Archived: Bridgewater Park Care Home

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.

There were no breaches of legal requirements at the last inspection. At the last inspection, the service was rated 'Good' overall, but the caring domain was rated ‘Requires Improvement’. At this inspection we found the necessary improvements had been made and all domains were rated good.

Bridgewater Park 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. Bridgewater Park Care Home is registered to provider residential and nursing care to older people and younger adults. Accommodation is situated on the ground floor. There are two separate units with single occupancy rooms. One unit provides care for people living with dementia. It is called Parkwood, accommodation for people requiring nursing care is provided on Westcliffe.

There was a registered manager in place 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.

There were enough staff available to meet people's needs. Safety at the service was maintained and robust medicine management and infection control measures were in place. Accidents and incidents were monitored and corrective action was taken to prevent further re-occurrence.

Staff undertook training in a variety of subjects to develop and maintain their skills. Staff supervision and appraisals occurred to support staff. New staff undertook a period of supervision and induction.

People were supported to eat and drink, where necessary. People’s dietary needs were monitored and corrective action was taken if there were any concerns.

People had choice and control over their lives, staff supported them in the least restrictive way possible. People made their own decisions about their care and support. The policies and systems in place support this practice.

Information was shared with people and their relatives about what the service could provide.

Staff were kind and caring and respected people’s privacy and dignity. People’s care needs and risks to their wellbeing were recorded. Reassessments of people’s needs took place, as their needs changed to ensure people received the help and support they required.

Complaints raised were investigated and this information was used to improve the service.

The service was well-led. People, staff relatives and visitors were asked for their views and feedback received was acted upon to maintain or improve the service.

Further information is in the detailed findings below.

People and their relatives spoke positively about their care. One person told us, 'I am well satisfied with the care; I have had excellent treatment.' A relative said, 'I can't fault them in any way with the sensitivity they showed to my mother. They keep us informed of everything.'

People spoke positively about the cleanliness of the service. One person commented, 'The cleanliness is very good; there are cleaners here and they are good workers.' A relative commented, 'Cleanliness is fine; that is one of the things that hit us when we first came; there is always the hand gel when you arrive; mum's room is absolutely spotless and the place is the same.'

There were effective recruitment and selection processes in place. People's comments about the staff that worked with them were mainly positive. Relatives' comments included, 'I can't fault the staff; they have been absolutely lovely and very accommodating,' and 'The staff have been pleasant; they were so welcoming.'

People we spoke with were clear about how to make a complaint. One person told us, 'I have no complaints at all so far,' and another person said, 'I would tell the chief nurse if I had a complaint, but I haven't had a complaint.'

People and their relatives spoke positively about their care. One person said, 'It is good care here.' A relative told us, 'The home has done all they can to look after my relative. I am happy at that because I can't wish for anything better for her condition.' We spoke with a visiting healthcare professional who said, 'The carers are very caring. It is good; there has been a lot of improvement.' People spoke positively about the staff that worked with them. One person commented, 'All the staff are fine. The staff are supported.' A relative told us, 'I would not criticise the people that work here. I expect the staff to do their job and they do.' Another relative said, 'The staff are brilliant. The staff have been very good and they do what they can.'