care plans did not always reflect what care, support or treatment they required for staff to be responsive to their needs. We found this was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.
Staff told us they felt supported by management. They said they had access to training which supported them to fulfil their role. Staff told us they received regular, formal supervision (one to one meetings with line managers) where they could discuss their professional development and roles. Records we reviewed showed that competencies had been completed regarding staff’s work performances and behaviour. However where it had been identified that staff were not meeting some competencies, actions needed to address this had not always been identified. Where some actions had been identified these had not been followed up to see if staff had made the required improvements. The staff had completed training to ensure that the care and support provided to people was safe and effective to meet their needs.
New staff members received an induction which included shadowing experienced staff before working independently. Staff completed workbooks which covered topics relating to care. However records showed that whilst the workbooks had been completed they had not been marked. This meant that the manager had not signed staff as being competent following their induction period.
The interim manager had knowledge of the Deprivation of Liberty Safeguards (DoLS). Deprivation of Liberty Safeguards is where a person can be deprived of their liberties where it is deemed to be in their best interests or for their own safety. They understood DoLS and where required had made applications to ensure people were supported appropriately.
People were protected from risks associated with their care because staff followed appropriate guidance and procedures. Staff understood the needs of the people they were supporting. We saw that care and support was provided in a considerate and compassionate manner. Relatives spoke positively about the home and the care and support provided.
People were supported to have a balanced diet which promoted healthy eating. There were arrangements for people to access specialist diets were required.
The interim manager and senior management had systems in place to monitor the quality of the service provided. Audits covered a number of different areas such as care plans, infection control and health and safety. Staff were aware of the organisation’s visions and values and there was a positive culture where relatives felt included and their views sought.