Background to this inspection
Updated
24 January 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was unannounced and was undertaken by one adult social care inspector.
Prior to the inspection, we looked at the information we had received about the service since January 2017. This included notifications that had been submitted by the service. Notifications are information about specific important events the service is legally required to report to us.
During our inspection we spoke with eight people and two visitors. We spoke with the assistant manager (the registered manager was on leave), three rehabilitation support workers (RSW) and one health and social care assistant (HSCA). A health care provider also had input into the care of people who used this service and we spoke with one nurse and one occupational therapist.
We looked at four people’s care files and other records relating to their care. We looked at staff training records, key policies and procedures, completed audits and other records related to the running of the service.
Updated
24 January 2018
This inspection took place on 12 December 2017 and was unannounced. The service was registered to provide accommodation and personal care for up to a maximum of 20 people over the age of 18 (only 18 beds were in use). At the time of our inspection there were 10 people in residence. This is a rehabilitation service, jointly funded by Bristol City Council (registered provider) and Bristol Community Health. Rehabilitation services are provided for up to six weeks in order to support people who are medically fit to be discharged from hospital but need further therapy. The service may also be used to prevent a hospital admission.
There was a registered manager in post. 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.
After the last inspection in June 2016 we rated the service overall as Requires Improvement. We had identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had then sent us their action plan which detailed the improvements they would make.
As part of this inspection we have checked to see that these improvements were made and sustained. We have now rated the service as Good and there were no breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
People were safe. Staff knew what to do if there were concerns about a person’s welfare and had received safeguarding adults training. Risk assessments were completed as part of the care planning process. Where risks were identified there were plans in place to reduce or eliminate the risk. Each person had a written personal emergency evacuation plan detailing the level of support they would need in the case of an emergency. The risks of employing unsafe staff were reduced because of robust staff recruitment procedures.
The premises were well maintained. Regular maintenance checks were completed to ensure the building and facilities were safe. Checks were also made of the fire safety systems, the hot and cold water temperatures and equipment to make sure they were safe for staff and people to use. The premises were clean tidy and fresh smelling.
Staffing levels were calculated and based on the collective needs of each person who was using the service at that time. This ensured the staff were able to meet all care and support needs safely. Medicines were managed safely.
The service was effective. New staff completed an induction training programme at the start of their employment and any new-to-care staff completed the Care Certificate. There was a mandatory training programme for all other staff to complete to ensure they had the necessary skills and knowledge to care for people correctly.
The mental capacity of each person to make informed decisions was assessed on admission to the centre and then reviewed. People were involved in making decisions and encouraged to make their own choices about their care and support. The service was meeting the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.
People were provided with sufficient quantities of food and drink. They were supported to regain life skills in order to enable them to return home and be able to look after themselves. There were arrangements in place to ensure people were temporarily registered with a local GP during their stay. The service worked in partnership with other healthcare professionals who supported the people using the service.
The service was caring. Staff had good working relationships with the people they were looking after and were committed to their role of rehabilitation. The person was the focus of all decisions made about their care and they were listened to. Any suggestions they made were acted upon.
The service was responsive. People were provided with a personalised care and support service that met their specific needs. The aim of the service was to rehabilitate them after a period of ill health and enable them to return to their own home.
The service was well led. The staff team was led by a registered manager and an assistant manager. They provided good leadership and management for the staff team. Staff meetings ensured they were kept up to date with changes and developments in the service.
There was a regular programme of audits in place, which ensured that the quality and safety of the service was checked. These checks were completed on a daily, weekly or monthly basis.