Bridge Haven

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm. The provider had acted to keep people safe and worked with other agencies to manage risk. Staff knew people well and people were involved in managing their risks. Medicines were managed safely. Staff received training and supervision to make sure they had the skills for their role.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Following a safeguarding concern being raised, the provider made sure they acted to learn from the incident. The provider had initiated an investigation into the circumstances. An external investigator had been employed to identify what had gone wrong and what lessons could be learnt in the long term. The provider reviewed their processes to identify immediate actions which could be taken. The actions identified were implemented and staff were supported to understand why the changes had been made. Staff told us they had been supported by the management team to understand and make the changes identified. Relatives told us they had been kept informed and supported to understand why changes to policies and procedures had been made to the way staff worked. Relatives had been involved with staff to make changes to people’s care and support as required. The lessons learnt at the service had been implemented across the providers other services. The process the management team followed to record incidents had been improved, all incidents were rated 1-5 with 5 being the highest risk and would be communicated across the providers services. There was an increased oversight of incidents, looking at the level of detail, training for staff and incidents could be reopened if needed, once closed. The provider had reviewed the induction for home and deputy managers, they had made changes to make them more competency based.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. There were processes in place to make sure when people moved into the service their needs could be met.

An assessment of people’s needs was undertaken before they moved to the service to help ensure the continuity of care. This was a comprehensive assessment of people’s health and personal care needs identifying the level of support the person needed. Nationally recognised screening tools for people’s nutritional and skin care needs were used. People were supported to access the health care support they needed relevant to their physical or medical needs. Guidance given by health care professionals was recorded and available to staff so they could act on it. Relatives told us they had been kept informed when their relative had gone into hospital and staff had supplied all the relevant information needed to make sure the person was supported safely.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. There were processes in place for staff to report safeguarding concerns, staff had followed these when they had identified a serious safeguarding concern. They had reported their concerns to the deputy manager, who had acted immediately to protect people. The whole team had understood their responsibilities and roles in reporting the concern and working with other professionals to make sure people were safe. Staff told us they had received safeguarding training, and this had been refreshed recently. The management team had praised staff for being brave and professional in reporting their concerns. Following the concern being raised, the provider had initiated additional checks and processes to mitigate risks to people. The actions taken at Bridge Haven had been rolled out over all the provider’s services to keep people safe.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Potential risks to people’s health and welfare had not always been recorded in people’s care plans. There was not always detailed guidance for staff to mitigate these risks. Some people were living with epilepsy, there was no information about what the persons seizures may look like and when to call for medical assistance. Other people were living with diabetes, the information for staff did not include what to do if the person had high blood sugar. Recent care plan audits had identified there were shortfalls in the care plans and an action plan had been put in place. Relatives were confident staff knew how to support people. A relative explained how staff supported their loved one with maintenance of their blood sugar and recognised when it was not quite right. Staff described how they supported people with different health conditions. Some people were living with Parkinson’s disease, care plans did not contain information about how this may affect people including a higher risk of falls. People required medicines to be given at specific times to reduce symptoms. Staff had alarms on their phones to make sure people received their medicines on time. Staff could describe how they supported people and understood their health needs. We observed staff supporting people in a person centred way, adjusting the support and approach for each person.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider completed regular checks on the environment and equipment to make sure it was safe and fit for purpose. A maintenance person was employed whose responsibility it was to ensure all equipment such as wheelchairs, hoists and specialist beds were checked and maintained regularly. Electrical and gas appliances were serviced and maintained. There were processes in place to record any shortfalls and the action required, these actions remained outstanding until the necessary repairs were completed.

Visual checks and servicing were undertaken on all fire equipment. Staff were trained and their competency checked to make sure they knew what to do in the event of a fire. People had individual plans about the support they needed to evacuate the building if there was a fire.

There was signage to guide people safely around their home. People had photos or pictures that were meaningful to them by their bedroom door to help people recognise which door led to their bedroom.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Relatives told us there were enough staff and people were supported by female staff if this was their preference. Relatives told us staff had the skills they needed to support people. One relative told us, “(Relative) no longer gets urine infections which were a big issue before (relative) moved into the service.” Staff told us they received appropriate training to complete their role. Staff received training in different formats including online and face to face. The management team completed checks on staff competency such as the administration of medicines. Staff were recruited safely. When concerns were raised about staff performance or behaviour, the recruitment process was reviewed to make sure all precautions had been taken. Checks were completed on staff’s performance in previous roles and on their character. Candidates right to work in the UK had been checked and staff were supported to work within any visa restrictions. There were enough staff deployed to meet people’s needs. The management team told us they completed a monthly assessment of people’s needs to ensure enough staff were always on duty. They also explained staffing levels were increased to support admissions, training courses, appointments, end of life care and people who required one to one support to keep them safe. We observed there were enough staff and people did not have to wait for the care they needed.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Relatives told us the service was clean. A relative described how they had observed the communal lounges being deep cleaned including the floors being cleaned by an outside contractor. There were processes in place to make sure the service was clean. Regular audits had been completed and action taken if shortfalls were found. Staff followed a programme of cleaning which ensured all areas of the service remained clean and hygienic. There were handwashing facilities throughout to promote regular hand washing. Staff told us personal protective equipment (PPE) such as gloves and aprons were always available when they needed it. This was used to make sure staff and people were kept free from the risk of infection. We saw staff using PPE appropriately during our visit.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Relatives told us they were kept informed of any changes to their loved one’s care. Staff told us they had received training and had their competency checked before they administered medicines. We observed a medicine round, staff were kind and compassionate with people. Staff spoke to people, supporting them to take their medicines including spending time to explain why they should take their medicine. People received time sensitive medicines at the time prescribed. There were effective systems in place to order, store and dispose of medicines. People were prescribed medicines on a ‘when required’ basis such as pain relief. There was guidance in place for staff about when and how often to give, and what action to take if they were not effective.