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 rema

The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans. Each person was supported to take appropriate risks to promote as much independence as possible.

Suitable arrangements were in place for people to take part in activities in line with their needs and preferences.

The relationships between staff and the people who lived there were good and personal support was provided in a way that promoted and protected their privacy and dignity.

Suitable arrangements were in place for handling complaints and for protecting people from abuse. Two people told us they could share any concerns with the staff and felt their views were listened to. Another person said “This place is just great it is my home. I have lived here for several years. I like living here because all my needs are taken care of and I feel safe.”

We saw the provider had a robust recruitment and selection policy in place. This meant people were cared for by staff who had all the necessary background checks carried out before they commenced employment.

People told us they had received lots of information about the service before moving in.

One person said, “I came for day care first of all, I then tried the respite care. This helped me to decide this was the right place for me.”

Another person said, “we have regular meetings and these provide us with a platform to voice what we think might make things better. We are all treated with dignity and respect and the staff listen to what we have to say.”

One person said, “I am fully involved in all aspects of maintaining information held about me.” Another person said, “I have seen all of my care plans. I made sure everything was correct before I signed them.”

People told us they felt safe living at Bradbury House. They said they would know how to make a compliant or raise a concern if they had to. One person said, “I can honestly say I have never needed to make a complaint about anything in the eight years I have lived here. We all have access to a free customer helpline, and an e-mail address that we can access if we are upset about anything.”

People told us there were enough staff around throughout the day to meet their needs.

One person told us they were part of the staff recruitment team. They said this was an important role as it promoted user involvement in a very positive light.

People told us they were consulted about the ongoing management of the service.

One person said, “I am a member of the residents committee, we have a voice and we are heard.”

We inspected this service on 19 and 26 November 2014 and our visit was unannounced. This meant the staff and provider did not know we would be visiting.

Bradbury House provides care and accommodation for up to 24 people, two of the beds are used to provide a respite care service. The home specialises in the care of people who have a physical disability who require nursing care. On the day of our inspection there were a total of twenty two permanent people using the service and one person in receipt of respite care.

The home had 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.’

During our inspection there was a calm and relaxed atmosphere in the home and we saw staff interacted with people in a very friendly and respectful manner.

We spoke with care staff who told us they felt supported and that the registered manager was very approachable. Throughout the day we saw that people and staff appeared very comfortable and relaxed with the registered manager and staff on duty.

Care records contained risk assessments, which identified risks and described the measures in place to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health professionals as appropriate. We saw people were assisted to attend appointments with various health and social care professionals to ensure they received care, treatment and support for their specific conditions.

We found people’s care plans were very person centred and written in a way to describe their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for service users to understand by the use of plain English and everyone had a copy of their care plan in their bedroom. We saw lots of evidence to demonstrate that people were involved in all aspects of their care plans.

The staff that we spoke with understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff were responsive to people’s needs and wishes and we viewed records that showed us staff were enabled to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended training and development activities to maintain their skills. They told us they had regular supervisions with a senior member of staff where they had the opportunity to discuss their care practice and identify further training needs. We also viewed records that showed us there were appropriate recruitment processes in place.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

During the inspection we saw staff were attentive and patient when supporting people. We spoke with people who used the service and their relatives. We were told they were happy with the service the home provided. Comments received included “The staff treat me well,” “The staff are lovely. If I didn’t like it here I would ask to be transferred. The staff always knock on my door, they never just come in.”

We observed people were encouraged to participate in activities that were meaningful to them. For example, we saw staff spend time engaging people with arts and crafts in the designated activity area. We also saw how people were supported to achieve their lifetime goals. For one person this meant completing the Great North Run. We saw the care home had won an award given by the organisation for providing personalised care.

We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered choice and if people required assistance to eat their meal, this was done in a dignified manner.

We found the building met the needs of the service users. For example, corridors were wide and spacious for people who used a wheelchair and there was overhead tracking from everyone’s en-suite toilet to their bed which meant people’s personal space was maximized to the full therefore promoting people’s independence.

We saw a complaints procedure was displayed in the main reception of the home. This provided information on the action to take if someone wished to make a complaint. We saw an audio version of this was also available to people called a ‘talking tin’.

We discussed the quality assurance systems in place with the registered manager. We found the way the service was run it had been regularly reviewed. Prompt action had been taken to improve the service or put right any shortfalls they had found. We found service users were regularly asked for their views. We saw the registered manager had been nominated for an award from the provider for ‘outstanding leadership’.