12 April 2017
During a routine inspection
We last inspected the service on 26 March 2015 and rated the service as good. At this inspection we found the service remained good and met all the fundamental standards we inspected against.
Berwick Bridges provides care for up to six people who have learning disabilities. Accommodation is provided in a purpose built bungalow which is located in a housing estate. There were six people living there at the time of the inspection.
There were safeguarding procedures in place. Staff were knowledgeable about what action they should take if abuse was suspected. The local authority safeguarding team informed us that were no safeguarding concerns regarding the service.
The premises were clean. Checks and tests had been carried out to ensure that the premises were safe. Medicines were managed safely.
At our last inspection we found that recruitment checks were carried out to ensure that staff were suitable to work with vulnerable people. We did not check staff recruitment at this inspection because there had been no new staff recruited.
Some staff told us that more staff would be appreciated to support people to access the local community. We observed staff carry out their duties in calm unhurried manner and people accessed the local community. Records confirmed that training was available to ensure staff were suitably skilled. Staff were supported though an appraisal and supervision system.
The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). The registered manager was liaising with the local authority with regards to DoLS applications.
People's nutritional needs were met and they were supported to access healthcare services when required.
We observed positive interactions between staff and people who lived at the service. Staff promoted people's privacy and dignity. There were systems in place to ensure people were involved in their care and support.
Care plans were in place which detailed the individual care and support to be provided for people.
People were supported to maintain their hobbies and interests and housekeeping skills were encouraged to help promote people’s independence. There was a complaints procedure in place. No complaints had been received.
Checks were carried out on the environment and medicines. We found minor shortfalls with the maintenance of records. There was no formal system in place to assess staffing levels. The registered manager told us she was included in the staffing numbers which sometimes made it difficult to concentrate on her management duties. We have made a recommendation that the provider reviews its assurance and auditing system.
Following our inspection, the registered manager wrote to us and stated that a new auditing tool had been formulated, a staffing ratio tool would now be used and daily records had been reintroduced. She also informed us she was updating the consent paperwork.
Further information is in the detailed findings below.