Background to this inspection
Updated
18 May 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 11 April 2018 and was unannounced. This meant the provider and staff did not know we would be visiting.
The inspection team consisted of one adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We contacted the commissioners of the relevant local authorities, the local authority safeguarding team, the local fire brigade and other professionals who worked with the service to gain their views of the care provided by The Bridgings (Middlesbrough).
During the inspection we spoke with three people who used the service. We spoke with one relative of a person using the service. We also spoke with an external professional who was visiting the service during the inspection. We looked at two care plans, three medicine administration records (MARs) and handover sheets. We spoke with four members of staff, including the registered manager and three support workers. We looked at one staff file, which included recruitment records.
Updated
18 May 2018
This inspection took place on 11 April 2018 and was unannounced. This meant the provider and staff did not know we would be visiting.
At the last inspection in January and February 2017 the service was rated Requires Improvement.
We also identified a breach of regulation in relation to the safety and condition of the premises and equipment. This was because tests of the fire alarm, emergency lighting and electrical installation had not been carried out by someone qualified to do so. In addition, the premises and furniture was not properly maintained. We took action by requiring the provider to send us plans setting out how they would address this. When we returned for this latest inspection we found that action had been taken and the service was no longer in breach of regulation.
The Bridgings (Middlesbrough) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection 10 people with learning disabilities or autism were using the service.
The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager in place. 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. The registered manager was also one of the owners and registered providers of the service.
The registered manager carried out a range of checks of the premises and equipment to ensure they were safe to use. Plans were in place to support people in emergency situations. Risks to people were assessed and steps taken to address them. Measures were in place to ensure appropriate standards of infection control. Policies and procedures were in place to safeguard people from abuse. People’s medicines were managed safely. The provider and registered manager monitored staffing levels to ensure enough staff were deployed to support people safely. The provider’s recruitment policies minimised the risk of unsuitable staff being employed.
The premises had been redecorated since our last inspection. Staff were supported with regular training, supervision and appraisals. 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. People were supported to maintain a healthy diet. People were supported to access external professionals to monitor and promote their health.
People and their relatives spoke positively about the support provided by staff at the service. Throughout the inspection we saw numerous examples of kind and caring interactions between people and staff. People told us they were treated with dignity and respect. People were supported and encourage to maintain their independence. People were supported to maintain interests and relationships they had enjoyed before moving into the service. The service had received a number of written compliments from relatives of people using the service. We found the service had listened to family members as natural advocates for people to learn about people who used the service.
People received person-centred support that responded to their needs and preferences. People were supported to maintain their hobbies and interests and access activities they enjoyed. Policies and procedures were in place to investigate and respond to complaints and to arrange End of Life care if needed.
Staff spoke positively about the culture and values of the service and said they were supported in their role by the registered manager. The registered manager and provider carried out a number of quality assurance audits to monitor and improve standards at the service. Feedback was sought from people, relatives and external professionals who worked with the service. The registered manager and staff worked to create and sustain links with a number of community organisations to help improve the health and wellbeing of people at the service. The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.