Great Bradfords House

At the time of our inspection there were 30 people receiving personal care at the service. Not everyone at Great Bradfords House receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; which includes help with tasks such as support with personal hygiene and eating. Where they do we also take into account any wider social care provided.

This was the first inspection of this service since the provider, Abbeyfield Braintree, Bocking and Felsted Society Limited, (Abbeyfield) registered with us to provide personal care at Great Bradfords House in April 2017. Between April and October 2017, Abbeyfield was not carrying out care and support at Great Bradfords House, as this was being provided by another care organisation. Our inspection only reviewed the care and support provided after Abbeyfield took over responsibility for providing personal care at Great Bradfords House in October 2017.

A registered manager was 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.

The registered manager had been involved in the transfer of support services from the former care provider. This was a challenging time, and their focus was on making sure people were safe and there was an improved culture and morale at the service. As a result of effective management, the quality of support had improved and we received positive feedback from people, family and staff about the changes at the service.

Quality audits had been carried out by senior staff who had already identified issues we found in during our inspection. Action plans were in place to not only resolve any outstanding concerns but to continue to enhance the quality of life for people at the service. There was an open culture where feedback was encouraged across the service. People, their families and staff felt able to raise concerns and were confident senior staff would respond efficiently and respectfully and their support would improve. The registered manager used learning from feedback and complaints to make a difference to the support people received.

There were enough safely recruited staff to meet people's needs. They were deployed efficiently and flexibly. Staff were skilled at meeting people's needs and worked well as a team. They received training and guidance to develop their skills. The registered manager and senior staff met regularly with staff, and were

improving the systems to record individual meetings and attendance on training.

Staff supported people to remain safe while respecting their rights to independence and freedom. Risk was well managed and the registered manager was making the necessary changes to provide staff with more detailed guidance around how to keep people safe. There were effective measures in place to minimise the risk of infection and to support people to take their medicines as required.

People received the necessary support to eat and drink in line with their preferences. There was a focus on promoting people's wellbeing and staff worked well with other professional to provide consistent support. The registered manager understood their responsibilities under the Mental Capacity Act 2005 and ensured people's capacity was monitored.

The support staff provided was flexible and tailored to people's needs. There was a focus on encouraging people to remain independent and to make choices about the care they received. Care plans did not fully reflect the quality of support people received. The plans were being updated and revised. We made a recommendation around ensuring care plans for people with varying communication needs were more accessible, in line with best practice.

People benefitted from a consistent staff team and had the time to develop positive and meaningful relationships. Staff treated people with respect and promoted their dignity.

The five questions we ask about services and what we found