This inspection took place on 22 March 2017 and was unannounced. This meant the registered provider did not know we were inspecting the home at that time.We last inspected the service in March 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.
Bradbury House provides accommodation with personal and nursing care for up to 25 people. The home also provides for children in transition services (young people to adults.) Two of the places are used to provide a respite care service for people who wish to live at the home for short periods of time. The home specialises in the care of those who have a physical disability and require nursing care.
On the day of our inspection there were a total of twenty four people using the service.
Bradbury House was designed specifically to meet the needs of people with physical and neurological conditions. Further adaptations were taking place at the time of our inspection to ensure the building continued to meet the needs of people living there. The home is set in its own fully accessible garden, in a residential area near to town centre shops and local facilities and public transport routes.
There was a new registered manager in place who had been appointed since the last inspection in 2015. 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.
All the care records we looked at showed people’s needs were assessed before they moved into the home and we saw care plans were written in a person centred way.
There were sufficient numbers of staff on duty in order to meet the nursing and care needs of people using the service; and ensure they had an active and meaningful lifestyle. The registered provider had an effective recruitment and selection procedure in place and carried out robust checks when they employed staff to make sure they were suitable to work with vulnerable people.
There were robust procedures in place to make sure people were protected from abuse and staff had received training about the actions they must take if they saw or suspected that abuse was taking place.
We saw the home had in place personal emergency evacuation plans displayed close to the main entrance and accessible to emergency rescue services if needed.
We found there were cleaning schedules in place to ensure the home remained a pleasant and attractive place to live and to prevent the spread of infection.
People’s nutritional needs were assessed and plans of care drawn up if they were at risk of malnutrition or choking. The cook demonstrated an extensive knowledge of people’s likes and dislikes and prepared a wide selection of wholesome and popular meals to cater for people’s tastes.
Staff were extremely caring in their approach and had developed good relationships with people and their families. They respected people’s privacy and dignity and supported them to live as independently as possible. People and their representatives received information about the service and were involved in decisions about their care.
The registered provider successfully supported a small number of younger persons (aged 16-17) at this home. They had taken into consideration all legal requirements needed to ensure the safety of young people and their legal status, consent and rights were protected, and had liaised with children’s services to ensure they were meeting the needs of young people.
People who used the service, and family members, were complimentary about the standard of care provided. They told us the staff were friendly and helpful. We saw staff treated people with dignity, compassion and respect and people were encouraged to remain as independent as possible and for some, retain or regain skills to promote their independence and well-being.
The home supported people to have interesting lives. They produced an activities newsletter each month which reported on past and upcoming events. Activities were regular and frequent with emphasis placed on active and inclusive lifestyles.
People’s healthcare needs were closely monitored by highly trained and diligent nursing and care staff. This ensures that any changes in a person’s condition was monitored and discussed so that interventions, when required could take place quickly. In this way the service ensured peoples lifelong conditions were maintained and their good health was promoted. People were supported with health checks, from hospital and community specialists.
We saw the registered provider had a complaints policy in place and this was clearly displayed for people to see.
The registered provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources including people who used the service and their family and friends. The registered provider’s organisation collected this information and provided additional oversight and monitoring of the home. The staff and registered manager reflected on the work they had done to meet peoples’ needs so they could see if there was any better ways of working.
The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS). 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.
The registered manager and provider made regular checks to make sure the service was running as expected and took action where improvements were needed.
The registered provider was meeting the conditions of their registration. They were submitting notifications in line with legal requirements. They were displaying their previous CQC performance ratings at the service and on their website.
Further information is in the detailed findings below.