We carried out an unannounced inspection on the 14 May 2015. Our previous inspection took place on 22 April 2104 and we found the provider met the regulations inspected. Bridgeside Lodge Care Centre provides nursing care primarily for people with cognitive impairment, including dementia and other neurological conditions including spinal injuries. The service provides care and support for 64 adults of all ages.
There was a registered manager in place at the time of the inspection. 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.
We found that the registered manager and staff worked in partnership with local health and social care teams to provide a person-centred service that encouraged independence. There were strong links with the local community and an emphasis on creating opportunities for people to maintain interests and build friendships.
Activity programmes were detailed on a weekly activity board and arranged by the activity co-ordinator. We saw activities planned for the week that included poetry, movies, memory box, exercise to movement, card games, yoga, cinema and massage. People had designated one to one time with staff in order to pursue their interests; one example was a monthly cinema visit and shopping trips which people told us they looked forward to and enjoyed.
We saw innovative projects and initiatives in place to promote connectivity between people who use the service, relatives, friends and the local community. This included a new project called; ‘People like Me’ that had brought together people, staff, relatives and friends through their experiences, beliefs and interest. Outcomes were good and we saw that a number of people had developed friendships and rekindled the interests they had before coming to the home.
A volunteering project and partnership had been set up between Bridgeside Lodge and local university students. The aim of this initiative was to reduce isolation in the community by offering activities like gardening, baking and games. People were positive about the initiative and the opportunities that they had been given to interact again with the local community. They told us they missed the connections with the community and were happy to be once again doing the activities that they loved. This was another excellent demonstration of the emphasis the service put on creating opportunities for meaningful activities to take place and this ethos was at the heart of promoting and enhancing wellbeing for people, relatives and staff at the home.
Another positive development was the appointment of a dementia specialist. This person is the lead person for the company on setting up the “Who am I” document which is a passport to ensure people’s unique information and life stories are written down in one place, including choices and preferences and how they wished to be supported.
A ‘Carers Network’ had also been established to support families and friends as a result of feedback from families saying they sometimes feel alone. Relatives reported feeling less isolated and more connected to others in a similar position since the setting up of the network.
Staff had a good understanding of safeguarding adult’s procedures and keeping people safe. They knew how to recognise and report concerns appropriately and understood how to ‘whistle blow’.
Medicines were stored and administered correctly and staff had completed the appropriate training to ensure they were competent to administer medicines safely.
Risk assessments and care plans for people using the service were effective. They were person centred and recorded all the required information. People and their relatives were involved in the care planning process.
Staff had the knowledge and skills to enable them to support people effectively. They had undertaken induction training and currently thirteen staff had completed the new care certificate training, which are a set of standards which aim to give confidence that workers have the introductory skills, knowledge and behaviours to provide compassionate, safe and high quality care and support.
People consented to their care and treatment and staff had a good understating of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS exist to protect the rights of people who lack the mental capacity to make certain decisions about their own wellbeing. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.
The staff team were caring and promoted positive caring relationships. People’s dignity and privacy was maintained. They were supported with personal care and other tasks and were encouraged to do as much for themselves as possible in order to maintain and increase their independence.
The provider had invested in a training package devised by a renowned actress to support staff awareness in the area of dignity and compassion. DVD's from the package were also used during staff induction to ensure dignity and compassion were embedded at the start of the employment process.
Three were excellent practices in place to support people and their relatives around end of life care which was described by people and their relatives as being sensitive and supportive. Policies and procedures were in- depth and included information on cultural and religious customs.
There were innovative systems in place involving the robust and timely sharing of information between health and social professionals to support people achieve a dignified pain-free death.
There was a clear management structure in place and people, who used the service and staff, were fully aware of the roles and responsibilities of managers and the lines of accountability. Improvements were seen at the home and this was attributed to the extensive activity programme as well as the excellent management of the service.
People were given a service guide on how to make a complaint and other information about the service. Complaints were logged and addressed appropriately.
The registered manager conducted a number of regular audits at the service to ensure the service was delivering high quality care. Actions were carried through and discussed with the staff team for learning and improvements.