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Review carried out on 7 January 2022

During a monthly review of our data

We carried out a review of the data available to us about Bridge House on 7 January 2022. 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 Bridge House, you can give feedback on this service.

Inspection carried out on 11 April 2018

During a routine inspection

Bridge House is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection, Bridge House was providing care services to four adults with mild, moderate or complex learning disabilities, autism and mental health, some of whom had additional behaviours that challenged services.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager at the service. 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 continued to feel safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly.

People's needs and choices continued to be assessed and their care provided in line with up to date guidance and best practice.

People were supported to maintain a healthy diet and all health needs were met with the support from staff.

People continued to have access to healthcare services and were involved in monitoring their health needs.

Staff understood how to prevent and manage behaviours that may challenge the service.

People had developed positive relationships with staff and there was a friendly, calm, relaxed atmosphere within the home. Staff knew people's likes, dislikes and preferences well and supported them to engage in activities of interest.

People continued to be treated with dignity and respect and staff ensured their privacy was maintained. People were encouraged to make decisions about how their care was provided.

Medicines continued to be managed safely and people received their medicines as prescribed.

Staffing levels ensured that people's care and support needs were continued to be met safely and safe recruitment processes continued to be in place.

People continued to be supported by staff who had the right skills, knowledge and experience.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS applications had been made to ensure that people were only deprived of their liberty, when it had been assessed as lawful to do so.

There were policies and systems in place that ensured people would be listened to and treated fairly if they complained about the service.

The service was kept clean and hygienic. People were protected by the prevention and control of infection.

There were systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

The organisation's visions and values centred around the people they supported, which ensured their equality, diversity and human rights were respected.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve.

Further information is in the detailed findings below.

Inspection carried out on 11 December 2015

During a routine inspection

We inspected this home on 11 September 2015. This was an unannounced inspection.

Bridge House is registered to provide accommodation and personal care for five persons who have a learning difficulty, Autism and /or Mental Health issues. The people needed support to understand their particular conditions; identify triggers for unwanted behaviours and learn life skills to increase their independence. At the time of our inspection, there were five people who lived in the home. Most people were learning the skills needed to become independent, therefore required specific individual support. People were working towards having their own home with support in the community.

There was a registered manager at the home. 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.

Staff made sure people were protected from the risk of abuse. People said they felt safe and staff were able tell us about the signs of abuse or neglect and what to look out for. They understood their role and responsibilities to report any concerns and were confident in doing so.

The home had risk assessments in place to identify and reduce risks that may be involved when meeting people’s needs. There were risk assessments related to people’s physical and social needs and details of how the risks could be reduced. This enabled the staff to take immediate action to minimise or prevent harm to people.

There were sufficient numbers of suitable staff to meet people’s needs and promote people’s safety. Staff were aware of their roles and responsibilities and the lines of accountability within the home. Staff attended regular supervision, had an annual appraisal and regular team meetings.

The registered manager followed safe recruitment practices to help ensure staff were suitable for their job role at the home. Staff morale appeared high and staff talked very positively about their roles within the home. Staff told us the management was approachable, very open, and supportive.

We observed that staff had developed very positive relationships with the people who used the service. Staff were kind and respectful, and were aware of how to respect people’s privacy and dignity. People told us that they made their own choices and decisions, which were respected by staff. They found staff provided really helpful advice.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS authorisations were in place for two people. People who had been assessed as lacking capacity to make decisions for themselves and made sure their best interests were taken into account. Staff received training in the Mental Capacity Act 2005 and DoLS to enable them to understand the need for referrals and their responsibilities around best interest decisions.

The systems for the management of medicines were followed by staff and people received their medicines safely. People had good access to health and social care professionals when required.

People were very much involved in the care planning processes. Their support needs, likes and lifestyle preferences had been carefully considered and were reflected within the care and support plans.

People were encouraged and supported to pursue activities inside and outside of the home. People were also encouraged to keep active and continue learning.

Health action plans were in place and people had their physical and mental health needs regularly monitored. Regular reviews were held and people were supported to attend appointments with various health and social care professionals. This ensured they received treatment and support as required. Those people who were able made their own appointments with their GP and attend unsupported was encouraged.

Staff meetings and residents meetings took place on a regular basis. Minutes were recorded and any actions required were documented and acted on. People’s feedback was sought and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

The registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained. The registered manager understood the requirements of their registration with the commission.

Inspection carried out on 28 January 2014

During a routine inspection

The inspection was carried out by one Inspector over four hours. During this time we saw and/or met all four of the people living in the home; talked with staff; viewed the premises; and read a variety of documentation. The manager was available throughout the inspection.

We saw that people living in the home were generally relaxed and that staff members interacted well with them. People living in the home were being supported in carrying out pre-arranged activities. We had brief conversations with three of the people. One said that it was fine, and he liked living there; and another said it was �Okay�.

We found that every aspect of people�s care and support was discussed with them, and they signed consent to show their agreement to their care planning and risk assessments.

We saw that people were being supported to develop their skills and abilities, in line with their preferences. People were supported in carrying out work placements and visiting places in the community, as well as with in-house activities.

We found that the service had safe processes in place for the storage and administration of medicines.

The premises provided a comfortable and well maintained home for the people living there.

The service had reliable recruitment procedures, which ensured that suitable staff were employed to carry out care and support for vulnerable people.

The service sought regular feedback from people using the service, their relatives or representatives, health professionals and staff. The manager used this information as the basis for ongoing improvements to the service.

Inspection carried out on 10 January 2013

During a routine inspection

During our visit we met and talked with the four people living in Bridge House. They told us that they liked living at the home and that staff were very supportive. One said that the staff had helped them with their hobby and were nice to talk too. Another talked about his music and that staff support him to go shopping and out socially.

People explained where they were going that day, one said �we have a weekly plan so we know what we will be doing�. Another talked about the jobs they do around the house to keep it clean and tidy; they also mentioned that they help mow the lawn in the summer. Three people said that they go to college and are doing courses to improve, for example, their reading and writing.

Inspection carried out on 10 October 2011

During a routine inspection

We had brief conversations with two people living in the home, and met a third person. We did not obtain people�s feedback verbally, but saw that they were relaxed with the staff, and were enjoying activities. These included a person playing a game of pool with a staff member, and a person playing a game on his computer.

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