The Bromford

Updated 3 March 2020

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 Care Act 2014.

Inspection team

The inspection team consisted of one inspector, one assistant inspector and a specialist advisor with experience in mental health.

Service and service type

This service provides care and support to people living in 14 ‘supported living’ settings located in one building, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 4 December 2019 and ended on 10 December 2019. We visited the office location on both dates.

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. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service about their experience of the care provided. We spoke with nine members of staff including the registered manager, operations manager, a recently recruited manager, safeguarding lead and support workers.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with four relatives to gather feedback about the service provided.

Updated 3 March 2020

About the service

The Bromford is registered to provide personal care as part of a supported living setting. At the time of this inspection 14 people were receiving personal care. The Bromford was purpose built and comprises of individual flats over two floors with communal areas on each floor.

Some aspects of the service have been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Improvements had been made since the last inspection where The Bromford was rated as inadequate. Systems had been put in place to improve people’s safety and the management of the service. However, we need assurances the improvements made so far, will be sustained and will remain embedded.

There were enough staff to support people safely. The provider completed employment checks to ensure staff were suitable to deliver care and support before they started work. They need to strengthen the process further and ensure a full employment history was completed for all staff. People we spoke with told us they felt safe with the care staff who supported them. Where people were supported with medicines this had been provided safely. Care plans we sampled had improved and demonstrated that people who lived at the home had risk assessments in place in relation to their specific conditions and to keep them safe. Some further improvement was needed to one person’s risk assessments.

People’s care and support reflected their individual assessed needs. Staff had the appropriate skills and knowledge to meet people’s needs and received training and ongoing support. People had been supported to maintain their health and wellbeing and had access to healthcare services when required.

People received help and support from a kind and compassionate staff team with whom they had positive relationships with. Staff showed respect for people's rights, privacy, dignity and independence. Staff providing care to people were limited to a small number to aid consistency of care and ensure positive relationships were maintained with people.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People received personalised care that was responsive to their needs. The provider had a complaints process and people felt confident to raise any concerns.

Action had been taken to improve the systems used to check and audit the quality of the care provided at the service. However, further improvement was needed. People told us that the manager was approachable and responsive and staff felt supported.

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

Rating at last inspection

The last rating for this service was inadequate (published 2 July 2019) and there were multiple breaches of regulation. We imposed conditions on the provider's registration. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 2 July 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.