This inspection took place on 14 and 15 February 2017 and was announced. We gave the provider 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available.

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.

At the time of this inspection the service was providing the regulated activity of personal care to 44 people who lived in their own homes. This included some people who were supported over 24 hours in supported accommodation. The service supported older people, people with learning disabilities and people with physical disabilities.

The service was last inspected in July 2015 when we found the service to be in breach of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following that inspection the service had submitted an action plan and when we returned for this inspection we saw that the actions had been followed up. At this inspection we found that the service was meeting all the requirements.

There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed. Staff were aware of their responsibilities in protecting people from harm and knew how to report any concerns about people's safety or wellbeing. We saw that safe recruitment processes were followed, and staff worked in small teams which helped to maintain consistency of care. People who used the service told us that they always knew the people who were visiting them. We saw that staff had enough time with people to meet their needs.

Care records identified specific risks to people, and care plans directed staff on how to minimise these risks. Where people required assistance with their medicines we saw that this was given safely by staff who had undertaken medicines competency training.

Staff employment records showed that checks had been made to determine their suitability to work with vulnerable people. Staff told us that they received good training which enabled them to meet the needs of the people who used the service. They were fully supported by the registered manager and a programme of training and supervision enabled them to provide a good quality service. People told us that they were supported by staff who could communicate with them in a way they understood, knew how to do their job, and who knew how they preferred to be supported.

We saw peoples choices were respected, and care staff did not use their role to impose their own values on people. Where people lacked capacity to make choices, decisions were made in the best interest of the person, but we noticed that decisions were not always clearly documented.

The service had established good links with healthcare professionals and ensured that people who used the service maintained good access to healthcare, including yearly health checks.

People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs. The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.

We saw that care provided was person centred, and recognised the individuality, culture and values of the people being supported. Care was delivered by kind and caring staff who had a relaxed and comfortable rapport with the people we visited, treating them with dignity and respect and encouraging people to maintain their independence.

People told us that staff encouraged them to do as much for themselves as they could and had helped them to maintain their i

This was an announced inspection on 29 and 30 July 2015. The inspection was announced 48 hours prior to our visit to ensure the registered manager or other responsible person would be available to assist with the inspection visit.

Bridging the Gap is registered to provide personal care and support to people in their own homes and to access the local community. At the time of our inspection 44 people used the service.

A registered manager was 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.

People we spoke with told us care staff were nice and good at what they did, we observed staff treating people with respect and people told us they felt safe when staff visited them at home.

We found care records were not always accurate and complete and did not contain information to demonstrate that potential risks to people’s health and wellbeing were being fully assessed, monitored and managed.

People were involved in decision making throughout the initial assessment process but continued involvement of people in reviews of risk assessments and support plans was not always being carried out and documented clearly. Risks were not mitigated because there was a lack of detailed risk assessment about people’s safety and care needs.

This was a breach of regulation 12 (1)(2)(a)(b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Although systems were in place to manage medicines safely, some staff did not follow these systems and did not complete records appropriately. This meant that accurate records of medicines either prompted or administered to people were not being maintained.

This was a breach of Regulation 12 (1) (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014

The provider did not have effective quality assurance systems in place for regularly reviewing care plans, managing medication, monitoring staff competencies and ensuring staff had the correct and current level of training in order to be able to complete task

This was a breach of regulation 17 (1)(2)(a)(b)(c)(d) of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014

We saw that that ten care workers had been employed by the service long enough to be required to complete the mandatory refresher course in Safeguarding Vulnerable People.

This was a breach of Regulation 18 (1)(2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found the provider was in breach of Regulations. You can see what action we told the provider to take at the back of the full version of the report.

Robust recruitment processes were in place to ensure staff employed by the service were safe to work with and support vulnerable people.

The staff we spoke with were knowledgeable about their roles and responsibilities. All Staff received mandatory training and were working towards a nationally recognised qualification the ‘Care Certificate’.

We saw evidence to show the service matched care staff to people’s needs, to ensure people were provided with the care and support they wanted and needed, this included communication in people’s chosen languages.

Staff at Bridging the Gap supported people to access the community and attend regular health appointments.

Procedures were in place to help keep people safe and staff had a good awareness of these procedures and what action they would take to protect people’s health and wellbeing

The registered manager and care manager have encouraged a positive culture amongst care staff and shared learning to try to improve practices and the quality of service provided.

The overall rating for this service is ‘Requires Improvement’

Services require improvement will be kept under review and, will be inspected again within six months.