The Bridges

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

This means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

All wards were safe, clean well equipped, well furnished, well maintained and fit for purpose. Staff assessed and managed risks to patients and themselves well. Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. The service used systems and processes to safely prescribe, administer, record and store medicines. The service managed patient safety incidents well.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff told us they felt able to raise concerns and felt positive about how approachable and proactive senior managers were. Staff told us that sharing information and continuous learning was implemented through various forms which included handovers, supervisions, and staff meetings.

Staff recognised incidents and reported them appropriately. Incidents were reviewed and any themes and trends identified and discussed. Managers could give examples of changes following lessons learnt from an incident. The service reported 3 incidents in the last 12 months. There were no themes or trends to the incidents however, the service took actions and learnt lessons and development for staff, were appropriate.

Clients told us they knew how to raise concerns and staff within the service were responsive.

We scored the service as 4. The evidence showed an exceptional standard. The service always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

The service had a clear admissions policy in place with clear stages from referral to admission. All essential information about the person was received to determine if the person’s needs could be safely met. Staff made regular contact with those waiting for admission to the service and this was confirmed by the clients we spoke with.

Staff and leaders gave examples of collaborative working with partners. Feedback received from partner organisations informed us that the service had a joint policy in place with probation services for unexpected end of treatment and this included a ‘safe exit plan’ to ensure actions in such an event were clearly defined for staff to follow.

Clients were central to leading their recovery and planning for a successful and safe discharge. As part of the 12 steps, they were actively involved in attending sessions and meetings to share their views. During the primary stage of admission clients agreed to remain in the service and any external sessions or trips were supervised. However, one client we spoke with had been supported to attend external appointments independently. They felt empowered by this positive risk taking and told us this was well organised, the client was encouraged to write a plan and staff went through this with the client beforehand.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Staff we spoke with told us they knew who to raise and report safeguarding concerns to. Safeguarding adults and children training was mandatory, and compliance at the time of the assessment was 64%. The outstanding 4 staff due to complete this training were new starters in 2025.

The provider had systems, policies, and processes in place to ensure that staff identified and reported concerns. Managers attended a quarterly safeguarding forum and the service completed a safeguarding performance framework compliance review in October 2024 and created a development plan to make improvements. In the previous 12 months the provider had made no safeguarding referrals. We reviewed 5 care records which captured any relevant safeguarding concerns for individual clients.

We scored the service as 3. The evidence showed a good standard. The service worked with people to understand and manage risks by thinking holistically. Staff assessed and managed risks to clients and themselves well and followed best practice in anticipating, de-escalating and managing challenging behaviour. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

All clients had up to date risk assessments and the 5 we viewed showed clients were included in developing these, they were signed by the client and copies given. Risk assessments were reviewed when required, for example after an incident.

The service had a restrictive practice database which listed 19 restrictions, which included restricted access to mobile phones, television, reading materials and other boundaries regarding visitors, nighttime and attendance at external appointments and groups. We saw evidence that the service regularly reviewed most restrictions and banned items. All restrictions, policies and procedures were outlined in the client handbook. Clients confirmed that the treatment contract was discussed in community meetings. There were 6 items which the service had indicated were last reviewed in August 2024 and overdue a review. No concerns had been raised by clients in relation to these restrictions except for access to streaming services. The provider told us they would review this.

The service worked with partner organisations to support clients’ access to the community or to maintain relationships by using effective risk management.

We spoke with 7 clients who all told us they felt safe in the service. Clients were involved in weekly community meetings where they were asked about the ward environment and safety on the ward.

We scored the service as 3. The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service compromised of 19 beds in total 10 male rooms, 4 single and 3 shared rooms and 9 female rooms, 5 single and 4 shared rooms, some rooms included a toilet and sink. All shared rooms were single sex. At the time of our assessment there were 12 people using the service, 11 primary and 1 secondary client.

Staff completed monthly health and safety assessments of the service. Risks identified within the ward environment were managed through an inclusion and exclusion criteria as part of the admission process, individual risk assessments and observations to manage individual risks. The service had panic buttons in communal areas for people to use if needed and ligature cutters on all floors were kept in a coded locked box. Clients, who required it, had personal emergency evacuation plans (PEEPs) in place. Clients were encouraged to comment on the ward environment in community meetings.

A service tour and check of the environment and equipment was undertaken during our onsite activity. We carried out a check of the clinic room and we found no concerns. However, we found that some areas of the hospital, in particular client rooms, required some redecoration. This was raised with the managers who explained that the provider had several unexpected and challenging issues with the new property that required some significant and costly improvements, and this was ongoing. Clients could raise any maintenance issues with the team.

We scored the service as 3. The evidence showed a good standard. The service 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.

The provider ensured they had enough qualified, skilled, and experienced staff. During the day the service employed a treatment lead, 3 counsellors, a resettlement worker and administrator. Overnight the service employed a senior night worker, one night worker and 3 support workers. The service used bank and agency staff overnight, when necessary. Overnight the service operated with 1 member of staff from 12am until the morning. The provider did not inform us of any current vacancies. The provider did not provide any sickness or turnover data. However, the provider had undergone a recent recruitment drive, and the counselling staff and senior night worker had been recruited in the previous 3 months. The registered manager had also recently left, and the registered manager of another location was adding The Bridges to their existing registration.

The provider had a spreadsheet for training compliance, which included safeguarding, data protection, health and safety, mental health and wellbeing, mental capacity act and equality, diversity and inclusion training. The hospital was 87% compliant with this training overall. Those courses which were under 75% compliant were due to new starters within the service. The new starters were also completing induction training which included an introduction to the provider, safeguarding and equality, diversity and inclusion. We identified that learning disability and autism training was not listed as mandatory on the providers training programme, however following our onsite inspection the provider submitted evidence to show that 100% of staff had completed this training in June 2025. Staff also told us that they completed Fire Warden training and Medication Administration training however this was not captured on the providers spreadsheet.

During their probation period staff had 3 reviews and then quarterly appraisals of their work. There were some gaps in the data provided as 3 reviews due in May 2025 were missing. However, staff we spoke with told us they were well supported and felt they had a regular appraisal of their work which included discussing concerns, objectives and training needs and feedback relating to their performance.

We observed good levels of staffing during the assessment and there was enough staff to meet the needs of clients, including groups and outings. Clients told us that they had regular opportunities to meet with staff.

We scored the service as 3. The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff we spoke with were aware of infection, prevention and control requirements and policies.

The provider had effective systems and processes in place to ensure they managed the risk of infection. This included testing clients and staff if a client was vulnerable to COVID-19 and they had introduced a monthly audit of infection, prevention & control. Clients and staff were responsible for daily cleaning and household tasks within the service.

We scored the service as 3. The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Staff followed systems and processes to support the administration of medicines safely.

At the time of inspection all clients’ medication was stored in a lockable cabinet within the medical room. Medication was stored in individual boxes with client’s names on each box. All medication prescribed by the GP was brought to the service by the client in a clearly labelled and named box. Patients medication was reconciled on admission and inputted into the services medication management platform.

Medication needs were assessed as part of the admission process and risk assessments completed according to the client’s needs.

All clients were invited to register with a local GP. Client medicines could be reviewed by a GP during their time at The Bridges and arrangements were made for safe travel to and from GP appointments. All medication was recorded on a digital system which was completed by staff when medication was administered. Staff told us the change to the digital system had reduced medication errors and improved compliance and management of medicines.

Staff we spoke with told us they had undertaken medication management training; practice was observed and staff supervised by the treatment lead. The service undertook weekly medication audits, and the service had support from a local pharmacy.

The service also had Naloxone on site (medication to reverse the effects of narcotic drugs), in line with public health England guidance, and staff had been trained to use this. In a medical emergency staff would contact emergency services in line with policy.

Staff learned from safety alerts and incidents to improve practice. Any incidents were reported and during inspection we reviewed the medication audits and could see that any errors were recorded and addressed.