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Archived: Bridge House

Reports


Inspection carried out on 5th-6th April 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

Safe

  • Communal areas that people used were all clean, comfortable and well maintained. Bedrooms were well maintained and furniture was in a good state of repair.

  • A new training matrix had been developed for staff.

  • Risk assessments for all clients were completed regarding the use of cleaning products.

  • The health and safety risk assessment for the building was updated on a weekly basis.

  • Electrical safety testing, legionella and gas safety checks had all been completed within appropriate time frames.

  • All staff had first aid training.

  • Clients could access a range of treatments and support and there were enough staff on duty to provide those treatments.

  • Appropriate pre-employment checks had been completed for all staff.

  • Care records had a comprehensive assessment, up to date care plan and risk assessment with plans in place for unexpected discharge from the service.

  • Medication administration records were up to date, well organised and clearly documented which medications had been prescribed.

  • Staff were offered a full debrief after incidents and we saw evidence in team meetings that lessons learned from incidents were fed back to the team.

Effective

  • Care records had a personalised recovery plan in place. All clients had been given a copy of their care plan.

  • Groups were well facilitated and well structured.

  • Staff meetings were well attended and staff were able to discuss any issues.

  • There were good links with local recovery communities.

Caring

  • Staff treated clients with kindness dignity and respect.

  • Clients were actively involved in their care and were able to raise any issues in community meetings.

  • Carers were invited to a monthly friends and family meeting where they were encouraged to give feedback and could be supported on an individual basis.

Responsive

  • All clients were given a copy of the residents handbook upon admission into the service.

  • We saw holistic needs assessments that had been undertaken for all the clients’ records we looked at.

  • Discharge planning was documented in care plans and clients attended moving on groups

  • Clients engaged in community activities to prepare them for discharge.

  • There was a weekly support group for ex-clients.

Well led

  • Sickness and absence rates were low at 3%.

  • Staff felt confident to raise their concerns to managers.

  • Morale was good and the team worked well together

However, we also found the following issues that the service provider needs to improve:

  • Clients and staff used a vestibule area to smoke and this filtered into the main building potentially affecting the health of others.

  • Medication checked in after delivery by the pharmacist was not itemised.

  • Staff were not aware of the Duty of Candour

  • Staff were not aware of best practice legislation or guidelines.

  • Staff were receiving regular supervision but this was not in line with the supervision policy.

  • Staff had not received Mental Capacity Act (MCA) training and were not aware of the principles of the MCA.

  • Some parts of the building were not accessible to people using wheelchairs or who had other types of restricted mobility.

  • Clients were not aware that forms were available if they wanted to provide written feedback to staff.

  • We found that the service had not developed some policies. These included the Duty of Candour and Mental Capacity Act 2005 policies. We found that some policies were out of date or had no review date. These included the supervision policy, lone worker policy and whistleblowing policy.

Inspection carried out on 15 August 2013

During a routine inspection

At the time of our visit ten people were using the service. They had all started their rehabilitation programme at different times during the previous twelve months. We found that people were given sufficient information to enable them to make informed decisions about taking part in the rehabilitation programme. The people we spoke with said they understood the need for rules and routines in the programme and said they did not find these too restrictive.

Written support plans were in place for each person. The plans provided clear instructions about how the person was to be supported and gave details of any relevant issues in relation to their support. People had also written their own specific goals for what they hoped to achieve from the rehabilitation programme. Plans and goals were reviewed weekly by key workers to monitor progress.

Effective systems were in place for inducting, training and supporting staff. Staff members were equipped with the right skills to do their job. We found that there was a small and well established team who provided continuity and consistency in the way the service was provided.

There was an effective system to regularly assess and monitor the quality of service that people received and to ensure the provision of safe and appropriate care at all times.

Inspection carried out on 25 October 2012

During a routine inspection

We spoke with two people being supported by the service. They told us they felt the staff were caring and approachable. Their comments included, “This place and the staff have been excellent. Thank you is just not a big enough word for everything that they have done for me” and “The Staff are so understanding. Everything that they do is to help you to help yourself. I would not be here without their help.”

We looked at the service user guide and resident’s handbook and found individuals were given good information both prior to admission and during their stay.

We also looked at people’s care records. We found records were accurate, up to date and regularly reviewed. We also saw how the organisation included people in decision making throughout their treatment and support.

We looked at staff records and found the staff were well trained and saw there were good systems in place to ensure they were well supported in their work.

Inspection carried out on 6 December 2011

During a routine inspection

During the course of the visit we spoke individually with the registered manager of the service and three of the people being supported at Bridge House. We also spoke collectively with two other people.

Without exception people using the service were extremely positive about the care, support and the dedication of the staff team. We were told, “The staff are really excellent and they really understand. We are very involved in putting our care plan together and in saying what we think.”

Another person told us, “They (the staff) have given me confidence and helped me to see things in a different way and there is now a light at the end of the tunnel”. It was clearly evident that there was an equal relationship between the staff team and people using the service and that people were respected and valued.

People staying at Bridge House told us that they were very involved in developing their support plan along with their key worker and that their support plan was constantly evolving as the programme progressed. One of the people spoken with said that best thing about being at Bridge House was that, “They (staff) care; they have given me self confidence and got me to open up”. Another person said, “I like the routine, it gives me something to do. Staff are very supportive and understanding”.

People using the service that were spoken with, all felt extremely well supported and safe staying a Bridge House. One person when asked said, “I am well safe and protected here”. Another person said, “I feel safe in this environment, safe with the staff and safe with the other people on the programme”. A third person told us, “I definitely feel safe here but not too safe as I am now needing to get home. I am ready to leave and get back to my children”.

People using the service consistently told us that the staff group were, “Excellent”. One person told us, “They (the staff team) have worked wonders, they have been brilliant, changed me completely and I have learned so much”. The staff communicate so well and will always listen, I cannot fault it here”. Somebody else said, “I am very happy with the service provided. The staff are very good and do listen, they have a serious side but you can have a laugh with them as well”.

Reports under our old system of regulation (including those from before CQC was created)