This inspection took place on 12 December 2017 and was unannounced. The service was registered to provide accommodation and personal care for up to a maximum of 20 people over the age of 18 (only 18 beds were in use). At the time of our inspection there were 10 people in residence. This is a rehabilitation service, jointly funded by Bristol City Council (registered provider) and Bristol Community Health. Rehabilitation services are provided for up to six weeks in order to support people who are medically fit to be discharged from hospital but need further therapy. The service may also be used to prevent a hospital admission.

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.

After the last inspection in June 2016 we rated the service overall as Requires Improvement. We had identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had then sent us their action plan which detailed the improvements they would make.

As part of this inspection we have checked to see that these improvements were made and sustained. We have now rated the service as Good and there were no breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were safe. Staff knew what to do if there were concerns about a person’s welfare and had received safeguarding adults training. Risk assessments were completed as part of the care planning process. Where risks were identified there were plans in place to reduce or eliminate the risk. Each person had a written personal emergency evacuation plan detailing the level of support they would need in the case of an emergency. The risks of employing unsafe staff were reduced because of robust staff recruitment procedures.

The premises were well maintained. Regular maintenance checks were completed to ensure the building and facilities were safe. Checks were also made of the fire safety systems, the hot and cold water temperatures and equipment to make sure they were safe for staff and people to use. The premises were clean tidy and fresh smelling.

Staffing levels were calculated and based on the collective needs of each person who was using the service at that time. This ensured the staff were able to meet all care and support needs safely. Medicines were managed safely.

The service was effective. New staff completed an induction training programme at the start of their employment and any new-to-care staff completed the Care Certificate. There was a mandatory training programme for all other staff to complete to ensure they had the necessary skills and knowledge to care for people correctly.

The mental capacity of each person to make informed decisions was assessed on admission to the centre and then reviewed. People were involved in making decisions and encouraged to make their own choices about their care and support. The service was meeting the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were provided with sufficient quantities of food and drink. They were supported to regain life skills in order to enable them to return home and be able to look after themselves. There were arrangements in place to ensure people were temporarily registered with a local GP during their stay. The service worked in partnership with other healthcare professionals who supported the people using the service.

The service was caring. Staff had good working relationships with the people they were looking after and were committed to their role of rehabilitation. The person was the focus of all decisions made about their care

This was an unannounced inspection carried out on 14 June 2016. When Bristol South Rehabilitation Centre was last inspected in August 2013 there were no breaches of the legal requirements identified.

Bristol South Rehabilitation Centre provides a rehabilitation service for a maximum of 20 people aged over 18. The service supports people with rehabilitation and ensures people can care for themselves independently before returning to their own homes following a life event such as a hospital admission or an illness. There was a multi-disciplinary team that supported people which included rehabilitation workers, physiotherapists, occupational therapists, pharmacists and nurses. At the time of the inspection there were 13 people using the service.

A registered manager was in post at the time of 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 and associated Regulations about how the service is run.

The provider had not ensured that training to meet the needs of all people at the service was provided for staff. Training that required updating had not been identified or undertaken placing people at risk of receiving unsafe or inappropriate care. People’s records were not always completed accurately by staff. Records did not always contain information that identified incidents that may impact on people’s welfare.

The provider had ensured sufficient staff were available to meet people’s assessed needs. People’s risks were assessed on admission and staff knew how to identify and respond to actual or suspected abuse. People’s support needs for their medicines varied and people received the support they required. The provider had a system that monitored incidents and accidents. People were cared for in a clean and hygienic environment.

People spoke highly of the caring nature of staff and told us they felt they were treated as individuals and with dignity and respect. The service had received a number of compliment cards that reflected the comments we received from people during the inspection. The provider had ensured people had important information about the service on admission and people were actively involved in their care planning and discharge goals. Staff understood the people they supported and people’s relatives and friends were welcomed.

The provider had a complaints procedure and people said they would be happy to communicate concerns. The service had a personalised admissions procedure as part of the initial admissions process and people were allocated a keyworker. People told us that through communication with their keyworker and other staff they felt they received personalised care.

People said that the registered manager was efficient and told us they felt the service was well led. People spoke of a friendly and well led environment. Staff told us they were happy in their employment and told us the registered manager was approachable. Staff spoke of good leadership and teamwork. There were systems in place for the management to communicate key messages to staff. The registered manager had submitted notifications as required and the requested Provider Information Return (PIR) was returned within the specified time frame.

On the day of our visit there were nine people staying in the centre. People we spoke with told us “it’s a homely sort of place” and “if you want anything they will see to it” and “they are very obliging about meals and the food is lovely”.

We found that the staff knew how to respect people as individuals and encouraged people to make decisions about their care.

Staff told us that they felt supported and attended training courses to enable them to deliver the care needed.

We saw that the environment was suitably clean and infection control measure were in place. The people we spoke with told us “it’s very clean here, there is always someone coming round cleaning”.

Systems were in place to monitor the quality of the service provided.

There were 17 people staying at the centre on the day of our visit. We were able to talk to 11 people about the support and treatment they received.

We talked with the registered manager, a nurse, an occupational therapist and three health and social care workers about how they supported people staying at the centre.

People had positive views about the support and treatment they received at the centre. Examples of comments we were told included, “I would say they have been brilliant, they are trying to get me to walk again”. “I should say the service has been excellent they come in regularly and give me exercise”. “I'm having exercises to help me balance again”. “The service is absolutely wonderful”. “They have been wonderful and they have been so attentive to me”. “They are average”.

People were effectively supported by the staff with their short term health difficulties. People were provided with their own unique care programme to enable them to regain the skills and confidence to return home.