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Bridge House Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 3 November 2021

About the service

Bridge House Nursing Home is a care home providing personal and nursing care to people aged 65 and over who may also live with dementia, a physical disability or a sensory impairment. Bridge House Nursing Home accommodates up to 54 people across two separate buildings, each of which has separate adapted facilities. At the time of inspection, 36 people used the service.

The service is also registered to provide care to people in their own homes. At the time of inspection no one who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

People told us they felt safe. People and relatives felt there was not always enough staff deployed. Staff training records were reviewed, and we made a recommendation. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The staff team followed procedures and practices to control the spread of infection using personal protective equipment. Medicines were not always managed safely. The registered person did not ensure that all required information was recorded, and appropriate checks were carried out.

People were supported with their nutrition and staff worked well with people, families and health and social care agencies to support people’s wellbeing.

People’s care was individualised in order to best meet their needs and activities were in place to support with stimulation. Care plans were person centred and included the input of the relevant person. We made a recommendation about the building and premises.

Systems were in place for people to raise concerns and they felt they would be listened to. People felt that staff were caring, and regular activities were available for them to take part in if they wished to.

Prior to the inspection, the provider had written their own action plan in August 2021 and identified areas of improvement, however actions were outstanding.

The provider did not ensure systems were embedded to oversee the service and ensure compliance with the fundamental standards. They did not have evidence to support effective governance. The service had an open and transparent way of working to ensure the safety of the people living at the service. Staff knew people they supported well and cared about their wellbeing. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17th January 2020).

Why we inspected

We received concerns in relation to the management of medicines, people’s nursing care needs, and staffing levels. 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 COVID-19 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 full 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 Bridge House Nursing Home 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 good governance, medicines management, safe recruitment of staff and premises. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Inspection areas

Safe

Requires improvement

Updated 3 November 2021

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 3 November 2021

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 3 November 2021

Responsive

Good

Updated 3 November 2021

Well-led

Requires improvement

Updated 3 November 2021

The service was not always well-led.

Details are in our well-led findings below.