We inspected Bridge Court Bungalow on 10 and 22 December 2014. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
Bridge Court Bungalow is a modern purpose-built property located in the grounds of Bridge House. The home accommodates up to six people with learning disabilities.
The home had a registered manager in place who commenced working at the home in February 2014. 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.
People living at the home required staff to provide support to manage their day-to-day care needs; to develop impulse control; as well as to manage their behaviour and reactions to their emotional experiences. We found that the manager had taken appropriate steps to ensure staff reviewed their behaviour; analysed what worked or not; and provided consistent responses when people’s needs changed to ensure that staff could continue to meet the individual’s needs.
Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards training and the manager understood the requirements of the Act. This meant they were working within the law to support people who may lack capacity to make their own decisions. The provider had not developed appropriate MCA records and staff remained unclear about the legislation. The registered manager was aware of this shortfall and had developed the necessary records as well as providing staff with additional support to ensure they understood the legislation.
People had difficulty discussing complex and thinking about the future but were able to share their views about day-to-day life at the home. People told us they liked living at the home and that the staff were kind and helped them a lot. We saw there were systems and processes in place to protect people from the risk of harm.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. All relevant infection control procedures were followed by the staff at the home. We saw that audits of infection control practices were completed.
We found that staff worked to assist people to lead ordinary lives and looked at how to assist individuals to reach their full potential. People were supported to go out and about in the local community and routinely went out with staff.
Staff had received a range of training, which covered mandatory courses such as fire safety as well as condition specific training such as managing epilepsy and other physical health needs. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that four to five staff routinely provided support to people who used the service during the day and two staff provided cover overnight.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
We reviewed the systems for the management of medicines and found that people received their medicines safely.
We observed that staff had developed very positive relationships with the people who used the service. We saw that the staff effectively assisted people to manage their anxiety. Interactions between people and staff were warm and supportive. Staff were kind and respectful. People told us that they made decisions about what they did throughout the day.
We saw that people had plenty to eat. We saw that each individual’s preference was catered for and and staff had ensured that each individual’s nutritional needs were met. Staff monitored each person’s weight and took appropriate action if concerns arose.
We saw that people living at Bridge Court Bungalow were supported to maintain good health and had access a range healthcare professionals and services. We found that staff worked well with people’s healthcare professionals such as consultants and community nurses.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and how they had worked with staff to create them.
People told us how staff encouraged them to develop their daily living skills and supported them with their courses, hobbies and leisure interests inside and outside of the home. During the visit we saw staff joined people doing creative work and identified activities people would enjoy doing.
We saw that the provider had a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and but did not have any concerns about the service.
The provider used a range of sytems to monitor and improve the quality of the service provided. We saw that the manager used them to critically review the service. This had enabled the manager to identify areas for improvement and make the necessary changes to the provision.