Bradley Apartments

Updated 5 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors.

Service and service type

Bradley Apartments is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Bradley Apartments is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service about their experience of the care provided. We spoke with 5 members of staff including the registered manager, nurse and care staff. We reviewed a range of records. This included 6 people's care records and multiple medication records. We looked at 4 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Following the inspection, we spoke with 3 relatives about their experience of the care provided. We received feedback from a further 5 staff members. We contacted two healthcare professionals by email but did not receive a reply. We looked at a range of documents sent to us such as audits, risk assessments, meeting minutes and care records.

Updated 5 January 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Bradley Apartments is a residential care home that provides accommodation, nursing and personal care to a maximum of 14 younger adults with a learning disability, some of whom may also have needs associated with their mental health and autism. At the time of our inspection there were 10 people using the service. The home provides five apartments consisting of bedrooms, bathrooms, communal area and kitchen.

People’s experience of using this service and what we found

The provider was not always able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support:

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Where people lacked capacity to make decisions, the provider had failed to put in place documents to support best interest decision making.

Medicines management was not always in line with best practice guidance; medicine administration records were not always fully completed and guidance for staff not always in place.

Risks to people had been assessed. People accessed specialist health and social care support where appropriate.

Right Care:

The provider had systems in place to report and respond to accidents and incidents. However, not all accidents, incidents or safeguarding concerns in the home had been investigated timely and thoroughly.

The service had enough staff to keep people safe. Staff received training and an induction to help them support people. We observed staff respecting people's privacy and dignity when providing care and support.

Systems to protect people from the risk of infection were effective.

Right Culture:

The provider's quality monitoring processes were not always effective at highlighting issues found at this inspection. They had offered assurances about actions they would take and were committed to making any necessary improvements as quickly as possible.

We received mixed feedback from staff about the support they received from management in order to fulfil their roles and responsibilities.

Staff knew people well and were responsive to their needs. People and their relatives were involved in their care.

Following our visit to the service, we asked the provider to send us an improvement plan which detailed the actions they had taken/were going to take in relation to the issues identified during our inspection.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 30 June 2021).

Why we inspected

We received concerns in relation to safeguarding and the quality of care being provided. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key

questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bradley Apartments on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to medicine management, safeguarding, consent and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.