St Bridget's - Care Home Physical Disabilities

Updated 3 July 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of one adult social care inspector.

Service and service type: St Bridget’s 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. St Bridget’s accommodates up to 38 people in one adapted building and a bungalow on the same site. At the time of our inspection there were 37 people living in St Bridget’s.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We visited the service on 24 and 25 April 2019 and our inspection was unannounced.

What we did:

The registered manager sent us a provider information return (PIR). Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

As part of the inspection we spent time with 12 people who received support from the service and spoke with three relatives. We also spoke with the registered manager, the deputy manager, the regional manager, the volunteer coordinator, the customer support adviser, the kitchen supervisor, the physiotherapist, the administration supervisor, three members of support staff, two volunteers, a computer room assistant and two members of the senior leadership team. We also spoke with a visiting external healthcare professional. We reviewed care records for three people and looked at three staff files including training and recruitment. We reviewed documentation relating to the running of the service, such as the accidents and incidents records, audits and complaints policies.

Updated 3 July 2019

About the service:

St Bridget’s – Care Home Physical Disabilities, referred to in this report as St Bridget’s, 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. St Bridget’s accommodates up to 38 people in one adapted building and three bungalows on the same site. At the time of our inspection there were 37 people living in St Bridget’s. The home supports people with a range of significant physical disabilities, physical health and mental health needs.

People’s experience of using this service:

People and relatives highly praised the care and support provided at St Bridget’s. The service had distinctive and very strong person-centred values and placed people’s wellbeing at the heart of their work. People received exceptionally personalised support which met their needs and preferences. The registered manager and staff ensured people were involved in every aspect of the service and their care and support. People told us staff knew them, their likes, dislikes and needs exceptionally well. They said they had full control over their care and were always encouraged to share their views. Comments included, “I do whatever I want”, “They listen to me. They know they’re just here to help me with what I need” and “I always choose.”

The service was owned and run by Leonard Cheshire Disability. It is a charitable organisation whose stated purpose was to ‘support individuals to live, learn and work independently, whatever their ability’. The provider and registered manager were clear about their purpose and acted as advocates for people with disabilities and campaigned to encourage equality and opportunity.

The registered manager and staff were all passionate about ensuring people were all equal, not judged or defined by appearance, ability, sexuality, age, background, race or belief. This created a non-judgemental, fully inclusive environment where people felt safe and confident to be themselves. The service respected and promoted people’s diversity and helped promote people’s rights. For example, they had recently created a Pride Network which was open to people who used the service and staff members. This network had online information and support for people to discuss any issues, ideas, make friends, share experiences and allow people to explore their sexuality.

People were supported to express their views in a number of different ways. People who lived in the service had a number of ways of communicating. People used verbal communication, sign language, picture boards and computerised communication aids. Staff knew how best to communicate with each person in order to understand their needs and give them choices. The registered manager and staff were passionate about enabling people to use technology to enable people to communicate more freely and to improve their skills, expand their knowledge, contact loved ones, enjoy entertainment, be active on social media and make friends.

At the time of our inspection two people living in the service had needs relating to a learning disability. The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The registered manager and the provider were committed to ensuring the service was outward facing and encouraged people to be active members of the local community. The service had a charity shop on site which was open to the public and advertised in the local town. The service also had a volunteer programme to encourage people to connect with members of the public who shared their interests. Events were held at the service twice a year to which the public were invited. Staff and people who used the service regularly attended events in the local community and the service regularly campaigned to encourage accessibility and equality within the local area.

The management team and staff were passionate about enabling people to lead fun, fulfilled lives and helping ensure people had access to activities that met their needs and interests. The service had a comprehensive activities programme but also worked hard to recruit volunteers. The volunteers had positively impacted on people’s lives. For example, one person was interested in bird watching and was hoping to learn more about it. Together with the person, the volunteer coordinator created an advert seeking a volunteer who shared this interest. A member of the Ornithological Society came forward and had been taking this person bird watching regularly since. This had brought the person a huge amount of enjoyment.

Staff and the registered manager were passionate about people’s happiness and wellbeing. Staff had gone ‘above and beyond’ for people. For example, the team leader in the computer room said; “I came in on Christmas morning last year especially to support one person to skype his sister in New Zealand. He and his sister really appreciated it. It made me feel all warm inside. It's one of the good parts of this job.”

The service was focused on achieving best outcomes for people and improving their independence and quality of life where possible. People’s care needs had been assessed and support plans had been created to guide staff on how best to meet people’s needs. These plans highlighted people’s wishes about how their care should be delivered and what was important to them. Staff were trained to a very high standard in a way that met the individual needs of people in the service.

The service was continually looking to improve with regards to food provision and regularly sought training from healthcare professionals such as nutritionists or speech and language therapists. People spoke very highly about the quality of the food. People made comments including; “The food is good here. We have some real stunning things. I have just had some chocolate sponge and chocolate custard and if that could be my last meal I’d be happy.”

The home delivered outstanding end of life care to people. The service was passionate about ensuring people received dignified and respectful end of life care which met their personal needs and preferences. Staff had also understood the importance of helping people to grieve and remember their loved ones when they had sadly passed away. For example, staff had created a string of fairy lights displaying the names of people who had passed away, including people’s loved ones. This was displayed in the home every year to help people and staff mourn their loss and ensure those people were still part of the Christmas celebrations.

People were protected from risks associated with their care needs. Risks had been identified and action had been taken to minimise these whilst ensuring people had freedom to take risks. People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable.

The registered manager and provider were strong, visible and exceptionally supportive. The service had an experienced and skilled registered manager in post, who provided stable and consistent leadership. People, staff and relatives spoke very highly of the registered manager and the management team. There was an open and positive culture at the service with people and staff feeling their voices were listened to.

Quality assurance processes, such as audits, were instrumental in driving standards of care to an outstanding level. Monitoring systems were in place and ensured the registered manager had the information they needed to monitor the safety and quality of the care provided and identify where improvements were needed.

More information is in the full report.

Rating at last inspection: At the last inspection the service was rated Good overall and Requires Improvement in Responsive. The last report was published on 24 October 2016.

Why we inspected: This was a planned comprehensive inspection based on previous ratings.

Follow up: We will continue to monitor the intelligence we receive about the service and plan to inspect in line with our re-inspection schedule for those services rated outstanding. If any concerning information is received we may inspect sooner.