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Inspection carried out on 10 December 2018

During a routine inspection

Bainbridge Close is a Supported Living Service and provides a domiciliary care service to 15 people living in five different bungalows. Two of the bungalows are adjacent in Bainbridge Close, North Walsham and the other bungalows are in Blofield Heath, Gressenhall and Norwich. The service provides 24 hours care to people who are living with learning and physical disabilities. The service’s registered office is at Bainbridge Close.

The service had been developed and designed in line with the values that underpin the CQC guidance, Registering the Right Support, and other best practice guidance. These values included choice, promotion of independence and inclusion. People with learning disabilities and autism who lived in the home could live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were kept safe because staff understood safeguarding principles. They conducted robust risk assessments and ensured that identified risks were mitigated.

Medicine management was safe and steps had been taken to minimise the risk of errors.

People were supported by sufficient numbers of staff that had been recruited safely and had checks undertaken to ensure they were suitable for their role. Staff were trained and competent to fulfil their roles.

People were encouraged to eat a varied diet that took into account their nutritional needs. People were supported to access healthcare professionals when needed to maintain their health and wellbeing.

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.

People received a service that was caring. Staff knew people's needs well and were responsive and supportive. Staff treated people with dignity and respect. Staff promoted people’s independence.

Staff were provided with the necessary support and encouragement to ensure people received good quality care.

Quality assurance systems were effective and the service showed that it learnt lessons and made improvements when things went wrong.

The service sought feedback from various sources to drive improvement and worked well with partner agencies.

Some notifiable incidents had not been reported to the Care Quality Commission.

Further information is in the detailed findings below.

Inspection carried out on 26 July 2016

During a routine inspection

The inspection took place on 26 July and we contacted the service before we visited to announce the inspection.

Bainbridge Close provides a domiciliary care service to a total of six people living in two bungalows adjacent to each other. The service provides 24 hour care to all six people who are living with learning and physical disabilities. The service’s registered office is also on the same site.

There was a registered manager in post. 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

Checks were completed on new employees to ensure they were suitable to work with the people who used the service. These were completed prior to staff starting in post. Enough suitably trained and competent staff were employed to meet the individual needs of people in a person-centred manner.

People benefited from receiving care and support from staff who felt valued and rewarded in their roles. Staff demonstrated team work and told us they felt supported by their managers and colleagues. They had received an induction that prepared them for their roles and ongoing training that was relevant and specific to the needs of those people they supported.

Staff respected each other and the people who used the service. They demonstrated warmth and a caring attitude in their approach. People’s dignity and privacy was maintained and staff understood the importance of confidentiality. People were supported and encouraged in making choices.

The service had processes in place to help protect people from the risk of abuse and harm. Staff understood how to prevent, protect, identify and report any potential abuse. The risks to people who used the service and staff had been identified and appropriately managed. Accidents and incidents had been recorded and analysed on a regular basis. The provider had an overview of these which assisted in identifying any trends and contributing factors.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service adhered to the five principles of the MCA and the registered manager and staff had a good understanding of this.

Care and support plans contributed to the person-centred care that was being delivered. These were detailed and accurate and contained information that assisted staff to provide an individual service. They had been reviewed on a regular basis and people had been involved in decisions around these. Staff knew the preferences, likes and dislikes of the people they supported.

Staff assisted people to maintain relationships, hobbies and interests and had knowledge of what each person liked in relation to these. The service was flexible which allowed people to follow their interests and access the community.

The service worked closely with health professionals to meet people’s wellbeing needs. Referrals were made promptly and staff supported people to attend healthcare appointments as and when required. Professional recommendations were followed.

People’s nutritional needs were met and people contributed to the menus and meal preparation. Staff were able to tell us people’s nutritional requirements as well as their likes and dislikes. People’s nutritional health was closely monitored to ensure wellbeing.

Systems were in place to monitor the quality of the service and these were effective. People, their relatives, staff and professionals were given the opportunity to contribute to the development of the service and we saw that suggestions were actioned as appropriate. Complaints were investigated and addressed promptly.

Inspection carried out on 4 June 2014

During a routine inspection

On the day of this inspection the service was supporting six people to live in the community, all of whom lived on the same site as the service's registered office.

We considered our inspection findings to answer the five questions we always ask: Is the service safe? Is the service effective?Is the service safe? Is the service responsive? Is the service well led? This is a summary of what we found based on our observations during the inspection.

We looked at written records, which included people's care records, staff personnel files, medication systems and quality assurance documentation. We could not speak with the people who used the service due to their communication needs, although we observed the care and attention they received from staff. We spoke with the manager and three members of care staff.

If you want to see the evidence supporting our summary, please read the full report.

Is the service safe?

The accommodation was adapted to meet the needs of the people living there. It was suited to caring for people with limited mobility and was properly maintained. The service was warm and clean.

The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. There were proper processes in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

Care plans and risk assessments were informative, up to date and regularly reviewed. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care records.

People were protected by safe and effective staff recruitment systems. People were cared for by staff who were properly trained and supported to develop professionally.

Is the service caring?

We were not able to speak with the people who used the service due to their communication needs. We observed the care and attention people received from staff. All interactions we saw were encouraging and friendly and there was a relaxed atmosphere throughout the service.

People were treated with dignity and respect. People were included in decisions about the service and about their support. People were supported to engage in a range of meaningful and enjoyable activities.

Is the service responsive?

Staff told us that the manager and other senior staff were approachable and they would have no difficulty speaking to them if they had any concerns about the service. We found that the provider listened to and acted upon views from people who used the service and their families.

Is the service well led?

Staff said that they felt well supported by the manager, there was a good team ethic and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

Inspection carried out on 13 December 2013

During a routine inspection

We saw that staff ensured that the people who used this service had the opportunity to be involved in all aspects of their day to day lives. This and the other evidence reviewed showed us that people�s privacy, dignity and independence were respected.

Each person had an individual care record including assessments of individual need and how these should be met in the form of care plans to help to support personal needs. This meant that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Staff understood their responsibilities around ensuring people were safeguarded. They told us they were confident they would know what action to take if any potential abuse was identified. This showed us that people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to prevent abuse from happening.

Staff spoken with felt that there were sufficient staff on duty to provide care to people. They knew what to do and who contact for support in an emergency situation. This demonstrated to us that there were enough qualified, skilled and experienced staff to meet people�s needs.

We saw that monthly monitoring visits and other audits were carried out and that systems were in place to address any identified concerns. This showed us that the provider had an effective system to assess and monitor the quality of service that people received.

Inspection carried out on 24 October 2012

During a routine inspection

Although the people who used this service were unable to verbally converse with us we were able to use methods of communication that were understood. For example, we were given plenty of smiles and signs that told us when things were ok and when they were not ok.

We looked at two care plan documents and talked about the support offered to one person who was at home at the time of this inspection. We were given positive answers to our questions. They let us know they were happy with their care support and that they were included in all aspects of the care provided. We saw person centred information that showed the care planning was tailored to the individual needs.

We discussed the use of other professionals with the manager who gave us clear examples of how expert help, specific to the needs of an individual, had been beneficial and necessary to get the correct support required.

Areas within these people's home, that staff used to provide the personal care, were clean. We found that staff had received training on infection control, had access to the correct equipment, cleaning materials and protective clothing to ensure they followed good infection control practices.

Staff were recruited appropriately to ensure people were cared for safely.

This service had not received a complaint but evidence gathered during our inspection demonstrated to us appropriate action would take place if a complaint was made.