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Bradbury House Requires improvement

We are carrying out a review of quality at Bradbury House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 26 April 2018

Bradbury House provides planned and emergency short term respite care for up to ten people with a learning disability, some of whom may have additional physical care needs. At the time of the inspection there were seven people including one emergency admission having a short break.

This inspection took place on the 14 March 2018 and was unannounced.

This is the first time the service has been rated Requires Improvement.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was 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.

Quality Assurance systems were in place to assess and monitor service delivery. Outcomes were assessed and where shortfalls were identified an action plan was devised. Although people's records were securely stored, they were not complete or up-to-date for some people. This was not identified within the audits of outcomes. The views of relatives were gathered about the respite care service.

People told us the types of day to day decisions they were able to make. The staff we spoke with were knowledgeable about the day to day decisions people made. Mental capacity assessments and best interest decision were not complete for all complex decisions. There were inconsistencies with the assessments of capacity for complex decisions and Deprivation of Liberty Safeguards (DoLS) applications.

Steps were taken to ensure medicine systems were safe. People told us staff administered their medicines. Medicine profiles included a photograph of the person and essential information such as known allergies and how the person preferred to take their medicines. Medicine administration records (MAR) charts were signed by staff to indicate the medicines administered. Where “as required” also known as (PRN) medicines were prescribed procedures were not devised on the administration of these medicines.

Risk management systems were mostly effective. Risks were assessed and for some people risk assessments were developed on how to minimise the risks. However, moving and handling risks assessments were devised but lacked detail.

The staff we spoke with were knowledgeable about people’s individual risks and the actions needed to minimise the risks. Individual risks to people included self harm, risk of malnutrition and for mobility impairments. Epilepsy profiles were in place for people at risk of seizures.

There were people who expressed their anxiety and frustration using aggression and self-harm. Staff told us and training records confirmed they had attended positive behaviour management training. Behaviour management plans included the triggers and the actions staff must take to prevent situations from escalating.

Incidents and accidents were reported and were analysed to identify emerging patterns and trends.

The safety of the living environment were regularly checked to support people to stay safe. For example, fire risk assessments, fire safety equipment checks and fire training for staff.

Safeguarding processes in place ensured people at the service were safeguarded from abuse. Members of staff told us and training records showed safeguarding of abuse training was attended. The people we spoke with said they felt safe and the staff gave them a sense of safety.

Staffing rotas were designed to ensure staffing levels were appropriate to meet the needs of people on respite care.

Staff received feedback through regula

Inspection areas

Safe

Requires improvement

Updated 26 April 2018

The service deteriorated to Requires Improvement.

Records lacked detail and medicines to be given when required lacked guidance to staff on when to administer these medicines.

Effective

Good

Updated 26 April 2018

The service remains Good

Caring

Good

Updated 26 April 2018

The service remains Good

Responsive

Good

Updated 26 April 2018

The service remains Good

Well-led

Requires improvement

Updated 26 April 2018

The service deteriorated to Requires Improvement.

Quality assurance arrangements were not always applied consistently because assessment outcomes had not identified that records were not always accurate or up to date.

Staff were aware of the values of the organisation and said the team was stable and worked well together.

People’s views about the service were gathered