Archived: The Bridgewell Centre

The Bridgewell Centre is a care home without nursing and provides a service for up to 42 people. They provide short term care (usually up to six weeks) for people needing professional help to improve their mobility or self-help skills. The service aims to make it possible for people to return to their own home and live as independently as possible in the community. People may be admitted to the service from hospital after an injury or period of illness, or from their own home to avoid hospital admission or having to move to a care home. At the time of our inspection there were 12 people using the service.

The service had been through a number of changes since our last inspection. From 31 March 2016 the service changed from a care home with nursing to a care home without nursing and stopped offering a service to people with nursing care needs. This was due to the end of the contract between the provider and Berkshire Healthcare NHS Foundation Trust, who had previously provided the on-site trained nurses and eight of the support workers. Since then, the registered nurse input has been provided by the local community nursing team.

The service did not have a registered manager at the time of our inspection. The previous registered manager left in May 2016. A new manager took on the responsibility of managing the service in May 2016 and filed an application with CQC to become registered at the same time. The new manager is the registered manager of another of the provider's services that works closely with The Bridgewell Centre. 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. The new manager was present and assisted us during this inspection.

Staff were professional and skilful when working with people. It was obvious staff knew how individuals liked things done and people were treated with care and kindness. Staff were aware of people's abilities and encouraged them to be as independent as possible.

People received support that was person centred and incorporated their personal preferences and needs. People said staff knew what they liked and what they were able to do for themselves. People confirmed staff helped them to work towards their individual goals for independence.

People received appropriate health care support. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way. Medicines were stored and administered safely.

People were protected from the risks of abuse and from risks associated with their health and care provision. They were protected by recruitment processes and people could be confident that staff were checked for suitability before being allowed to work with them.

There were sufficient numbers of staff on each shift to make sure people's needs were met. People benefitted from staff who received training to ensure they could carry out their work safely and effectively

Risks related to the premises were assessed and monitored. Checks were in place and action taken, where necessary, to address any identified risks.

People's rights to make their own decisions were protected. The manager and staff had a good understanding of the Mental Capacity Act 2005. They were aware of their responsibilities related to the Act and ensured that any decisions made on behalf of people were made within the law and in their best interests.

People knew how to raise concerns and felt they were listened to and taken seriously if they did. Staff were clear on what actions they should take should anyone raise concerns with them.

People benefitted from staying at a service that had an open and friendly culture. People felt staff were happy working at the service. People's wellbeing was protected and all interactions observed between staff and people at the service were caring, friendly and respectful. People's rights to confidentiality were upheld and staff treated them with respect and dignity.

People's privacy, dignity and independence were respected. People using the service told us they had been involved in the decision to move into the home on a temporary basis and were aware of the purpose of their stay. One person told us "I am here to get stronger so I can go back to my home."

People were protected from the risks of inadequate nutrition and dehydration. People were offered choices of menu for each meal and their likes and dislikes were noted and taken into account when meals choices were planned. One person told us "One thing that pleased me was the chef took time to sit with me and find out what I like and don't like to eat. He was very patient and it meant a lot to me."

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

There were enough qualified, skilled and experienced staff to meet people's needs. People told us staff were available when they needed them and didn't rush them when providing their care. One person commented "staff are very kind, they are always there if I need them."

There was an effective complaints system available. People using the service knew who to speak to if they had any concerns.

Before people received any care they were asked for their consent and felt the staff acted in accordance with their wishes. People we spoke with confirmed their consent was sought by the staff when providing their care or planning treatment. They felt their needs were being met and their care was delivered in the way they preferred.

We found the provider had introduced a new care planning system and ensured there was an accurate record of the care provided to people who use the service.

People were cared for by staff who felt supported by the management and who were receiving regular formal supervision. However, the provider did not have suitable arrangements in place to make sure care staff were receiving appropriate training to enable them to deliver care and treatment safely and to an appropriate standard.