Bradbury House - Care Home with Nursing Physical Disabilities

We found the following examples of good practice.

• Systems were in place to prevent people, staff and visitors from catching and spreading infections. The home was extremely proud to have had no known cases of Covid-19. The home supported people and staff as far as possible with social distancing.

• Staff had undertaken training in putting on and taking off personal protective equipment (PPE), hand hygiene and other Covid-19 related training. Nominated staff had received additional training to be infection control leads. Staff practices were monitored to ensure high standards and correct procedures were followed. Additional cleaning of all areas and frequent touch surfaces was being carried out. Staff were observed wearing appropriate PPE at all times. Suitable supplies of PPE were available and contingency plans in place.

• Staff supported people’s social and emotional wellbeing. Additional socially distanced group activities had been planned within the home to positively support people. Additional one to one activities were also implemented. People and their relatives were supported to keep in contact using a range of technology and regular newsletters.

• National guidance was being followed which meant that due to current local restrictions, only essential health and compliance visits could take place at the time of the inspection. When visits recommenced, plans were in place to safely manage visits in accordance with national guidance. Visits would be staggered and by appointment only. Infection prevention and control measures were in place to avoid the potential spread of infections with others.

• The home was following national guidance for anyone moving in. Staff worked with people and their relatives to ensure they were aware of self - isolation procedures. People were supported to understand the pandemic and the need for IPC measures.

• Infection control audits and checks were carried out. The registered manager spoke positively about the hard work, dedication and strong team spirit which staff had shown, which had helped to minimise the impact of the pandemic on people’s health and wellbeing. The provider continuously passed on important information about Covid-19 to staff. The provider had a dedicated Covid-19 noticeboard which was regularly updated.

Further information is in the detailed findings below.

Bradbury House is a care home providing personal and nursing care to 23 younger adults, under the age of 65, with physical support requirements, The service can support up to 25 people.

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

The provider's vision and values to promote a highly person-centred culture and place people at the heart of the service, at Bradbury House, was driven by the exceptional leadership of the registered manager.

The whole staff team were incredibly enthusiastic and passionate about the services they provided. They were highly motivated and said they were proud and inspired to deliver a high quality, caring service. A relative commented, “As a family we cannot believe how lucky [Name] is to have these wonderful people in their life. The care is beyond exceptional.”

Staff at Bradbury House demonstrated that they were extremely committed to making a positive difference to people's lives. They were exceptionally caring and often went the extra mile to support people to a more fulfilled life.The service was entirely flexible and provisions were changed and adapted to meet people's current needs and choices. There was excellent communication with external professionals to ensure services achieved positive outcomes for people.

People were extremely well-cared for, relaxed and comfortable. A staff member said, “Staff and people are friends, people see us more as friends rather than carers.” Care was completely tailored to each individual. Staff demonstrated an excellent understanding of each person's support needs and their personal preferences. They knew people and their histories very well.

Strategically the provider highlighted and influenced national policy to bring about a more inclusive society for people who were disabled. They supported children and adults overseas and in this country to ensure equal opportunities; the right to education, work, accessible transport, suitable living support and digital technology.

Staff training at the service was up-to-date and bespoke training was provided. The management team supported staff and encouraged them to become highly skilled and knowledgeable The registered manager had ensured resources and skilled staff were available to support people.

People and their relatives were involved and supported in decision making. 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.

The building was very well-designed, accessible, light and spacious for the comfort and inclusion of people. A relative said, “The fact [Name] is allowed to personalise their own room exactly how they want it is fantastic. It’s like living in a five-star hotel.”

A range of activities were arranged to maintain people's links with their local community and provided further opportunity for social interaction with family and friends. Risks were very well-managed. People, relatives and staff were confident about approaching the registered manager if they needed to.

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 good (published 20 June 2017).

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.

We last inspected the service in 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.

Bradbury House provides accommodation with personal and nursing care for up to 25 people. The home also provides for children in transition services (young people to adults.) Two of the places are used to provide a respite care service for people who wish to live at the home for short periods of time. The home specialises in the care of those who have a physical disability and require nursing care.

On the day of our inspection there were a total of twenty four people using the service.

Bradbury House was designed specifically to meet the needs of people with physical and neurological conditions. Further adaptations were taking place at the time of our inspection to ensure the building continued to meet the needs of people living there. The home is set in its own fully accessible garden, in a residential area near to town centre shops and local facilities and public transport routes.

There was a new registered manager in place who had been appointed since the last inspection in 2015. 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.

All the care records we looked at showed people’s needs were assessed before they moved into the home and we saw care plans were written in a person centred way.

There were sufficient numbers of staff on duty in order to meet the nursing and care needs of people using the service; and ensure they had an active and meaningful lifestyle. The registered provider had an effective recruitment and selection procedure in place and carried out robust checks when they employed staff to make sure they were suitable to work with vulnerable people.

There were robust procedures in place to make sure people were protected from abuse and staff had received training about the actions they must take if they saw or suspected that abuse was taking place.

We saw the home had in place personal emergency evacuation plans displayed close to the main entrance and accessible to emergency rescue services if needed.

We found there were cleaning schedules in place to ensure the home remained a pleasant and attractive place to live and to prevent the spread of infection.

People’s nutritional needs were assessed and plans of care drawn up if they were at risk of malnutrition or choking. The cook demonstrated an extensive knowledge of people’s likes and dislikes and prepared a wide selection of wholesome and popular meals to cater for people’s tastes.

Staff were extremely caring in their approach and had developed good relationships with people and their families. They respected people’s privacy and dignity and supported them to live as independently as possible. People and their representatives received information about the service and were involved in decisions about their care.

The registered provider successfully supported a small number of younger persons (aged 16-17) at this home. They had taken into consideration all legal requirements needed to ensure the safety of young people and their legal status, consent and rights were protected, and had liaised with children’s services to ensure they were meeting the needs of young people.

People who used the service, and family members, were complimentary about the standard of care provided. They told us the staff were friendly and helpful. We saw staff treated people with dignity, compassion and respect and people were encouraged to remain as independent as possible and for some, retain or regain skills to promote their independence and well-being.

The home supported people to have interesting lives. They produced an activities newsletter each month which reported on past and upcoming events. Activities were regular and frequent with emphasis placed on active and inclusive lifestyles.

People’s healthcare needs were closely monitored by highly trained and diligent nursing and care staff. This ensures that any changes in a person’s condition was monitored and discussed so that interventions, when required could take place quickly. In this way the service ensured peoples lifelong conditions were maintained and their good health was promoted. People were supported with health checks, from hospital and community specialists.

We saw the registered provider had a complaints policy in place and this was clearly displayed for people to see.

The registered provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources including people who used the service and their family and friends. The registered provider’s organisation collected this information and provided additional oversight and monitoring of the home. The staff and registered manager reflected on the work they had done to meet peoples’ needs so they could see if there was any better ways of working.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager and provider made regular checks to make sure the service was running as expected and took action where improvements were needed.

The registered provider was meeting the conditions of their registration. They were submitting notifications in line with legal requirements. They were displaying their previous CQC performance ratings at the service and on their website.

Further information is in the detailed findings below.

Suitable arrangements were in place for people to take part in activities in line with their needs and preferences.

The relationships between staff and the people who lived there were good and personal support was provided in a way that promoted and protected their privacy and dignity.

Suitable arrangements were in place for handling complaints and for protecting people from abuse. Two people told us they could share any concerns with the staff and felt their views were listened to. Another person said 'This place is just great it is my home. I have lived here for several years. I like living here because all my needs are taken care of and I feel safe.'

We saw the provider had a robust recruitment and selection policy in place. This meant people were cared for by staff who had all the necessary background checks carried out before they commenced employment.