Archived: Bridge House Residential Care Home

We last inspected Bridge House on 3 September 2015 where we found there were three breaches of the Regulations of the Health and Social Care Act 2008. These were in relation to the unsafe management of medicines, risks in relation to people’s health and well-being not always identified and sufficient staff not provided at all times to meet the needs of the people who used the service. During this inspection we found the previous breaches in the Regulations had been met.

Bridge House is presently registered to care for up to 40 people who require residential care. Due to one wing of the home having recently been demolished, the provider was in the process of applying to the Care Quality Commission (CQC) to vary the number of people they can be registered for. Bridge House is a large detached building situated in spacious grounds. Accommodation is provided on two floors and all bedrooms are single occupancy with an en-suite shower and toilet. There is level access to the front of the home, a lift to the first floor and wide corridors that enable wheelchair access. There is adequate parking in the grounds at the front of the home. The home is within easy reach of local shops, public transport and the motorway network. Bury Town Centre is only a short distance away.

The home had a manager registered with the CQC who was present on the day of the inspection. A registered manager is a person who has registered with the CQC 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.

We found that suitable arrangements were in place to help safeguard people from abuse. Staff knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred. Staff were able to demonstrate their understanding of the whistle blowing procedures (the reporting of unsafe and/or poor practice).

We found people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.

We saw people looked well cared for and there was enough equipment available to ensure people's safety, comfort and independence were protected. A range of activities were provided and people who used the service told us they enjoyed the activities and looked forward to them.

People's care records contained enough information to guide staff on the care and support required. The records showed that risks to people's health and well-being had been identified and plans were in place to help reduce or eliminate the risk. We saw that people were involved and consulted about the development of their care plans.

People told us they received the care they needed when they needed it. They told us they considered staff were kind, had a caring attitude and felt they had the right skills and knowledge to care for them safely and properly. We saw that staff treated people with dignity, respect and patience.

Procedures were in place to prevent and control the spread of infection and risk assessments were in place for the safety of the premises. All areas of the home were secure, clean, well maintained and accessible for people with limited mobility; making it a safe environment for people to live and work in.

We saw that appropriate environmental risk assessments had been completed in order to promote the safety of people who used the service, members of staff and visitors. Systems were in place for carrying out regular health and safety checks and equipment was serviced and maintained regularly. Procedures were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and water supply.

The medication system was safe and we saw how the staff worked in cooperation with other healthcare professionals to ensure that people received appropriate care and treatment.

Staff were also able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

People were provided with a choice of suitable and nutritious food and drink to ensure their health care needs were met. We saw that food stocks were good and people were able to choose what they wanted for their meals.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of the running of the home and there were opportunities, such as resident/relative meetings for people to comment on the facilities of the service and the quality of the care provided.

' Is the service safe?

' Is the service caring?

' Is the service effective?

' Is the service responsive to people's needs?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with four people who used the service, speaking with the staff supporting them, and from looking at records.

Is the service safe?

The care records we looked at contained enough information to show how people were to be safely supported and cared for.

The care records showed that people's health was regularly assessed and monitored to ensure their health and welfare was protected.

People were provided with a choice of suitable and nutritious food and drinks to ensure their nutritional needs were met. People we spoke with told us, 'Yes the food is very good" and 'We get plenty to eat and there's nothing wrong with the food'.

There were a number of quality assurance systems in place to ensure people were cared for safely.

Systems were in place to help ensure the manager and staff learnt from events such as accidents and untoward incidents. This should help reduce the risk to people and help the service to continually improve.

Sufficient staff were provided at all times to help ensure the needs of people who used the service were met.

There were a number of procedures in place for dealing with an emergency situation that could affect the safety and well-being of the people who used the service..

Is the service caring?

People who used the service looked relaxed and they had a friendly rapport with the staff. The people we spoke with were complimentary about the care provided. Comments made included; 'I am as well as can be expected', 'I am just fine, very happy and I just keep going' and 'They look after me really well'. People also spoke positively of the kindness and attitude of the staff. We were told, 'They are lovely girls' and 'Can't fault them'.

People's care records showed that their preferences, likes and dislikes had been clearly documented and their care and support had been provided in accordance with their wishes.

Is the service effective?

People were assessed by a senior member of staff from the home before they were admitted to ensure their individual needs could be met.

We visited one person in their bedroom to see how they were being looked after. They looked clean, comfortable and well cared for. They had pressure relieving equipment in place to aid comfort and help in the prevention and treatment of pressure ulcers.

To ensure that safe and effective care was provided, staff updated their skills and knowledge with regular training and updates.

Staff were very good at caring for people who were very ill and at the end of their life. We were told that most of the care staff had completed training in The Six Steps to Success programme. This programme aims to enhance 'end of life care' for people.

Is the service responsive to people's needs?

Information in the care records showed the staff at the home involved other health and social care professionals in the care and support of the people who used the service.

Suitable arrangements were in place to ensure that information was passed on when a person was transferred to another service, such as a hospital.

People who used the service were offered regular opportunities to comment on the care and support they received.

Is the service well led?

The home had a manager who was registered with the Care Quality Commission and was qualified to undertake the role.

Feedback was sought from people by means of annual questionnaires that asked for their views on how they felt they were being cared for, and if the facilities at the home were to their satisfaction.

Meetings were held regularly for staff, people who used the service and their relatives. These meetings gave people the opportunity to be kept informed of any developments within the service, and also to express their views, about the service and facilities provided.

One relative spoken with told us, 'The Manager is ever so good. I know if my relative needed a doctor she would let me know immediately. My relative is in very good hands here, it's a very good home'.

People's care records contained enough information to show how they were to be supported and cared for. They also showed that people gave consent to their care and treatment.

Systems were in place to protect people who lacked the capacity to make decisions about their own care and support.

Adequate equipment and adaptations were available to promote people's independence and comfort and assist in their safe moving and handling.

People were cared for by staff that were properly trained, supported and supervised.

Regular monitoring of the services and facilities provided was in place to help protect people against the risks of inappropriate or unsafe care.

Some of their comments were:

'They are all very kind'.

'The staff know what I like to do and they respect that. I keep busy by helping out with the plants, the gardens and the painting'.

'Lovely girls, very respectful'.