This inspection took place on 18 October 2016 and was announced.

Bridgewater House provides personal care for up to nine people with learning and physical disabilities. At this inspection they were providing care and support for nine people.

A registered manager was in post but owing to pre-arranged annual leave was not present at this inspection. 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 supported day to day by a deputy manager who was present at this inspection.

People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People had individual assessments of risk associated with their care. Staff knew what to do in order to minimise the potential for harm.

People were supported by enough staff to safely meet their needs. People received help with their medicines from staff who were trained and assessed as competent to support them safely. The provider followed safe recruitment practices and completed checks on staff before they were allowed to start work.

The provider had systems in place to address any unsafe staff practice including retraining and disciplinary processes if needed.

Staff members had the skills and knowledge to meet the needs of those they supported. Staff attended training that was relevant to the people they supported and any additional training needed to meet people’s specific requirements was provided.

Staff members were aware of the guidance and legislation that governed their practice. People were supported in a way that maintained their individual rights. People were involved in decisions about their care and were given information they needed in a way they understood. When people were not able to make decisions themselves staff members knew what to do to ensure any decisions made were in their best interests.

People had positive and caring relationships with staff members who supported them. People’s likes and dislikes were known by staff who assisted them in a way which was personal to them.

People had their privacy and dignity respected by staff members. People had access to healthcare when needed and staff responded to any changes in needs promptly and consistently. People were supported to eat and drink sufficient amounts to maintain good health.

Staff were supported by a management team who they found approachable. The provider undertook regular quality checks in order to drive improvements. People were involved in their home and felt their opinions mattered to the provider. Any suggestions people made were valued. The provider had systems in place to respond to the suggestions of others.

Because the people living in the home have complex needs, they were not all verbally able to tell us of their experiences. We spent time observing people’s interaction with staff and observed their body language and facial expressions. There were eight people living in the home at the time of our visit. One person was out at college. One person that spoke with us said. “I like it here X is happy.”

There were processes in place that enabled people, wherever possible to make informed decisions about the care and support they received.

For each person living in the home there was a clear, person centred plan of care in place that was regularly reviewed and updated to reflect people’s changing needs.

We spoke with staff and reviewed records that showed us that people were protected from risk of abuse and that their care was planned and delivered in a safe manner.

People were cared for by an experienced and well trained staff team. Three staff that spoke with us said they were well supported by the manager.

There were procedures in place to audit and monitor the quality of service being provided and to identify and carry out ongoing improvements to the service.

Comments from two family members that spoke with us included. “I have no concerns or criticisms at all, my daughter has lots of activities, she goes out a lot and is very happy living there.”

We spoke with four people who used the service, three relatives, three external professionals, the manager of the home and four other members of staff during the inspection period. Everyone we spoke with told us that the staff were caring and supportive.

People all said that they liked living in the home. One person told us that they had “Loads of my mates – and in college as well”. Another showed us the menu folder with pictures and recipes for them to choose the next week’s meals. One person said they made “Very good bread and butter pudding”.

Family members told us they were pleased with the care and support their relatives received in the home. One family member said, “At long last it is nice to have somewhere we can trust”. They all felt well informed and involved in the care of their relatives.

Activities included attending college courses, cooking, swimming and horse riding. We saw that people had access to health care professionals when required. External professionals we spoke with told us that there was good implementation of agreed care and treatment plans.

Staff told us that they felt well trained and supported by management and we saw evidence of recruitment processes, induction and training in place. Staff demonstrated a good knowledge and understanding of the people they cared for and supported. Staff understood the importance of accurate record keeping and we saw evidence of regular review and update of people’s care plans.

People told us that they were happy with the care and support they received and that their needs were being met. They said that the staff treated them with respect, listened to them and supported them to raise any concerns they had about their care. People told us that the service responded to their health needs quickly and that staff talked to them regularly about their plan of care and any changes that may be needed.

Some people who use the service were unable to communicate and tell us what they thought of the quality of the care due to their communication difficulties. However through observation during the site visit we were able to observe staff supporting people who use the service in a respectful way.