1 December 2022
During an inspection looking at part of the service
About the service
Bradley Apartments is a residential care home that provides accommodation, nursing and personal care to a maximum of 14 younger adults with a learning disability, some of whom may also have needs associated with their mental health and autism. At the time of our inspection there were 10 people using the service. The home provides five apartments consisting of bedrooms, bathrooms, communal area and kitchen.
People’s experience of using this service and what we found
The provider was not always able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support:
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Where people lacked capacity to make decisions, the provider had failed to put in place documents to support best interest decision making.
Medicines management was not always in line with best practice guidance; medicine administration records were not always fully completed and guidance for staff not always in place.
Risks to people had been assessed. People accessed specialist health and social care support where appropriate.
Right Care:
The provider had systems in place to report and respond to accidents and incidents. However, not all accidents, incidents or safeguarding concerns in the home had been investigated timely and thoroughly.
The service had enough staff to keep people safe. Staff received training and an induction to help them support people. We observed staff respecting people's privacy and dignity when providing care and support.
Systems to protect people from the risk of infection were effective.
Right Culture:
The provider's quality monitoring processes were not always effective at highlighting issues found at this inspection. They had offered assurances about actions they would take and were committed to making any necessary improvements as quickly as possible.
We received mixed feedback from staff about the support they received from management in order to fulfil their roles and responsibilities.
Staff knew people well and were responsive to their needs. People and their relatives were involved in their care.
Following our visit to the service, we asked the provider to send us an improvement plan which detailed the actions they had taken/were going to take in relation to the issues identified during our inspection.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 30 June 2021).
Why we inspected
We received concerns in relation to safeguarding and the quality of care being provided. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key
questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bradley Apartments on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to medicine management, safeguarding, consent and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.