Background to this inspection
Updated
22 April 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Three inspectors visited the service on 8 March 2021 and two inspectors visited on 9 March 2021.
Service and service type
Bridgewater Park Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission who had resigned three weeks before the inspection. The provider had deployed their turnaround manager, already in post, to support the service. During the inspection the nominated individual (provider’s representative) confirmed recruitment for a new permanent manager was underway. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced on the first day and announced on the second day.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority safeguarding and commissioning teams, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with eight people who used the service about their experience of the care provided. We spoke with the nominated individual and 13 members of staff including the area directors for operations and quality, the turnaround manager, registered nurse, two nursing assistants, two senior care assistants, three care staff, a housekeeper and a laundry assistant. We reviewed a range of records. This included nine people’s care records, multiple medication records and a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We reviewed additional evidence requested from the provider and continued to seek clarification to validate evidence found. We spoke with six relatives.
Updated
22 April 2021
About the service
Bridgewater Park Care Home is a care home with nursing providing care for older people and younger adults who may be living with a physical disability or dementia. The service is registered to support up to 63 people in one adapted building. Forty-five people were using the service when we inspected.
People’s experience of using this service and what we found
There were not enough staff to give people timely care, provide the reassurance and support people required when they were distressed and keep the home clean. Areas of the service needed redecoration and renewal. Maintenance issues made it difficult to effectively clean the service.
Some people’s health needs had not been managed effectively to ensure they received timely emergency care, pain management and oversight from professionals involved in their care. Lessons were learned when things went wrong. Staff had been provided with additional training, support and guidance in recent weeks to develop their confidence and competence when assessing and monitoring people’s needs, completing care tasks and records.
For people who lacked the mental capacity to make decisions about their care, the policies and systems in the service did not support people to have maximum choice and control of their lives.
Quality assurance systems were not operated effectively and failed to ensure compliance with regulations. Where issues had been identified the provider had not always acted in a timely manner to address these. Staff morale was low. Not all staff felt confident to speak up or felt they would be listened to.
People told us they felt safe, liked the staff and were happy and settled in the service. Staff understood how to identify and report safeguarding concerns.
Good practice guidance had been followed to help minimise risks relating to COVID-19. Risk assessments were in place to guide staff on how to safely meet people’s needs. The management team reviewed all accidents and incidents to identify any actions that could be taken to prevent a similar thing happening again.
Medicines were managed and administered safely. People’s nutritional needs were met.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection.
The last rating for this service was good (published 27 January 2018).
Why we inspected
We received concerns in relation to the timeliness of a person’s health care support and the approach and skills of staff. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bridgewater Park on our website at www.cqc.org.uk
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care, decisions on behalf of people, the environment, staffing, records and overseeing quality monitoring at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.