We carried out an unannounced inspection at Bradmere Residential Care Home on 24 July 2017. The service had not been previously inspected since registering with the Care Quality Commission in June 2016.Bradmere Residential Care Home provides rehabilitation and continuing care for up to 16 people. It offers a flexible, person-centred service that is personalised to individuals who have experience of mental ill health and or a learning disability. The home is situated in the Eccles area of Salford, close to local shops, pubs and public transport routes. The home is a large modern style house with car parking at the front and a small garden at the rear.
At the time of the inspection there was a registered manager who had been registered at the service since June 2016. 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 indicated satisfaction with the service and spoke positively about the staff team who were employed to support them. People looked relaxed in the presence of the staff team. People told us they were, “Happy” and “Felt safe.” People told us they could access the community alone whenever they wished. We saw evidence of people leaving the service without any restrictions placed on them.
We noted the service had developed processes and procedures to maintain a safe environment for people using the service and for staff and visitors. This included environmental risk assessments health and safety checks on the building, appliances and controlled substances hazardous to health (COSHH).
Fire audits were in date and compliant. Fire safety checks and fire exercises were carried out and staff had received fire training. The service had clear procedures to follow in case of an emergency. All people using the service had a personal emergency evacuation plan (PEEP).
Staff displayed knowledge of the various signs and indicators of abuse and were clear about what action they would take if they witnessed or suspected any abusive practice. Training in safeguarding and whistle blowing had been completed and procedural guidance was evident to support this.
We saw suitable staffing levels at the time of inspection and within the rotas we reviewed. Staff told us staffing arrangements were good and they felt they had the time to carry out daily tasks and support people safely. People corroborated this by telling us they had the support they needed when they needed it. We also observed a good level of staff interaction with people during the inspection to support this.
Recruitment systems were in place which ensured the service took appropriate steps to verify people’s identity, previous conduct and any criminal behaviour before being successfully appointed. Induction processes ensured the correct amount of training and support was given to new staff. Staff corroborated this by telling us the induction process was detailed and allowed time for the staff member to familiarise themselves with people living at the home. Disciplinary procedures were in place to support the provider to take action in the event of staff misconduct.
The service had processes in place for the safe administration of medicines and staff had received appropriate training. Medicines were stored safely and in line with current National Institute for Health and Care Excellence (NICE) guidance. NICE provides national guidance and advice to improve health and social care practice.
Support files were in date and regularly reviewed and detailed information which was individual to each person such as consideration to their needs, wishes, feelings and health conditions. It was evident that the person had contributed to these files and had signed to confirm this when appropriate. Risk assessments captured important information and contained guidance around how to mitigate the perceived risk, whilst taking into consideration positive risk taking.
Appropriate training was provided. Staff confirmed they received a variety of appropriate training to equip them too safely and knowledgably support people living at the service.
The service was working within the principles of the Mental Capacity Act 2005 and ensured any conditions or authorisations to deprive a person of their liberty were being met. These provide legal safeguards for people who may be unable to make their own decisions. At the time of inspection these safeguards were being appropriately managed.
Meal times were relaxed and people could choose what they wished to eat. People freely used the kitchen area to prepare meals, snacks and drinks with the support of staff when required. Weight management and dietary care plans were in situ when there was an identified need and appropriate referrals had been made to health professionals.
During the inspection we noted positive staff interaction and engagement with people using the service. Staff addressed people in a respectful and caring manner and the service had a calm and warm atmosphere. We observed people enjoying each other’s company, conversing and accessing the community.
People told us they were happy to approach the manager with any concerns or questions.
We found the manager to be very approachable and they assisted us professionally with our inspection by providing us with any requested documentation without delay. The manager displayed an awareness of people's current needs and circumstances and was committed to the principles of person centred care and inclusion.