About the service: Newbridge Towers provides accommodation and personal care for up to 20 older people. People who live at the home access nursing care through the local community healthcare teams. At the time of the inspection 18 people were living at the home.

We undertook an unannounced comprehensive inspection on 10 and 15 April 2019.

People’s experience of using this service: People were supported for by a staff team who were kind and caring. Staff had good relationships with people and knew them well.

The provider and senior staff had completed audits on the home to support quality checks. However, these checks had not prevented repeated and new shortfalls in the quality of service provision. The provider had also failed to conspicuously display their last inspection rating on their website as required by regulations.

There were enough staff to meet peoples' basic needs. Staff training was provided but did not always ensure people’s specific needs were covered. Staff recruitment procedures were not always followed appropriately. Staff had received regular supervision.

Care plans were not consistently person centred and there was a lack of detailed guidance within peoples' risk assessments for staff to follow. There was some unhygienic storage of food and poor cleanliness and infection control measures in place. Radiators were not covered to prevent burns to vulnerable people.

People had access to healthcare professionals and medicines were stored safely. Some improvements are required in relation to medicine administration and documentation.

People did not have regular access to the local community and activities were limited.

The provider protected the rights of people living in the home in line with the Mental Capacity Act 2005. DoLS applications had been made for all people that required them.

Rating at last inspection: Requires Improvement (report published May 2018.)

Why we inspected: This inspection was scheduled based on the previous rating.

Enforcement: We found five breaches of The Health and Social Care Act Regulations (2014).

Follow up: We are now considering the appropriate regulatory response to resolve the problems we found.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 5 and 6 April 2018 and was unannounced.

Newbridge Towers 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.

Newbridge Towers accommodates up to 20 people in one adapted building across four floors. At the time of our inspection there were 18 people living at the service. There were gardens to the back and sides of the building which were being landscaped and a paved are in front of the premises.

A manager was in post at the time of our inspection. They were undertaking the registration process to be the registered manager of the home. 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.

Risks to people’s safety had not always been identified, rectified or reduced. Radiators were not covered to prevent the risk of burns and other risks did not have effective plans to reduce the risk to people. People’s individual risks were not always identified and staff had not developed plans to manage these. For example risks to people’s skin and mental health.

Staff had not always learnt from accidents, for example when one person had sustained falls staff did not develop a care plan to keep them safe and reduce the risk of further falls.

Staff had not received regular and effective supervision to support them to carry out their work.

Care plans were minimal and generic and did not contain full information about people’s care needs. Care plans did not contain information about how people liked their care to be delivered. One person’s care records were not completed but the provider’s systems had not identified the records were missing.

The provider did not have an effective system in place to monitor the quality and safety of the service. Regular quality assurance checks had been conducted but did not identify or address the shortfalls we found during our inspection.

Everyone we spoke with at Newbridge Towers told us they felt safe living there or that they felt their relatives were safe living there.

People were supported to eat and drink enough and were very complimentary about the food. The introduction of breakfast in the dining room rather than people’s bedrooms had increased people’s weight and food intake.

Staff liaised with health professionals as needed and outcomes of visits were recorded in people’s care files. However, care plans were not updated to contain any changes to people’s care to guide staff.

Staff had a clear understanding of the Mental Capacity Act 2005 (the MCA) and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

People were complimentary about the staff and we observed staff spoke about people warmly. Staff were friendly in their manner towards people.

Medicines were managed safely. The provider had ensured all equipment at the home was regularly serviced and safe to use.

Safeguarding procedures had mostly been followed; however we found one incident which had not been reported to the local authority safeguarding team and the Care quality Commission.

There were sufficient numbers of suitably qualified staff at the service who had undergone checks before employment. The provider addressed staff performance problems and took suitable action.

The manager had a vision for the service and had begun to make some changes. The service was now fully staffed.

Staff morale was good and they were positive about the manager.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You