• Care Home
  • Care home

St Bridget's - Care Home Physical Disabilities

Overall: Outstanding read more about inspection ratings

Ilex Close, Rustington, West Sussex, BN16 2RX (01903) 783988

Provided and run by:
Leonard Cheshire Disability

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about St Bridget's - Care Home Physical Disabilities on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about St Bridget's - Care Home Physical Disabilities, you can give feedback on this service.

24 April 2019

During a routine inspection

About the service:

St Bridget’s – Care Home Physical Disabilities, referred to in this report as St Bridget’s, 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. St Bridget’s accommodates up to 38 people in one adapted building and three bungalows on the same site. At the time of our inspection there were 37 people living in St Bridget’s. The home supports people with a range of significant physical disabilities, physical health and mental health needs.

People’s experience of using this service:

People and relatives highly praised the care and support provided at St Bridget’s. The service had distinctive and very strong person-centred values and placed people’s wellbeing at the heart of their work. People received exceptionally personalised support which met their needs and preferences. The registered manager and staff ensured people were involved in every aspect of the service and their care and support. People told us staff knew them, their likes, dislikes and needs exceptionally well. They said they had full control over their care and were always encouraged to share their views. Comments included, “I do whatever I want”, “They listen to me. They know they’re just here to help me with what I need” and “I always choose.”

The service was owned and run by Leonard Cheshire Disability. It is a charitable organisation whose stated purpose was to ‘support individuals to live, learn and work independently, whatever their ability’. The provider and registered manager were clear about their purpose and acted as advocates for people with disabilities and campaigned to encourage equality and opportunity.

The registered manager and staff were all passionate about ensuring people were all equal, not judged or defined by appearance, ability, sexuality, age, background, race or belief. This created a non-judgemental, fully inclusive environment where people felt safe and confident to be themselves. The service respected and promoted people’s diversity and helped promote people’s rights. For example, they had recently created a Pride Network which was open to people who used the service and staff members. This network had online information and support for people to discuss any issues, ideas, make friends, share experiences and allow people to explore their sexuality.

People were supported to express their views in a number of different ways. People who lived in the service had a number of ways of communicating. People used verbal communication, sign language, picture boards and computerised communication aids. Staff knew how best to communicate with each person in order to understand their needs and give them choices. The registered manager and staff were passionate about enabling people to use technology to enable people to communicate more freely and to improve their skills, expand their knowledge, contact loved ones, enjoy entertainment, be active on social media and make friends.

At the time of our inspection two people living in the service had needs relating to a learning disability. The service applied 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.

The registered manager and the provider were committed to ensuring the service was outward facing and encouraged people to be active members of the local community. The service had a charity shop on site which was open to the public and advertised in the local town. The service also had a volunteer programme to encourage people to connect with members of the public who shared their interests. Events were held at the service twice a year to which the public were invited. Staff and people who used the service regularly attended events in the local community and the service regularly campaigned to encourage accessibility and equality within the local area.

The management team and staff were passionate about enabling people to lead fun, fulfilled lives and helping ensure people had access to activities that met their needs and interests. The service had a comprehensive activities programme but also worked hard to recruit volunteers. The volunteers had positively impacted on people’s lives. For example, one person was interested in bird watching and was hoping to learn more about it. Together with the person, the volunteer coordinator created an advert seeking a volunteer who shared this interest. A member of the Ornithological Society came forward and had been taking this person bird watching regularly since. This had brought the person a huge amount of enjoyment.

Staff and the registered manager were passionate about people’s happiness and wellbeing. Staff had gone ‘above and beyond’ for people. For example, the team leader in the computer room said; “I came in on Christmas morning last year especially to support one person to skype his sister in New Zealand. He and his sister really appreciated it. It made me feel all warm inside. It's one of the good parts of this job.”

The service was focused on achieving best outcomes for people and improving their independence and quality of life where possible. People’s care needs had been assessed and support plans had been created to guide staff on how best to meet people’s needs. These plans highlighted people’s wishes about how their care should be delivered and what was important to them. Staff were trained to a very high standard in a way that met the individual needs of people in the service.

The service was continually looking to improve with regards to food provision and regularly sought training from healthcare professionals such as nutritionists or speech and language therapists. People spoke very highly about the quality of the food. People made comments including; “The food is good here. We have some real stunning things. I have just had some chocolate sponge and chocolate custard and if that could be my last meal I’d be happy.”

The home delivered outstanding end of life care to people. The service was passionate about ensuring people received dignified and respectful end of life care which met their personal needs and preferences. Staff had also understood the importance of helping people to grieve and remember their loved ones when they had sadly passed away. For example, staff had created a string of fairy lights displaying the names of people who had passed away, including people’s loved ones. This was displayed in the home every year to help people and staff mourn their loss and ensure those people were still part of the Christmas celebrations.

People were protected from risks associated with their care needs. Risks had been identified and action had been taken to minimise these whilst ensuring people had freedom to take risks. People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable.

The registered manager and provider were strong, visible and exceptionally supportive. The service had an experienced and skilled registered manager in post, who provided stable and consistent leadership. People, staff and relatives spoke very highly of the registered manager and the management team. There was an open and positive culture at the service with people and staff feeling their voices were listened to.

Quality assurance processes, such as audits, were instrumental in driving standards of care to an outstanding level. Monitoring systems were in place and ensured the registered manager had the information they needed to monitor the safety and quality of the care provided and identify where improvements were needed.

More information is in the full report.

Rating at last inspection: At the last inspection the service was rated Good overall and Requires Improvement in Responsive. The last report was published on 24 October 2016.

Why we inspected: This was a planned comprehensive inspection based on previous ratings.

Follow up: We will continue to monitor the intelligence we receive about the service and plan to inspect in line with our re-inspection schedule for those services rated outstanding. If any concerning information is received we may inspect sooner.

19 July 2016

During a routine inspection

The inspection took place on 19 and 26 July 2016 and was unannounced.

Following an inspection in August 2015, we asked the provider to take action in response to breaches of regulation. The service was not safe in all areas. Risk assessments were in place but people may not have been protected from harm as their care records did not always contain the most up-to-date guidance on how to mitigate risks. Medicines were not always managed properly or safely and there was unclear guidance for staff on the use of barrier creams. There were not enough staff at all times of day to meet people’s needs in a timely way. The service was not consistently responsive. People could not be certain to receive personalised care that met their needs because records detailing their needs were inconsistent. The service was not well-led. The quality assurance system was not effective at monitoring and improving the quality of the services provided. As a result, the provider sent us an action plan that outlined the actions that had been taken in order to achieve compliance. At this visit, we found that action had been taken and these requirements had been met.

St Bridget's - Care Home Physical Disabilities is run by the provider Leonard Cheshire Disability. It is a care home for people needing personal care and accommodation that provides care for up to 38 people who have a range of physical disabilities, some of whom have an associated learning disability. At the time of our visit there were 30 people living at the home. The home’s brochure states that they [Leonard Cheshire Disability], ‘Have been providing support to people for over 60 years and we now work at over 200 sites in the UK.’ The website states that, ‘We support disabled people to have the freedom to live their lives the way they choose.’

In the Provider Information Return (PIR), the registered manager stated that, ‘In addition to their bedrooms people have access to communal areas including lounges, activities room, a small kitchen, and various outside spaces. All accommodation and facilities for people who live at St. Bridget's is on the ground floor and accessible for people who use a wheelchair. All bathrooms have been refurbished in the last year and have fully automatic baths and ceiling track hoists.’

The home had 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.

People were protected from risks to their health and wellbeing. Up to date plans were in place to manage risks, without unduly restricting people’s independence. Risk assessments were reviewed regularly so information was updated for staff to follow.

People said they felt safe at the service and knew who they would speak to if they had concerns. The service followed the West Sussex safeguarding procedure, which was available to staff. Staff knew what their responsibilities were in reporting any suspicion of abuse.

People were treated with respect and their privacy was promoted. Staff were caring and responsive to the needs of the people they supported. Staff sought people's consent before working with them and encouraged and supported their involvement.

People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way. Medicines were administered safely.

People were supported to eat and drink enough to maintain their health. People at risk of choking had been assessed by a Speech and Language Therapist (SaLT). The assessments gave clear details of people’s eating, drinking and swallowing needs. This included the different textures of food and thicknesses of fluids that people needed to manage their individual risk of choking. Additional snacks and drink were available; however the onus was on people to ask for them. They were not routinely offered to people.

There was an open and friendly culture combined with a dedication to providing the best possible care to people. Staff at all levels were approachable, knowledgeable, professional and keen to talk about their work. The atmosphere in the home was happy and calm. Every person we spoke to, without exception was extremely complimentary about the caring nature of the registered manager.

Staff received training to enable them to do their jobs safely and to a good standard. They felt the support received helped them to do their jobs well.

There were enough staff on duty to support people with their assessed care needs. The registered manager considered people’s support needs when completing the staffing rota and staffing levels were calculated appropriately. The registered manager followed safe recruitment procedures to ensure that staff working with people were suitable for their roles.

People benefited from receiving a service from staff who worked well together as a team. The registered manager and care supervisor took an obvious pride in their work and were looking for ways to improve the service. Staff were confident they could take any concerns to the management and these would be taken seriously. People were aware of how to raise a concern and were confident appropriate action would be taken.

The home had a programme of activities, however people complained of being, “Bored”. We recommend that the registered manager review the activities provision at the home to ensure that it meets people’s needs.

The premises and gardens were well maintained. All maintenance and servicing checks were carried out, keeping people safe. People were able to feedback their views about the home.

11 and 13 August 2015

During a routine inspection

The inspection took place on 11 and 13 August 2015 and was an unannounced inspection.

St Bridget's - Care Home Physical Disabilities provides accommodation and personal care for up to 38 people. The service consists of a main building split into three wings and separate bungalows. The bungalows are set up for people to live more independently and can be used for transition into or out of the service. At the time of our visit, there were 32 people in residence, including one person on respite care.

The service had a registered manager. 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.

We identified issues with how the quality and safety of the service was monitored. The registered manager did not have an effective governance system in place to ensure that all aspects of the service were assessed and to mitigate risks to people’s safety. People’s care records did not provide consistent information to staff on how to meet their needs and there was no record of some agreed support being delivered. We also observed that medicines were not always locked securely when unattended and that staff lacked guidance on the application of topical creams prescribed to people on an ‘as required’ basis.

People spoke positively about the staff who supported them but were unhappy about the recent use of agency staff. They had raised their concerns with the registered manager who had apologised and explained that agency staff had been used to maintain staffing numbers in a period of staff sickness and holiday. The registered manager had identified that additional staff were needed at particular points in the day and was completing their analysis. We have made a recommendation about staff deployment to ensure that people’s needs are met in a timely way.

Staff received regular training and were supported in their roles. They spoke of a strong staff team and valued the support of their colleagues. New staff were given an induction and the opportunity to shadow experienced staff until they were confident and assessed as competent in their role

Following an incident in May 2015, the service had worked closely with the safeguarding team and with external healthcare professionals. People who were at risk of choking had been referred to the Speech and Language Therapist (SALT). Staff had also attended training in food textures, providing support at mealtimes and emergency first aid. People were happy with the choice of food on offer at the service. They were also able to use a residents’ kitchen to prepare their own meals if they wished.

There was an open and positive atmosphere at the home. People and staff appeared relaxed and happy in each other’s company. People and staff felt able to raise concerns with the registered manager and were confident that action would be taken. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse.

Staff understood how people’s capacity should be considered and had taken steps to ensure that their rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). People were supported to be as independent as they were able and to make decisions relating to their care and treatment.

People were supported to participate in activities that interested them. In addition to a varied activity programme, the service had a team of volunteers who assisted people individually or in groups.

People’s mobility needs had been considered in the design of the premises. The corridors were wide and bedrooms were equipped with tracking hoists. People were able to open key-coded doors as sensors had been fitted to their wheelchairs. A new button-operated system for opening and closing bedroom doors had recently been installed to promote people’s independence.

People were supported to access healthcare services. The service also provided in-house physiotherapy and occupational therapy services which were available to everyone who lived at the home at no extra cost.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

8 August 2014

During a routine inspection

During our visit we spoke with four people who live in the home and a visiting relative. We spoke with the manager and four members of staff. We also spoke with the local safeguarding team.

We used this inspection to answer our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

Is the service safe?

We spoke with four people who live in the home. People told us they had no concerns about the support they received and they felt safe. A person told us, 'I've never seen the staff being abusive to anyone.' We saw that care was planned and delivered in a way that ensured people's safety and welfare. All of the care plans we looked at had assessment tools in place to assist staff in establishing the level of risk for people.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

There were arrangements in place for the service to deal with foreseeable emergencies such as loss of electrical power or loss of gas supply. The home had a contingency plan should the home become uninhabitable and people could not return to the home after an evacuation.

Is the service effective?

Each person had a plan of care and support. These explained what the person could do for themselves and what support they needed from staff. Staff told us the care and support plans gave them the information they needed to provide the level of support people required.

We observed staff supporting people. The care staff we spoke with were aware of the needs and the preferences of people they cared for, and how people wanted their care to be delivered. A person told us, 'Care is individualised. I like things a certain way.' We saw staff offering advice and support and enabling people to make their own choices and decisions.

Is the service caring?

We saw people being treated kindly and with dignity and respect by the care staff. Care staff spent time chatting with people and responded promptly to people's request for assistance. People described their satisfaction with the home. One person told us, "If staff weren't caring it would be identified.' Another person told us, 'The staff are generally caring.'

We heard staff speaking to people appropriately and staff using people's preferred form of address. People told us the staff' were kind and patient in their approach. A person said, 'Most of the staff are tolerant.'

Is the service responsive?

Staff responded promptly to peoples request for assistance. People had regular reviews of the care and support they received and care plans showed alterations that had been made to people's plans of care, as people's needs had changed. One person told us, 'They are responsive to people.'

People who used the service and their relatives were asked for their views about how the home was meeting people's needs, and any concerns or ways to improve the service were acted on.

Is the service well led?

A relative we spoke with told us they had regular contact with the home and said, 'They are approachable.' The relative told us they were kept informed about any issues which affected their relative.

All of the staff we spoke with said they felt supported. A person told us, 'The manager is very hands on.' We saw the provider had systems to monitor and assess the quality of the service provided by the home. These included senior staff at the home conducting a number of monthly audits including inspections of the property, people's care records, and staff training. The provider also conducted a comprehensive annual audit of the home's services.

Records we viewed confirmed the provider had effective recruitment procedures to ensure that staff were of good character and had the necessary skills for the job.

17 September 2013

During an inspection looking at part of the service

We spoke with two of the 34 people who lived at St Bridget's - Care Home Physical Disabilities. We asked them if they thought there were sufficient staff on duty. People told us they did not think so. They told us that, this was because people accommodated had become more dependent. One person told us, 'The problems we have are to do with the changing patterns of people living in care homes. Their needs have become more complex and how they are met is more labour intensive.' Another person told us, 'Everybody needs more help.'

We spoke with three members of staff, who were on duty. They told us they believed they had sufficient time during their shifts to do what was expected of them.

We also gathered evidence of people's experiences of the service by looking at staff rotas and records of assessments of people's needs. This demonstrated that the manager had a means of working out how many staff needed to be on duty, according to peoples' identified needs.

17 May 2013

During a routine inspection

We spoke with two people who lived at the home and three family members. Overall the people who lived at the home were happy with the care provided. One person said, "The care is tailored to me and I can tell them what I want." Another said, "I'm happy living here." The family members we spoke to said that they had some concerns about the care provided but that it had improved recently.

We spoke with four members of staff. They said that overall they received sufficient training to undertake their roles. Not all of the staff felt that the arrangements in place for staff supervision were effective. They therefore did not always feel well supported.

We looked at the care records of three people. We saw evidence that people's needs had been assessed and that care plans were in place. The care plans were regularly reviewed and updated to reflect any changes that were required.

We looked at staffing levels in the home. The staff and the people we spoke with all said that they did not always feel there were enough care workers on duty, particularly at certain times of the day. This meant that they could not always meet people's needs.

We found that people who used the service had been asked for their views about their care and treatment. The provider had systems in place to monitor the quality of the service it provided.

11 September 2012

During a routine inspection

We spoke with three people accommodated at the service. They told us about their experiences whilst living at St Bridget's - Care Home Physical Disabilities.

They told us they have been respected and involved in the delivery of their care. One person told us, " I have given my consent to the care provided. It has been in line with my expectations."

When we asked about staffing levels people gave us mixed views. People mostly told us staffing levels were sufficent. However, we were also told that recent changes to staffing rotas meant there were not as many staff on duty at certain times of the day.

They told us they were satisfied with the care and support they have received. One person told us, " My wishes and preferences have been taken into account."

They also told us they found staff were sufficiently skilled and competent when delivering care. One person told us, "I have found that staff know what they are doing when providing my care."

People we spoke with confirmed that, overall, they were satisfied with the care they have received.

17 January 2012

During a routine inspection

People told us that they liked living at the home and that they were happy there and that staff were attentive, kind and caring.

People told us they were treated with respect and that staff asked them how they like to be supported. People said staff talked to them and explained what they were doing when providing support.

People said that their needs were met by staff at the home. People told us the staff always responded to calls for assistance; however people said that sometimes they had to wait a short time before staff came to help them.

Three of the people we spoke with said that they felt that some staff were not happy in their work. One person told us 'You can feel an atmosphere'. Another person said ' The care provided is still good but you can tell that staff are not happy in their work'

People said that they knew how to make a complaint and said they would speak to staff if they had any complaints.

We spoke with two visiting relatives who told us that in their opinion the care provided was good. One person told us that he/she felt that staff at the home were not adequately supported by management. He/she said that staff remained professional but it was noticeable that some staff were not happy. They said that staff did not always seem to work as a team and that there was conflict between some staff members.

We spoke with nine members of staff who were on duty and six told us that they felt that they had not been supported by the management at the home. Three people said they had not received any supervision for over six months. Staff said that they were not having their voice heard.

Staff also told us that they felt the current staffing levels were at an absolute minimum. They said they were working to capacity. One staff member said 'I used to have time to stop and chat with people, however as people's needs increased the staffing levels have remained the same'.