Date of Assessment: 19 March to 9 April 2026. East Bristol Intermediate Care Centre is a care at home service providing support to adults with sensory impairments, physical disabilities and dementia. At the time of our inspection, 39 people were receiving the regulated activity of personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. This was a scheduled assessment, all quality statements were reviewed. At our last inspection this service was rated good. At this inspection the service has remained good. The service was in breach of a legal regulation in relation to good governance. Governance systems had not identified areas found at this assessment to consistently identify regulatory shortfalls or drive service improvements. This included the omission of safeguarding notifications submitted to the Care Quality Commission (CQC), shortfalls in medicines management, person-centred care planning, goal monitoring, individualised risk and environmental assessments. Documentation lacked detail in people’s preferences and communication needs. The service supported people for a short length of time in their reablement journey. The service promoted people’s independence and choices. Safe recruitment procedures were followed. Staff were skilled and knowledgeable in their roles and were supported by a range of training, induction and supervision. There was a positive staff culture where leaders and staff adhered to the provider’s values and behaviours. Staff were supported in their roles and leaders were open and transparent. Regular meetings were held and information shared and reflected upon. Staff followed best practice models and guidance and escalated concerns when needed.
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This was a targeted IPC inspection of East Bristol Intermediate Care Centre conducted on 3 February 2022, covering both the residential reablement unit and the community rehabilitation team. The provider was found to be meeting all assessed infection prevention and control requirements, with no concerns identified; no overall or domain ratings were assigned as this was a focused inspection only.
Strengths
· Strong infection prevention and control practices including COVID Pass checks, LFT evidence, and vaccination status verification for all visitors and contractors
· Effective PPE usage and spot checks in the community to ensure staff compliance
· Robust emotional wellbeing support for people, families, and staff throughout the pandemic
· Clean premises with rigorous cleaning schedules and enhanced cleaning for high-touch surfaces
· Workforce contingency plan ensured continuity of safe, quality care during COVID-19 staffing pressures
Quality-Statement breakdown (1)
safe: Prevention and control of infectionInsufficient evidence to rate
East Bristol Intermediate Care Centre received an overall Good rating across all five key questions at its July 2017 inspection, having successfully remediated two prior regulatory breaches relating to medicines management and quality assurance identified in April 2016. Minor ongoing concerns were noted around medicines documentation and ensuring reablement service users had current prescribed medicines lists in place before support commenced.
Concerns (2)
moderateMedication management: “concerns were that some people who were supported by the service did not have a prepared list of their medicines in the home and may also have large stocks of medicines in the home”
minorRecord keeping: “improvements were required in the completion of the medicine administration records (MARs). This included the information recorded if people needed assistance with applying creams and topical medicines”
Strengths
· People confirmed they felt safe and staff demonstrated good safeguarding awareness and knowledge of reporting procedures
· Risk assessments were completed comprehensively including falls, skin damage, malnutrition, moving and handling, and home environment
· Staff received regular supervision, mandatory refresher training, and were supported to achieve diploma qualifications
· Multi-disciplinary meetings held weekly in both services to review individual goals and coordinate discharge planning
· Previous regulatory breaches regarding medicines management and quality assurance had been remediated and sustained
East Bristol Intermediate Care Centre was rated Requires Improvement overall following an unannounced inspection in April 2016, with two regulatory breaches found: unsafe medicines management (Regulation 12) and ineffective governance systems (Regulation 17). The service demonstrated genuine strengths in caring relationships and staffing, but required significant improvement in medicines administration, care plan personalisation, supervision frequency, and monitoring of missed domiciliary visits.
Concerns (10)
criticalMedication management: “gaps in Medicine Administration Records (MAR) where records had not been completed...unclear which inhaler had been administered”
criticalMedication management: “PRN (as required medicines) protocols were not in place...one person prescribed a strong pain relieving medicine...instructions 'as required'”
criticalGovernance: “no effective governance systems in place to prevent the medicine shortfalls found at this inspection...quality monitoring systems in place were not effective”
criticalMissed or late visits: “one person's care record we found that they had not received their daily morning visit...not noted until some 24 hours later”
criticalRecord keeping: “number of times the strong pain relieving medicine was administered...on only five occasions was the time of the administration recorded”
moderateCare planning: “care plans lacked detailed information to reflect personalised support...one care plan simply stated 'assistance required'”
moderateSupervision / appraisal: “staff supervisions had not been undertaken as often as directed by the provider's supervision policy”
moderateConsent / capacity: “Staff we spoke with had variable knowledgeable about the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards”
moderatePerson-centred care: “care plans across the service were not personalised and did not contain unique individual information and references to people's daily lives”
minorStaff training: “people using the service who lived with dementia. Specific training for staff to meet people's needs is good practice”
Strengths
· Positive and caring relationships between staff and people; people praised staff and relatives gave positive feedback
· Robust staff recruitment process including enhanced DBS checks, application forms, interviews and references
· Risk assessments reviewed and amended appropriately when a person's needs changed
· People felt safe and staff had received safeguarding training with clear policy and procedure
· Sufficient staffing levels with timely responses to call bells and domiciliary visits arriving on time
Quality-Statement breakdown (17)
safe: Medicines administration and PRN protocolsRequires improvement
safe: Risk assessmentsGood
safe: SafeguardingGood
safe: Staffing levelsGood
safe: RecruitmentGood
effective: Staff trainingRequires improvement
effective: Supervision and appraisalRequires improvement
effective: Nutrition and hydrationGood
effective: Mental Capacity Act and DoLS
Requires improvement
caring: Kindness, dignity and respectGood
caring: Involvement of people and familiesGood
responsive: Care planning and personalisationRequires improvement
responsive: Complaints handlingGood
responsive: Access to healthcareGood
well-led: Quality assurance and governanceRequires improvement