Background to this inspection
Updated
3 March 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 is 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.
This inspection took place on 24 January 2018 and was unannounced. This meant the provider and staff did not know we would be visiting.
The inspection team consisted of one adult social care inspector, a specialist advisor electrician and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.
The provider completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We contacted the commissioners of the relevant local authorities, the local authority safeguarding team and other professionals who worked with the service to gain their views of the care provided by The Bridgings (Eston).
During the inspection we spoke with five people who used the service. We looked at two care plans, four medicine administration records (MARs) and handover sheets. We spoke with four members of staff, including the registered manager and three support workers. We looked at two staff files, which included recruitment records. We also looked at records relating to the day to day running of the service.
Updated
3 March 2018
This inspection took place on 24 January 2018 and was unannounced. This meant the provider and staff did not know we would be visiting.
At the last inspection in January 2017 the service was rated Requires Improvement. We also identified a breach of regulation in relation to the safety of the premises and equipment. This was because tests of the fire alarm, emergency lighting and electrical installation had not been carried out by someone qualified to do so. We took action by requiring the provider to send us plans setting out how they would address this. When we returned for this latest inspection we found that action had been taken and the service was no longer in breach of regulation.
The Bridgings (Eston) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection 11 people with learning disabilities or autism were using the service.
The care service had 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.
There was a registered manager in place. 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. The registered manager was also one of the owners and registered providers of the service.
Risks to people using the service – including from the premises and equipment – were assessed and monitored. Plans were in place to support people in emergency situations. The provider had systems in place to promote effective infection control. People’s medicines were managed safely. Policies and procedures were in place to safeguard people from abuse. The registered manager and provider monitored staffing levels to ensure they were sufficient to keep people safe. The provider’s recruitment processes reduced the risk of unsuitable staff being employed.
Staff received a wide range of mandatory training in order to support people effectively. Newly recruited staff were required to complete induction training before they could work with people unsupervised. Staff received regular supervisions and appraisals. Staff applied the principles of the Mental Capacity Act 2005 (MCA). People were supported to maintain a healthy diet and to take control of their own food and drink. People were supported to access external professionals to monitor and promote their health. The premises had been adapted to make them suitable for the people living there.
People spoke positively about staff at the service, describing them as kind and caring. People were treated with dignity and respect and promoted their independence. The registered manager was able to describe how advocacy services would be arranged should they be needed.
People told us staff provided them with the support they needed and wanted. Care plans were personalised and based on people’s support needs and preferences. People at the service were supported to access a wide range of activities and interests in the local community. The provider had a complaints policy in place, setting out how people could raise issues and explaining how they would be investigated. Staff received end of life care training, and policies and procedures were in place to support this should it be needed.
Staff spoke positively about the culture and values of the service. The registered manager told us about links they, people and staff had forged with the local community. The registered manager and provider carried out a number of quality assurance checks to monitor and improve standards at the service. Feedback was sought from people, relatives and external professionals. The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.