We carried out a review of the data available to us about Bridgewood House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bridgewood House, you can give feedback on this service.
Bridgewood House is a residential care home providing personal care to 18 people with learning disabilities and physical disabilities. People living at the home had varying abilities with some people living more independently in four bungalows on the site.
The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
The service was in a rural location with limited access to public transport and the service was larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and other domestic homes of a similar size. There was a separate building with bungalows that allowed people to develop their independence. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
Individualised risk assessments had improved. Staff were confident they would raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.
Medicines were stored safely and staff were trained to administer them correctly. We found records relating to 'as and when required' medicines needed to be put in place, the registered manager actioned this immediately.
There were enough staff to support people and staff were always visible. Staff received support and a variety of appropriate training to meet people's needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Care plans were person centred and people were involved in their reviews where they were able. The registered manager confirmed additional work would be taken place to ensure people’s care plans were easier to navigate.
People were supported to engage in activities they enjoyed, and we saw the service promoted people accessing local community facilities and supporting them to go on trips and holidays.
There were quality assurance systems in place to ensure care and support were kept to a good standard. The service worked with a range of healthcare and multidisciplinary professionals to achieve good outcomes for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating.
Rating at last inspection
The last rating for this service was requires improvement (published12 March 2019).
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
¿There were areas of care which needed to improve to ensure they met the fundamental standards of care and we found breaches of the regulations in safe care and treatment and good governance. This included how the service recorded their assessment of risk, care records, and robust auditing systems.
¿ Recorded risk assessment and risk management plans in some areas of support needed to improve to demonstrate all risks had been fully explored. The registered manager could tell us how they minimised the risk of harm to people, but the records did not reflect this. The service was not using an evidence-based tool to assess the risk of developing pressure ulcers. We have made a recommendation about this and seek advice from a reputable source.
¿There were enough staff to meet people’s and staff had been recruited safely to ensure they were appropriate to work with people at the home. We found the service was clean and tidy and people were protected from the risk of infection.
¿ We observed medicines to be administered safely, although there were issues with the medicines audit and storage. We have made a recommendation the service refers to current guidance.
¿People who were able to communicate verbally and their relatives told us they were safe in the home; systems were in place to manage any allegations of abuse.
¿Our observations during this inspection confirmed staff were friendly, kind and compassionate. They ensured people were comfortable, safe and provided a homely environment, so people enjoyed living there.
¿The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; promotion of choice and control, independence and inclusion. Where relevant people's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
¿People were supported by staff who were motivated, enjoyed their job and felt well supported through regular supervision, feedback, appraisal and training.
¿Staff were kind and caring, treating people with respect and maintaining their dignity.
¿People received adequate nutrition and hydration which supported a healthy and balanced diet. People's likes and dislikes were accommodated within menu planning. The provider ensured that people were referred to healthcare professionals as required.
¿People were able to make choices and were involved in decisions about their care. Staff asked people for consent before providing care. Some best interest decisions were specific and considered all the available options. Others did not and were not in line with the MCA Code of Practice.
¿Care records were difficult to navigate and contained out of date information. The registered manager recognised improvements were needed to make sure all the care records were accurate. The provider was planning to imminently introduce computers at this service which would help rectify this issue.
¿People, relatives and staff praised the management of the home and spoke highly of the registered manager who they said was approachable and always available.
¿People and relatives knew how to raise any concerns and had confidence in the complaints process.
¿Regular checks were undertaken to ensure the environment and equipment was safe. However, audits were not robust or detailed which meant opportunities to improve were missed.
¿Policies had not been updated to reflect current best practice or legislation to guide staff to best practice.
¿For more details, please see the full report which is on the CQC website at www.cqc.org.uk. Please see the ‘action we have told the provider to take’ section towards the end of the report.
Rating at last inspection: Good. Publication date: 19 July 2016.
Why we inspected: This was a scheduled inspection based on previous rating.
Follow up: We will continue to monitor the service to ensure that people receive safe, high quality care. The registered provider will be asked to send us an action plan and further inspections will be planned to check for improvements. We will follow up on the breaches of regulations and recommendations we have made at our next inspection.
Bridgewood House is a care home currently providing care for up to a maximum of 23 adults. The home main building has19 bedrooms with a further four bungalows in the grounds where people who require a lower level of day to day support live. On the day of our inspection 18 people were living at Bridgewood House.
The service had a registered manager in place. 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.
People we spoke with told us they felt safe. Staff received training in safeguarding vulnerable people, and were aware of how to keep people safe.
Equipment was provided within the home but risk assessments did not address all areas of identified risk.
There were systems in place to reduce the risk of recruiting staff who may be unsuitable to work with vulnerable people. there were enough staff to meet people’s needs.
The storage of medicines needed to be improved to reduce the risk of staff and people who lived at the home having unauthorised access to them. When this was brought to the attention of the registered manager they took immediate action to rectify this matter. Medicines were administered safely to people.
New employees were inducted into their role. Staff received an on-going programme of training and management supervision.
Our discussions with the registered manager and staff evidenced they understood the principles of the Mental Capacity Act 2005 and how they would act in people’s best interests where people lacked capacity to make decisions.
People were supported to eat and drink and were enabled to choose what meal they would like to eat. We observed the lunch time meal on the day of our inspection, people enjoyed their meal and the atmosphere while people were eating was relaxed.
People told us staff were caring and kind. When we spoke with staff they were knowledgeable about people’s individual needs, likes and preferences. Staff demonstrated how they maintained people’s privacy and dignity and they gave us examples of how they supported people to make choices about their daily lives.
People were supported to participate in a range of activities; these were planned around people’s likes, preferences and abilities. Care plans recorded a level of detail which enabled staff to provide person centred care and support.
Staff understood their role and spoke positively about the registered manager and the people they supported. The registered provider had a system in place to audit the service provided to people. the views and opinions of both staff and people who lived at Bridgewood House were gained through meetings and surveys.
We looked at the care records of four people and saw their needs had been assessed and care was delivered in relation to their needs. We saw when people required support from other healthcare professionals such as district nurses or GP's, this was actioned and clear records of treatment and actions were kept.
The people we spoke with told us they were involved in making decisions about their care and staff respected their views and beliefs.
One visitor told us that they were happy with the standard of care provided for their relative. The two visiting health professionals told us that care standards were high.