Bridge House 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. 11 people with a learning disability were receiving care at Bridge House. They were between the ages of 29 and 67. Bridge House is a large terraced house adapted as a care home.

The care service has 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.

At the last inspection, the service was rated Good.

At this inspection, we found the service remained Good.

Why the service is rated Good

People were safe at the service because recruitment, staffing, medicine management, infection control, and upkeep of the premises protected people from unsafe situations and harm. Individual risks to people were assessed and managed with as little restriction to the person as possible.

Staff had a good understood of how to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken. The registered manager was a strong defender of people’s rights and protection.

Staff were supported to be skilled and efficient in their roles and spoke of good teamwork and how much they liked working at Bridge House.

People’s legal rights were understood and upheld with as little restriction as possible. People’s health care needs were met through working with external health care professionals and staff’s detailed knowledge of the people using the service.

The premises provided people with a variety of spaces for their use with relevant adaptation to meet their needs where possible. Bedrooms were very individual and age and gender appropriate.

People received a home cooked and varied diet and specialist diets were met. Some people enjoyed eating out on a regular basis.

Staff promoted people’s dignity and privacy. The service was centred on each person as an individual. Staff were kind, caring and people enjoyed banter, laughter and a friendly atmosphere. Information was provided in different formats according to people’s communication needs. However, the organisation had expected people to complete a form, which would require good reading, and interpretative skills, which people using the service did not have. The registered manager will discuss this with the provider.

Support plans were detailed and reviewed with the person when possible, staff who supported the person and family members. Staff looked to identify best practice and use this to people’s benefit. Staff worked with and took advice from health care professionals.

Some people were reluctant to engage in activities but many options were available to them. These included art, crafts, music, sport, dancing, walking, and eating out. People had a holiday each year and went into the community on a daily basis. There was strong support of relationships with friends and family.

The registered manager showed strong leadership and a passion for the people in their care. People’s views were sought and opportunities taken to improve the service. Staff were supervised, supported and were clear what was expected of them. Audits and checks were carried out in-house and through the provider, so any problem could be identified and rectified.

The registered manager understood and met their legal responsibilities.

This inspection took place on 27 October 2015 and was an unannounced inspection.

This was the first inspection of the service since the provider changed their legal entity from Voyage 3 Limited to Voyage 1Limited in June 2014. Voyage 1 limited is the provider of a number of services throughout the country.

The home is situated close to Taunton town centre. Bridge House (Somerset) is registered to accommodate up to 11 people and it specialises in providing care and support to adults who have a learning disability. All bedrooms are for single occupancy and the home is staffed 24 hours a day.

When we visited there were nine people living at the home all of whom had lived there for many years. People had complex needs and communication difficulties associated with their learning disability. Because of this we were only able to have very limited conversations with people about their experiences. We therefore used our observations of care and our discussions with staff to help form our judgements.

There was a registered manager in post. 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 home was well-led by a registered manager who was passionate about enabling people to have a “happy, fulfilling and exciting life.” Staff demonstrated the same ethos. Staff spoke with great pride and compassion when they told us about the people who lived at the home. One member of staff said “It’s like they are part of my family. I really care about everyone here. All the staff do.” Another member of staff told us “I feel really proud about the way we support people here. This is their home and I just want people to have the best life possible. It’s all about always looking forward and looking for ways to continually improve people’s quality of life.”

People received care and support in accordance with their needs and preferences. Staff knew people well and they knew what was important to them. People appeared very comfortable and relaxed when staff interacted with them.

People saw health care professionals when they needed to. People’s health needs were monitored and staff implemented any recommendations made.

There were procedures in place to reduce risks to the people who lived at the home. Staff had received training and they knew how to recognise and report any signs of abuse. All were confident in reporting concerns and felt confident concerns would be taken seriously to make sure people were safe. Checks were made on prospective staff to make sure they were appropriate and safe to work with vulnerable people.

Staff knew how to make sure people’s legal and human rights were protected. They knew the procedures to follow where a person lacked the capacity to make certain decisions about their day to day lives or health care needs. This helped to ensure that decisions had been properly considered and agreed to be in the person’s best interests.

People needed staff to manage and administer their medicines. This was only carried out by senior staff that had been trained to do so. There were systems in place to make sure staff remained competent by observation of their practice and on-going training. People received their medicines when they needed them. Medicines were managed safely and stored securely.

People were supported to maintain relationships with the people who were important to them, such as friends and relatives. People were provided with opportunities for activities and social stimulation in accordance with their needs and preferences.