What the CQC found at Brightwater

Care plans gave staff detailed guidance about each person's routines, communication, preferences, relationships and goals.

“People had very personalised support plans that contained clear guidance for staff on how best to support them.” from the report

Staff knew people well and used respectful, relaxed and good-humoured interactions. People were supported to maintain important relationships.

“Throughout the inspection, the atmosphere at the home was relaxed and people seemed contented and happy in the presence of their support staff.” from the report

People were supported to use public transport, work, attend activities, visit the community and go on holidays where possible.

“People living at Brightwater, although living with autism, were able to live as ordinary a life as any citizen and were given chances to expand their horizons” from the report

People chaired weekly house meetings and could influence food, activities and changes in the home. Relatives felt able to raise concerns.

“They [people] decide the agenda and can say whether they have any complaints, they can say what they want to change” from the report

The medicine cabinet temperature was slightly above the recommended limit on two occasions. The home agreed to check temperatures daily and give staff clearer instructions.

“on two occasions in July 2018, the temperature was recorded as being slightly more than the recommended limits for the storage of medicines.” from the report

Protocols explained when as-required medicines should be offered, but staff were not recording why the medicine had been needed. The provider said this would be documented in future.

“We did note that staff did not keep a record of the reason why the PRN medicine had been required.” from the report

Some staff were concerned that having one staff member on duty at certain times could limit responses to incidents or medical emergencies. Inspectors asked the provider to discuss staffing ratios with commissioners.

“Some of the staff we spoke with expressed some concern that these staffing arrangements could, for example, limit their ability to respond to incidents or medical emergencies.” from the report

One unexplained bruising incident had not initially been referred to the local safeguarding team. The registered manager notified the local authority after the inspection.

“We did note that one incident of unexplained bruising had not been escalated to the local safeguarding team which is best practice.” from the report

Water sampling and temperature checks were taking place, but inspectors recommended that a legionella risk assessment should be completed by a competent person.

“we have also recommended that the provider ensure a legionella risk assessment is in place and undertaken by a competent person.” from the report