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Inspection report

Date of Inspection: 24 June and 3 July 2014
Date of Publication: 9 August 2014
Inspection Report published 09 August 2014 PDF

Overview

Inspection carried out on 24 June and 3 July 2014

During an inspection in response to concerns

We had received information of concern about this service in relation to the behaviour of some people in the home and the risks posed to staff and other people in the home. Two adult social care inspectors and a specialist advisor carried out the inspection over two days. We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five questions we always ask:

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well led?

This is a summary of what we found:

Is the service safe?

Most people living in the home were safe and were supported by sufficient competent staff. The provider had installed systems to ensure the safety of the building and to improve the security of people living in the home.

Staff we spoke with were aware of the Mental Capacity Act 2005 and how to support people who were unable to make decisions for themselves. We saw examples of how they had involved other agencies in making decisions when someone lacked the capacity to make a decision for themselves. We saw examples of good practice for example when assisting someone to access healthcare.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. People's rights were therefore properly recognised, respected and promoted.

The decision to offer a placement to a person was taken by the provider after a thorough assessment process. The process resulted in places being offered to people of different ages and with very different needs. We found the criteria for admission was not specific enough to consider the potential risks of service users to other people living in the home.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to carrying out an assessment of the needs of the service user and establishing any risks to themselves or others.

Is the service effective?

Most people received effective care and support. We saw the care plans and daily living notes for one person who had complex social and health needs. The positive actions of the manager and staff had prevented deterioration in the person�s health and improved their lifestyle.

Whilst most people flourished in the setting of Bridgwater Court for some it had not been a successful placement. At the time of the visit one person was preparing to be transferred to another service due to the breakdown of the placement. Another person had been assessed in preparation for a move to another service. One person�s behaviour had been affected by social interaction with others. Another person had been disturbed at night by the disruptive behaviour of others.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to planning and delivering care that meets people�s individual needs.

Is the service caring?

We talked with the manager and deputy manager and heard of the ways the managers and staff supported and cared for the individuals in the home. Each person was well known to the manager and deputy and they understood people�s needs. We found staff to be kind and caring. One person told us they were happy with the care they received and how much they �liked� the staff. This person told us they were able to make choices for themselves and were helped by staff to �do what I like�.

We heard and saw staff treating people with respect. A member of staff told us this was "a good place to work" and felt people's best interests, care and welfare were considered to be the main focus of the service.

Is the service responsive?

People received care that was responsive to their individual needs. The home had systems in place to plan and monitor people's individual care and support. For example one person needed to be active and participate in sporting activities. We met the member of staff who had recently been on two 22 mile bike rides with the person. Another person liked to go on long walks and these were arranged. Other people enjoyed more leisurely pursuits such as the opportunity to visit a cafe and have coffee and cake.

The service had acknowledged it was unable to meet the needs of two people in the home. They had arranged for them to have re-assessments of their needs and had supported them on their transfer to new placements.

Is the service well led?

There was a registered manager in place who had many years' experience of caring for people and managing a service. They were very knowledgeable about the needs of people in the home and led the staff in providing good standards of care.

There was a staffing structure in the home which gave clear lines of accountability and responsibility. There was always a senior member of staff on duty to offer advice and support to less experienced staff. During the period of time when there had been some disruptions in the home the manager and the deputy manager had worked additional hours to support staff and the people in the home.

The manager listened to people's views and action was taken to make sure suggestions were put in place where appropriate.