This inspection took place on 27 February 2017 and was unannounced. This meant that the staff and registered provider did not know that we would be visiting.

Bridge Court Bungalow is a modern purpose-built property located in the grounds of Bridge House. Both homes have their own gardens. The home is situated off Normanby High Street and accommodates up to six people with learning disabilities.

At the last inspection on 11 February 2015 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

People we spoke with told us they felt the service was safe. Risks to people using the service were assessed and plans put in place to reduce the chances of them occurring. Safeguarding and whistleblowing procedures were in place to protect people from the types of abuse that can occur in care settings. People’s medicines were managed safely. There were enough staff deployed to keep people safe. The registered provider’s recruitment processes minimised the risk of unsuitable staff being employed.

Staff received mandatory training in a number of areas, which assisted them to support people effectively and they were supported with regular supervisions and appraisals. People’s rights under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were protected. People were supported to maintain a healthy diet and to access external professionals to monitor and promote their health.

People spoke positively about the staff at the service, describing them as kind and caring. Staff treated people with dignity and respect. Staff knew the people they were supporting well, and throughout our inspection we saw staff having friendly and meaningful conversations with people. People were supported to be as independent as possible. People were supported to access advocacy services where needed and to discuss end of life care.

Care plans were person centred and regularly reviewed to ensure they reflected people’s current needs and preferences. People were supported to access activities they enjoyed. Procedures were in place to investigate and respond to complaints.

People, relatives and staff spoke positively about the service and people said they were proud of where they lived. Staff spoke positively about the registered manager, saying she supported them and included them in the running of the service. The registered manager and registered provider carried out a number of quality assurance checks to monitor and improve standards 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.

We decided to visit the home in the evening time to gain a wider view of the service provided. This was part of an out of normal hours pilot project being undertaken in the North East region.

During the inspection we spoke with three people living at Bridge Court Bungalow. We also spoke with the manager, a senior care assistant and two care workers. People told us what it was like to live at this home. They expressed satisfaction with the care and service that they received. One person told us, “I am very happy living here and the staff look after me.”

We were able to observe the experiences of people who used the service. The staff were attentive and encouraging when interacting with people. We saw staff provide explanations of care to people in a way that could be easily understood.

We observed people being offered choice throughout the inspection. We saw that people had their needs assessed and that care plans were in place.

We found there were appropriate arrangements in place to ensure a suitable skill mix and adequate staffing levels.

We found that appropriate systems were in place to ensure the safe use and management of medicines.

We found that systems were in place to deal with comments and complaints.

The visit took place because we were following up compliance actions made at the last inspection in April 2012 around care planning and documentation within care records.

We spoke with two people who used the service. They both told us they felt safe at the home and were happy. One person said, “I like it here”, another person told us, “The staff are alright.”

We saw there was a friendly and relaxed atmosphere between people living and working at the home. We observed staff interacting well with people and supporting them, which had a positive impact on their wellbeing.

We found that care records had been updated and duplicate information had been removed. We saw that staff had regularly signed care records to say they had been reviewed. We also saw that support plans and assessments had been regularly reviewed by the manager.

We spoke with one individual who said that they chose when to get up and when to go to bed. They were able to make choices about what they did during the day.

They told us that they liked going shopping and to the pub. They said that they got good dinners and they liked listening to the radio and watching TV.

We observed people being supported with daytime activities and during their lunch in a caring and sensitive manner.

We spoke with one individual who said that they felt safe but that they got upset when another individual living at the home shouted. We were told "I have to go to my room if they shout, I dont want to go to my room."

We were told that people living at the home liked the staff and could tell them if they didn't like someone.

We could see that people attended meetings and could share their views.

The people living at Bridge Court Bungalow experience difficulties with verbal communication so they had difficulty at times explaining what they thought. However people were able to tell us about their experience of living in the home. They said they liked the staff and were happy at the home. From our observations it was evident that staff had developed a good relationship with people and were aware of how to help people to manage their behaviour.

We inspected Bridge Court Bungalow on 10 and 22 December 2014. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

Bridge Court Bungalow is a modern purpose-built property located in the grounds of Bridge House. The home accommodates up to six people with learning disabilities.

The home had a registered manager in place who commenced working at the home in February 2014. 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.

People living at the home required staff to provide support to manage their day-to-day care needs; to develop impulse control; as well as to manage their behaviour and reactions to their emotional experiences. We found that the manager had taken appropriate steps to ensure staff reviewed their behaviour; analysed what worked or not; and provided consistent responses when people’s needs changed to ensure that staff could continue to meet the individual’s needs.

Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards training and the manager understood the requirements of the Act. This meant they were working within the law to support people who may lack capacity to make their own decisions. The provider had not developed appropriate MCA records and staff remained unclear about the legislation. The registered manager was aware of this shortfall and had developed the necessary records as well as providing staff with additional support to ensure they understood the legislation.

People had difficulty discussing complex and thinking about the future but were able to share their views about day-to-day life at the home. People told us they liked living at the home and that the staff were kind and helped them a lot. We saw there were systems and processes in place to protect people from the risk of harm.

We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. All relevant infection control procedures were followed by the staff at the home. We saw that audits of infection control practices were completed.

We found that staff worked to assist people to lead ordinary lives and looked at how to assist individuals to reach their full potential. People were supported to go out and about in the local community and routinely went out with staff.

Staff had received a range of training, which covered mandatory courses such as fire safety as well as condition specific training such as managing epilepsy and other physical health needs. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that four to five staff routinely provided support to people who used the service during the day and two staff provided cover overnight.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

We reviewed the systems for the management of medicines and found that people received their medicines safely.

We observed that staff had developed very positive relationships with the people who used the service. We saw that the staff effectively assisted people to manage their anxiety. Interactions between people and staff were warm and supportive. Staff were kind and respectful. People told us that they made decisions about what they did throughout the day.

We saw that people had plenty to eat. We saw that each individual’s preference was catered for and and staff had ensured that each individual’s nutritional needs were met. Staff monitored each person’s weight and took appropriate action if concerns arose.

We saw that people living at Bridge Court Bungalow were supported to maintain good health and had access a range healthcare professionals and services. We found that staff worked well with people’s healthcare professionals such as consultants and community nurses.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and how they had worked with staff to create them.

People told us how staff encouraged them to develop their daily living skills and supported them with their courses, hobbies and leisure interests inside and outside of the home. During the visit we saw staff joined people doing creative work and identified activities people would enjoy doing.

We saw that the provider had a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and but did not have any concerns about the service.

The provider used a range of sytems to monitor and improve the quality of the service provided. We saw that the manager used them to critically review the service. This had enabled the manager to identify areas for improvement and make the necessary changes to the provision.