4 March 2022
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.
As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 3 February 2022 and was announced. We gave the service short notice of the inspection to ensure a manager was available.
4 March 2022
The inspection took place on 6th, 7th, 26th and 27th July 2017 and was unannounced.
When we last inspected the service in April 2016 we found there were two breaches of regulations. This was because, medicines were not managed in a safe way and, the quality assurance measures the provider had in place had not ensured that any risks to people’s safety were identified or mitigated.
The provider wrote to us and told us what action they were going to take to rectify those breaches. We have checked the improvements the provider said they would make and have seen that these have been sustained.
At the time of this inspection the reablement service were supporting 40 people by providing care and support in their own homes. The rehabilitation centre were looking after seven people.
Both the reablement part of the service (community) and the rehabilitation centre had a number of staff vacancies and some recent recruitment of new staff had already been completed. In the rehabilitation centre because of a number of staff vacancies. the provider had reduced the number of people they could look after at any given time to 12 from the 17 registered beds. The provider, Bristol City Council were currently in the process of changing the staffing structure at the service and changing job roles.
The service was registered for two regulated activities: accommodation for people who require personal or nursing care (the rehabilitation centre) and person care (community – reablement service). There was already a registered manager in post for the rehabilitation centre but the person in charge of the reablement service (team leader) was in the process of completing their application for registration. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
People said the care they received was safe. All staff received safeguarding adults training as part of their induction and mandatory training. They knew what to do if there were concerns about a person’s welfare. They also completed moving and handling training which meant people who needed to be assisted to move about, were supported safely. Staff recruitment procedures ensured only suitable staff were employed. Risk assessments were completed and management plans were put in place to manage the risk. People were encouraged to look after and administer their own medicines but provided with assistance where required to keep them safe.
People received an effective service that met their care and support needs. They received either the rehabilitation service or reablement service they expected and, which enabled them to return to their own homes, with or without on-going support. Staff were knowledgeable about the people they supported and received the appropriate training and support to enable them to undertake their roles effectively. Where identified in the assessment process, people were provided with support to have food and drink. People were supported to access health care services if needed.
People received a caring service. The staff in both services had good relationships with the people they supported. They were genuinely committed to helping them either return to their own homes or remain at home during a period of ill health. People reported to us that the staff were kind and caring. They said they were treated with kindness and respect. People in both services were involved in having a say about the support they received and how their service was delivered.
People received a service that was responsive to their individual care and support needs. The assessment and care planning ensured each person received the specific service they needed to meet their goals. People were included in making decisions and encouraged to express their views about the service they received.
People received a service that was well-led. The registered manager and team leader provided good leadership and management for their respective staff teams. The quality and safety of the service was regularly monitored and used to make improvements.