Bradbury Grange

Staff said they were demoralised and felt unsupported and not listened to by the management team. At the time of the inspection there was no registered manager in post. The registered manager had recently left the service. The provider was trying to recruit a new manager. People told us that they were bored, there was nothing to do. People, relatives and staff said they had reported this to management, but little action had been taken. Staff were recruited safely. Safety checks had been completed before staff started working with people.

Some people had medical conditions. Staff had not received specialist training in these areas like diabetes, catheter and stoma care. Risks to people's health and wellbeing had been assessed and there was guidance in place on how to mitigate these risks. However, risk assessments gave little guidance on how to support people consistently and in a way that suited them best when they became upset and distressed.

Medicines were managed safely. Some people were supported to take their medicines independently and this was assessed and monitored. However, when people were prescribed 'as and when' medicines when they were distressed there was no guidance in place to make sure these medicines were given consistently and safely.

Safety checks and risks within the environment were checked and action taken if any shortfalls or concerns were identified. Fire exits were accessible for people in the event of an evacuation. The environment was clean and safe. There were procedures to protect people from the risk of infection. Some areas of the service were in need of redecorating and improvements to support people living with dementia.

People were protected from abuse and avoidable harm and were treated with respect and dignity. People were supported to have day to day choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. Staff helped to maintain people's independence by encouraging them to do as much as possible for themselves.

People's needs were assessed and reviewed to ensure care being delivered was up to date and reflective of their needs. People had care plans that provided guidance for staff on the support and care that they needed on a daily basis. People received a healthy, balanced and nutritious diet that supported their health and wellbeing.

The service worked with healthcare professionals to ensure people's health needs were met. People and relatives said GP's and other specialists were contacted when needed. When health care professionals had raised concerns, these had been responded to and action taken. Visiting professionals told us they thought the service had improved over the past couple of years, but they were concerned this may not continue due to the registered manager leaving. When accidents or incidents occurred, learning was identified to reduce the risk of them happening again.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.