Archived: Bristol South Rehabilitation Centre

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 and they were listened to. Any suggestions they made were acted upon.

The service was responsive. People were provided with a personalised care and support service that met their specific needs. The aim of the service was to rehabilitate them after a period of ill health and enable them to return to their own home.

The service was well led. The staff team was led by a registered manager and an assistant manager. They provided good leadership and management for the staff team. Staff meetings ensured they were kept up to date with changes and developments in the service.

There was a regular programme of audits in place, which ensured that the quality and safety of the service was checked. These checks were completed on a daily, weekly or monthly basis.

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.

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.