Mediline Supported Living Bradgate

We found the following examples of good practice.

Procedures were in place to reduce the risk of infection entering the home, for example, a log of all visitors, temperature monitoring and lateral flow tests. In the foyer of the small care home visitors had access to personal protective equipment (PPE), hand sanitiser and antibacterial wipes. There were safe and effective arrangements for visitors to the home, although contact from relatives was mainly via the telephone and post.

The home had mechanisms in place to communicate to people about the pandemic, the use of PPE and why safety measures were necessary. Staff used pictures and social stories to inform and give reassurance. People were also encouraged to follow good hand hygiene practice.

People preferred not to leave the home due to the pandemic. The service had worked hard to develop and encourage use of the large rear garden, especially during the warmer weather. Additional seating had been purchased so that social distancing could be adhered to. The service had implemented garden visits when these were allowed, to enable people to maintain relationships that were important to them.

Staff had received additional training on infection control, donning and doffing PPE and hand hygiene. The manager regularly reminded staff of the importance of good infection control practice, including the correct donning and doffing procedures for PPE, to prevent complacency.

The staff followed enhanced cleaning regimes, including deep cleans. There were cleaning procedures and recording systems in place for audit purposes. These helped staff maintain a high standard of cleanliness and hygiene in the care home.

The registered manager had set up a COVID-19 file. This contained all the relevant government guidance, information and company processes introduced during the pandemic. This could be easily accessed by staff in the event of the manager’s absence.

As this was a small care home no admissions had taken place during the pandemic.

Visiting health professionals did not visit communal areas but carried out necessary clinical care in people’s bedrooms.

Mediline Supported Living Bradgate, known as Bradgate Close, is a residential care home. This service supports people with a learning disability and autism. The service is registered to care for four people; there were four people living at the service at the time of the inspection.

The service applied the principles of Registering the Right Support and other best practice guidance. These principles 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 outcomes for people using the service reflected the principles and values of Registering the Right Support in the promotion of choice and control, independence and inclusion.

People’s experience of using this service:

People's support focused on them having numerous opportunities to participate in activities they enjoyed doing but people were also encouraged to try different activities, gain new skills and become more independent.

Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities and recognised the importance of keeping people safe from harm.

People received care from consistent, regular staff. Enough staff were employed each day to meet people's needs and help keep them safe. Staff supported people to be as independent as possible with activities of daily living, such as shopping, cooking meals, preparing drinks and personal care.

Staff received a range of training appropriate to their role and people's needs and were supported by the registered manager through regular supervision.

People were encouraged and supported to eat and drink well. People with dietary needs were given a choice of suitable meals and snacks. People were supported to access healthcare when needed.

The leadership of the service promoted a positive culture that was person-centred and inclusive. We received positive feedback about the quality of care and support people received and the overall management of the service.

The registered manager and the staff team were committed to improving the quality of life for people living at Bradgate Close and looked for ways to improve on the service provided.

Effective systems were in place to check the quality and safety of the service. The environment was safe and in a good state of repair and decoration.

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; (report published 10 November 2016). Since the last inspection the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned comprehensive inspection to confirm that the service remained good.

Follow up

We will continue to monitor the service through the information we receive. If any concerning information is received, we may inspect sooner.

62 Bradgate Close provides care for four people with learning disabilities who may also have mental health needs.

The registered manager has been in post since September 2016. 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.

At the time of the inspection we met three of the four people who lived at the home. Two people who lived at the service had very limited verbal communication so we observed how staff interacted with them.

One person told us that they were very happy with the service and found it met their needs. They told us all about the improvements they had made when interacting with others and the communication skills they had learnt. One person told us they felt able to freely discuss any concern and ask questions about everyday matters. We found that there was a lot of humour and jovial interactions between the people and staff.

We found that the registered manager and staff consistently ensured people were supported to lead an independent lifestyle. Staff readily identified triggers that would lead people to become distressed and were adept at using deescalating techniques.

Staff were aware of how to respect people’s privacy and dignity. We saw that staff supported people to make choices and decisions.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. We noted that the registered provider is in the process of reviewing the format to ensure they are easy to navigate.

We saw that people were offered plenty to eat and assisted to ensure that their nutritional needs were met. We saw that each individual’s preference was catered for and people were supported to maintain a healthy weight.

We saw there were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. We saw that people had hospital passports. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as working with people who have learning disabilities and autism spectrum disorders.

Staff had also received training around the application of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The staff we spoke with understood the requirements of this Act and were ensuring that where appropriate this legislation was used.

Staff discussed with us how they as a team worked very closely with people to make sure the service enabled each person to reach their potential.

People and the staff we spoke with told us that there were enough staff to meet individuals’ needs. We found there were sufficient staff on duty to meet people’s needs.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work.

We reviewed the systems for the management of medicines and found that people received their medicines safely.

We saw that the registered manager had an effective system in place for dealing with people’s concerns and complaints. People were confident that staff would respond to any concerns they raised and take action to deal with any issues.

We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety measures were in place. We found that action was taken to minimise known risks.

The registered manager had developed a range of systems to monitor and improve the quality of the service provided. We saw that the registered manager had implemented these and used them to critically review the service.

People were involved in developing their plan of care as much as possible. A range of social activities were provided which ensured people's social care needs were met. Staff monitored and planned for people's physical health care needs.

One of the people who used the service told us, 'I have lived here for seven months and have settled in and am happy to stay.' They described the staff as 'great' and 'really good' and said staff were always around to talk to.

Relatives of the people who used the service said they were very happy with the way their relative was looked after. They said they were always kept informed about their relative's general well-being.

Staff were trained on how to safeguard people from abuse and the manager knew what to do if an allegation of abuse was made.

One of the people who used the service said they would speak with any of the staff if they wanted to make a complaint. They told us, "If I wasn't happy I would speak to the manager, I like them.'

Relatives spoken with said that although they were not aware of the home's formal complaint procedure, they would speak with the manager directly if they wanted to raise a concern. Neither of the relatives we spoke with had any concerns to raise.