About the service:

The Bromford is registered to provide personal care as part of a supported living setting. On the day of this inspection site visit 24 people were receiving personal care. The Bromford was purpose built and comprises of individual flats over two floors with communal areas on each floor.

The Bromford had 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.

People’s experience of using this service:

People received safe care and support as the staff team had been trained to recognise signs of abuse or risk and knew what to do to safely support people. People received safe support with their medicines by staff members who had received appropriate training and had been assessed as competent. People were supported by the right amount of staff to meet their needs. The provider followed effective infection prevention and control procedures when supporting people.

The provider supported staff in providing effective care for people through person-centred care planning, training and one-to-one supervision. Staff members were knowledgeable about the relevant legislations that informed their practice and supported the rights of those receiving personal care at The Bromford. People were promptly referred to additional healthcare services when required. People were supported to maintain a healthy diet and had choice regarding food and drink.

People received help and support from a kind and compassionate staff team with whom they had positive relationships with. People were supported by staff members who were aware of their individual protected characteristics. People were supported to develop their independence and to set achievable goals in life.

People were provided with information in a way that they could understand. Policies and guidelines important to people were provided in an easy to read format with pictures to aid their understanding. The provider had systems in place to encourage and respond to any complaints or compliments from people or their relatives.

The provider had systems in place to ensure the Care Quality Commission was notified of significant events in a timely manner and in accordance with their registration. The provider had effective systems to monitor the quality of the service they provided and to drive improvements where needed. The provider, and management team, had good links with the local community which people benefited from.

More information in Detailed Findings below.

Rating at last inspection:

‘Good’ overall with requires improvement for the key question ‘Safe,’ (date last report published 11 September 2018). At that inspection we found the provider needed to improve the consistency of their risk assessments regarding the care and support people received. At this inspection we found improvements had been made.

Why we inspected:

The inspection was prompted following concerns raised by the Local Authority (who commission services for people at The Bromford). We had received concerns in respect of the risk assessment processes completed by the provider, staff training and knowledge of people’s needs, care planning and overall staffing.

Follow up:

We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

We undertook our comprehensive inspection of The Bromford between 02 August 2018 and 08 August 2018. We visited the location on 02 August 2018 and spoke with people’s relatives over the phone between the 06 August 2018 to 08 August 2018. The inspection was unannounced. The inspection was prompted in part by concerns raised by the local authority (who commission services for people at The Bromford). We had received concerns in respect of people who were at risk of self-harm, harm from others living at the location, unsafe medicines management and absconsion from the building.

This was the first inspection of the service since they were registered to provide personal care on 11 December 2017 and there has been no previous rating for the service.

People receiving personal care live in a ‘supported living’ setting, so that they can live in their own home as independently as possible. Some people live there as permanent tenants while others live at The Bromford on a short-term tenancy agreement while receiving ‘respite care’ from the service. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The Bromford was purpose built and comprises 20 flats over two floors with a communal lounge on each floor. In addition, there are several stand-alone flats on site. Not all tenants receive a personal care service.

The service may provide personal care to younger adults or older people that may be living with dementia, learning disabilities/autistic spectrum disorder, mental health, physical disability or sensory impairment. On the day we visited the site there was 24 people receiving personal care, seven of these people living in a flat on a short-term tenancy with personal care provided. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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.

The service has a registered manager who was present during our 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.

Staff were aware of the risks to people and how to keep them safe but inconsistencies in the recording of risk assessments meant that these records were not always up to date or available. People thought there was sufficient staff available throughout the day and night and this made them feel safe. People felt safe when receiving care from staff who were aware of how to respond to allegations of abuse. People were happy with the way their medicines were managed. The provider carried out appropriate checks on new staff which ensured they were safe to work with people living at The Bromford.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People had confidence in staff and felt they were well trained and knowledgeable. People received the level of support they wished with food and drink, whether preparing their own food or having meals cooked for them. People had access to community healthcare as needed.

People felt the staff were kind, caring and respectful. People thought they were treated well and had their privacy res