Bridgecare Solutions Ltd 2

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. 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.

This service scored 63 (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 promoted a proactive and positive culture of safety based on openness and honesty. Staff raised, listened to, investigated and reported safety concerns and incidents. The provider used learning from incidents to identify improvements and embed good practice across the service.

The provider had effective systems for staff to report incidents and near misses. Managers reviewed incidents, identified learning and made changes to people's care and support where required to help keep them safe. Staff told us they would report any concerns to the office immediately and were confident managers would take prompt action to reduce risks and protect people from harm.

One staff member said, “The team receives feedback through meetings, supervision and discussions about incidents. For example, if an incident happens, the team may review what happened, identify what could have been done differently, and agree on changes to reduce the risk of it happening again. This helps everyone learn from incidents and improve the way we work.”

This demonstrated the provider fostered a culture of continuous learning and improvement, where staff used feedback and reflection to enhance people's safety and the quality of care provided.

The provider worked closely with people and healthcare professionals to establish, maintain and monitor safe systems of care. Staff coordinated effectively with partner agencies to promote people's safety and wellbeing and ensure continuity of care when people moved between services.

The provider supported people to transition safely into the service, including following hospital admissions. Staff completed comprehensive initial assessments with people and, where appropriate, their representatives to identify their risks, needs and preferences before care commenced. The provider maintained regular communication with healthcare professionals and hospital teams to plan safe and effective discharges. The provider explained how they liaised with hospital staff to confirm when people were medically fit to return home and ensured the necessary care and support arrangements were in place before discharge. This helped promote a safe transition and continuity of care for people returning to their homes.

The provider did not always work effectively with people and healthcare partners to understand what being safe meant to them or how best to achieve this. The provider did not consistently focus on improving people's experiences or protecting their right to live safely, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider also did not always share concerns in a timely and appropriate way.

The provider reported safeguarding concerns to the relevant local authority and cooperated with safeguarding investigations. However, they did not consistently submit statutory safeguarding notifications to CQC without delay, as required by regulation. Following the inspection, the provider submitted the required notifications as they were not aware of the need to send allegation of abuse notifications.

People told us they felt safe when receiving support from the service. Staff and the registered manager demonstrated an understanding of safeguarding responsibilities. They described how to recognise potential signs of abuse and explained the actions they would take to report concerns and protect people from harm.

The provider assessed risks to people and sought to involve them in understanding and managing those risks. Staff completed risk assessments covering areas such as personal care, moving and handling, and mobility.

However, the provider did not always provide staff with clear and detailed guidance on how staff should support people to reduce identified risks. Care plans did not consistently contain sufficient information to guide staff on managing risks associated with people's health conditions or supporting people living with dementia. This meant staff could not always rely on care records to understand how to provide safe and consistent support.

People told us they felt safe and well supported by staff. Staff demonstrated a good understanding of people's individual needs and described how they managed risks in practice. Feedback from staff showed they knew people well and could explain the measures they took to keep people safe. The service benefited from a stable and consistent staff team, which helped mitigate the risks associated with gaps in care planning documentation.

One staff member told us, “Risk assessments are in place to help staff support people safely. I find them helpful because they explain the main risks, the correct procedures to follow, and how to provide safe and appropriate care.”

Following our feedback during the inspection, the provider took immediate action to address these concerns. They showed us that they had begun reviewing and updating care plans and risk assessments to ensure staff had access to clear and comprehensive information about how to support people safely.

The provider did not always identify, assess and manage risks within people's home environments effectively. They did not consistently ensure that equipment and care-related information supported the safe delivery of care.

Staff completed environmental risk assessments in people's homes to identify and reduce risks associated with providing care. However, the provider did not always complete these assessments robustly or ensured they contained sufficient information to guide staff. For example, the provider had not completed fire risk assessments for people who used prescribed creams that increased the risk of fire. In addition, records for people who used air mattresses did not include guidance on the required settings, so staff could monitor these were safe to use.

These gaps meant staff did not always have access to clear information about how to manage environmental and equipment-related risks consistently.

We shared our concerns with the provider during the inspection. The provider responded promptly and took immediate action to strengthen risk management arrangements. They began providing staff with more comprehensive guidance on managing fire risks associated with emollient creams and improved the information available to support the safe use and maintenance of equipment within people's homes.

The provider deployed enough suitably recruited staff with the skills, knowledge and experience to meet people's needs safely. They supported staff through training, supervision, competency assessments and team meetings to help them deliver safe and effective care.

Most people told us they received support from a consistent staff team, which helped staff understand their needs and preferences. However, some relatives told us too many different staff members visited their family members. They felt this could be confusing for people, particularly those living with cognitive impairments, and said they had raised these concerns with the registered manager.

The provider followed safe recruitment practices and ensured staff completed training relevant to their roles. Managers monitored staff performance through regular supervision and competency checks and promoted continuous learning by sharing information and lessons learned during team meetings.

One staff member told us, “My training is kept up to date and is relevant to my role. It helps me understand my responsibilities, follow the correct procedures, and provide safe and effective care to the people I support. I would welcome further refresher and practical training where appropriate.”

Staff demonstrated a good understanding of their roles and responsibilities and worked together to provide care that met people's individual needs and helped keep them safe.

The provider assessed and managed infection prevention and control risks to help protect people from harm. Staff followed procedures designed to reduce the risk of infection spreading and understood when to escalate concerns to appropriate professionals and agencies.

People did not raise any concerns about infection prevention and control. They told us staff wore appropriate personal protective equipment (PPE) when providing care and support. The provider maintained infection prevention and control policies and procedures to guide staff in safe working practices.

Managers monitored staff practice through regular spot checks and observations to ensure staff followed infection control procedures and used PPE correctly. Staff told us the provider supplied sufficient PPE to enable them to work safely and maintain good hygiene standards when supporting people in their homes.

These arrangements helped reduce the risk of infection and supported the delivery of safe care.

The provider did not always ensure medicines and treatments were managed safely and in line with people's needs, preferences and prescribed plans of care. They did not consistently maintain accurate records to demonstrate staff followed best practice when supporting people with prescribed creams.

Medicines Administration Records (MARs) showed staff administered people's routine medicines as prescribed. Staff demonstrated a good understanding of safe medicines management and had completed relevant training and competency assessments before supporting people with medicines in their homes.

However, the provider had not consistently implemented robust systems for recording and monitoring the application of prescribed creams. For example, MAR charts for prescribed creams were not always in place, which meant the provider could not demonstrate people received these medicines as intended. One relative told us they were concerned staff did not always know where or how to apply prescribed creams and felt they had sometimes been applied incorrectly or not applied properly.

We discussed these concerns with the registered manager, who acknowledged the shortfalls and took prompt action to address them. The registered manager confirmed prescribed creams would be included on MAR records. Following the inspection, the provider supplied evidence they had enhanced guidance for staff and provided body maps and clear instructions showing where prescribed creams should be applied. This helped strengthen medicines management processes and reduced the risk of inconsistent care.