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Bradbury House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 31 January 2020

About the service

Bradbury House provides planned and emergency short term respite care for up to 10 people with a learning disability, some of whom may have additional physical care needs. All accommodation is on the ground floor and in single rooms. There are shared recreational rooms and accessible gardens.

The service was taking steps to apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

There was action being taken to promote choice and control, independence and inclusion to fully reflect the principles and values of Registering the Right Support. Action was being taken to focus support on people having as many opportunities as possible for them to gain new skills and become more independent.

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

There were people who at times expressed frustration and anxiety which placed them, and others at risk of harm. However, risk assessments lacked clear guidance and there were some inconsistencies with approaches from staff. The manager told us about the actions taken to ensure the safety of people and staff. They said staff had attended relevant training and referrals were made for specialist support. This included referrals to specialist nurses to update the strategies.

We responded to concerns about the food made to CQC before and during the inspection. We looked at the stocks of food and found there were adequate quantities of frozen and tinned foods. However, most food was processed and people had limited access to fresh fruit and vegetables. The manager told us they would take action to support staff to prepare fresh meals. Better cleaning routines were required to ensure the fridge was kept clean.

Risk assessments were in place for individual risks. The assessment format had been updated for staff to better detail the identified risk and the measures to minimise the risk.

Safeguarding procedures were on display at the service and staff had attended safeguarding training. The staff we spoke with knew the signs of abuse and felt confident to report their concerns.

While staff said there were staff shortages we saw staffing levels were consistent with the funders allocations of staff hours. We saw there were sufficient staff on duty when people were at the service. Some people were having one to one staff as agreed.

Medicine systems had improved. Staff were to attend training. While there had been medicine errors they were being addressed and systems had improved.

The staff were supported with their roles and responsibilities. The training matrix in place listed the mandatory and specialist training attended. Where training was overdue this was identified. The staff we asked said they had attended all training that was set as mandatory by the provider. Staff had regular one to one supervision sessions.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People's capacity was assessed, and best interest decisions reached where they lacked capacity. The manager was reviewing documentation in relation to mental capacity assessments and Deprivation Liberty Safeguards (DoLS). This will ensure a legal framework was in place to make best interest decisions for people identified to lack capacity to make specific decisions.

The staff were knowledgeable about the procedure to follow in the event people became ill during their stay at the home.

The staff were caring towards people. We saw staff use a variety of methods to engage with people. The relative we spoke with said their family member showed signs of enjoyment whenever they went for respite care. Staff told us it was import

Inspection areas

Safe

Requires improvement

Updated 31 January 2020

The service was not always safe.

Details are in our safe findings below

Effective

Good

Updated 31 January 2020

The service was effective.

Details are in our effective findings below

Caring

Good

Updated 31 January 2020

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 31 January 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 31 January 2020

The service was not always well-led.

Details are in our well-Led findings below.