We inspected this service on 10 May 2018 and it was unannounced. This meant that the service did not know we were going to inspect. We last inspected the service on 4 March 2016 when it was rated as good overall with requires improvement in the area of effective. There was a breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Premises and Equipment. This was because the premises were not properly maintained. The passenger lift was not suitable for the purpose for which it was being used and all areas of the home were in need of redecoration and refurbishment.

Following our last inspection we asked the provider to complete an action plan to show us what they would do and by when to improve the key question of effective to at least good. During this inspection, we found the service was meeting the requirements of the current legislation. We made recommendations in relation to individual risk assessments to manage people’s self harm behaviours and to ensure the refurbishment to the property was continued.

Bridgeway care home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. At the time of our inspection seven people with a learning disability lived in the home.

Bridgeway care home accommodates up to 27 people in one building. The home was in the process of a substantial refurbishment across all areas. It provides accommodation for persons who require nursing or personal care for people living with a dementia, learning disabilities, physical disabilities and sensory impairment. At the time of our inspection there were 23 people in receipt of care.

The service had a registered manager in post at the time of our 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 2008 and associated Regulations about how the service was run.

Systems to record and act on allegations of abuse were in place. Staff had undertaken safeguarding training, which provided them with the knowledge and skills to protect people from harm. We saw one person was displaying self-harm behaviours, but the registered manager immediately ensured their risk assessment reflected the measures for staff to take to protect them from unnecessary risk of harm.

Appropriate levels of staffing were in place to ensure people’s needs were met. The registered manager told us they were implementing a staffing analysis following our inspection. Safe recruitment practices were followed.

Medicines were managed safely. We observed staff providing people with their medicines with dignity, offering support and time for them to take.

There was an ongoing detailed refurbishment programme taking place. Improvements since our last inspection were noted, however work was still required to make the necessary improvements to all areas of the home.

Staff told us and records confirmed they had undertaken a wide variety of training that supported the delivery of care to people. We saw evidence of the use of advocacy services when people required support with important decisions.

Consent had been recorded in most people’s care files. We observed most staff knocking on people’s doors and waiting to be invited into their bedrooms. Relevant DoLS applications had been submitted to the assessing

The inspection took place on 04 & 09 March 2016 and was unannounced. This was the first inspection of the service since a new provider took over responsibility for the home in August 2014. The service was previously inspected in July 2014, when it was fully compliant with the regulations we inspected against.

Bridgeway provides nursing and personal care for up to 27 adults living with dementia, learning disabilities, physical disabilities and sensory impairment. The home offers short and long term care. The home is situated in a residential area on the outskirts of Preston. Shops and local amenities are easily accessible and the home has its own transport.

The home did not have a registered manager in post at the time of our inspection. The manager who is registered with CQC left employment over 12 months previously and had not submitted an application to de-register. 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. There was however, a manager in post who was responsible for the day to day running of the service but they had not yet submitted an application to register with CQC.

The provider had a plan in place for refurbishment and extension of the premises, in order to improve the premises for the people who used the service. However, they were not able to give us a date for when work was likely to start. We looked at all areas of the home and found the home was in need of redecoration and refurbishment, with the exception of the recently decorated lounge and two bedrooms, which were decorated to a good standard. In addition, the passenger lift, used by people to access the first floor, had been assessed as not meeting suitability requirements for access by disabled persons. The above matters constituted a breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, because the premises were not properly maintained and the passenger lift was not suitable for the purpose for which it was being used.

People who used the service told us they felt safe. Staff were trained to keep people safe and had a range of policies and procedures to guide them in doing so. There were sufficient numbers of suitably qualified, skilled and experienced staff deployed at all times. The service had appropriate processes in place and staff were trained to make sure people received their medicines safely. The service ensured risks to people's health and well-being were assessed and managed effectively.

People were supported by staff who had the skills and knowledge to meet their needs effectively. The home carried out assessments of people's capacity to make decisions and acted in accordance with the Mental Capacity Act 2005. The service provided a good standard of food and people were satisfied with the quality and choice of food available. People were able to and supported to access outside healthcare services if they required them.

Staff knew people well, including their preferences and social histories, however, these details were not always well recorded in people's written plans of care. Staff took a kind, caring and compassionate approach to the delivery of care and respected people's privacy and dignity. People were able to receive visitors without restriction.

The service responded well to people's needs. Assessments of people's needs and their involvement in the care planning and review processes helped to ensure people received care that met their needs which was delivered in accordance with their preferences. People's needs were kept under regular review so that the service could continue to deliver suitable care in line with changes in people's circumstances. A range of activities were provided at the ho