28 July 2016
During a routine inspection
The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run. The registered manager was not present at the office on the day we inspected the service. We were told they planned to step down from this role, but an acting manager had been recruited and their application to become the registered manager was being considered by the Commission.
Bridge Centre provides personal care to people living in their own homes in the Doncaster area. At the time of our inspection the service was mainly supporting older people and people with a learning disability. The manager told us they planned to expand the agency to cover other areas of care in the future. Care and support was co-ordinated from the services office which is based near the centre of Thorne.
On the day of the inspection there were 13 people receiving support with their personal care. We spoke with six relatives to obtain their views on how the service operated, as people using the service were unable to talk to us on the telephone. All the people we spoke with told us they were happy with the service provided and praised the staff who delivered care.
The provider had a policy in place to protect people from abuse. The policy included types of abuse, and how to recognise and report potential abuse. Staff we spoke with confirmed they had received training about protecting people from abuse. However training records did not demonstrate that all staff had received this training.
People’s needs had been assessed and the relatives we spoke with told us they had been involved in formulating and updating care plans. Care records sampled identified people’s needs, as well as any risks associated with their care. However, the management team told us not all care files reflected people’s needs and preferences in sufficient detail. We saw the management team had begun to review and update people’s care plans in order to improve them. Relatives confirmed staff were meeting their family member’s individual needs, while this process was completed. We found staff were knowledgeable about the needs and preferences of the people they were supporting.
There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. However, this had not been consistently followed. For example, one staff member’s file did not include a reference from their last employer and there was no rationale for this recorded in their file. The manager took immediate action to rectify this.
We saw new staff had received an induction at the beginning of their employment, but documentation was not always up to date. Staff said they felt they had received enough training and support to enable them to carry out their job. However, training records did not demonstrate that all essential training had been provided in a timely manner. Staff had however received regular supervision sessions and spot checks to provide support, and to assess their capabilities.
Where people needed assistance taking their medication appropriate support was provided. However, medication records sampled contained occasional gaps and there was no evidence to show that the management team had checked to make sure these records had been completed in line with company policy. We also noted that protocols were not in place with regards to medication to be administrated ‘as required’ [PRN]. The manager told us they would address this as soon as possible.
People’s capacity to make decisions was recorded in their care files and people had signed to acknowledge their agreement in the planned care.
The company had a complaints policy which was provided to each person at the start of their care package. We saw a system was in place to record the details and outcomes of concerns raised. People we spoke with raised no concerns or complaints.
People had been consulted about their satisfaction in the service they received. The provider also had a system in place to check if staff had followed company polices. However, some aspects of the system had not been fully utilised and embedded, which meant areas for improvement could be missed. The manager told us they would introduce appropriate monitoring tools to capture this information.