The Bridge Care Home

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 75 (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.

Staff described the daily flash meetings as an effective forum for discussing incidents and reflecting on areas where things had not gone to plan. A staff member told us, “We have regular meetings. We discuss care and any concerns and resolve things. We talk about how we can avoid the incident or how to deal with it in case it happens again.” Another staff member commented, "We use the flash meetings to discuss incidents, concerns about people and handovers. We also record on Nourish.”

We observed a flash meeting during our inspection. Staff openly raised incidents and collectively explored solutions. The registered manager played an active role in facilitating reflection and supporting staff to learn from events. This contributed to a learning culture where improvements were continuously identified.

Incidents were logged, investigated and addressed, with outcomes and learning routinely shared with the team. Records were detailed, timely and demonstrated follow‑through to ensure improvements were implemented.

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.

People were supported through a well‑structured admissions process. A person described in detail the steps taken before they moved into the home. They told us they had visited the service several times, had lunch, and spent time in the home to help them decide whether it met their needs. Staff completed comprehensive assessments prior to admission to ensure the service could meet each person’s needs safely. Where required, equipment was arranged and installed before people moved in so that safety was maintained from the outset. Staff also ensured that people received the medications they required from the outset, and they worked with relevant healthcare professionals to organise or adjust services as needed to support a smooth transition.

The service used a checklist to prompt staff to complete all necessary actions to ensure people were supported safely when moving into the home, as well as when moving on to another service. This helped ensure important information was not missed and that transitions were well‑coordinated.

The registered manager provided an example of how they had supported 1 person who was staying at the service for respite care to return home safely. They worked closely with the person and relevant professionals to ensure all necessary support and equipment were in place for their safe discharge.

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. The provider shared concerns quickly and appropriately.

People told us they felt safe living at the service. A person said, “Oh yes, I feel very lucky to be here. I’m very safe.” Another commented, “The staff keep us safe. I feel safe. I have no worries about my safety, that’s why I came to live here.” Their feedback reflected the confidence people had in the staff and the environment.

Staff had completed safeguarding training and demonstrated a good understanding of the signs of abuse and how to recognise them. They told us they would immediately report any concerns to the registered manager. The registered manager understood their responsibilities to safeguard people, and records showed they had followed the provider’s safeguarding procedures appropriately when concerns or allegations of abuse had been raised.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Staff had received training on MCA and understood their role and responsibility in promoting the principles of MCA.

People’s rights and freedom were promoted in the home. People had valid DoLS in place or a pending application with the local authority. We saw people leave the home and return as they wished. The registered manager understood their responsibility to promote people’s right and to notify CQC of any approved DoLS.

The provider ensured risks were fully planned for and managed, which meant people were supported in the safest way possible while having their individual needs met.

Risks were identified during assessment and reviewed on a regular basis. Management plans were in place to guide staff in supporting people safely. Risk assessments were in place for people’s mobility, risk of falls, pressure damage, health conditions, moving and handling, choking, malnutrition, the use of paraffin‑based creams due to fire risks, and for people prescribed medicines that increased the risk of bruising or bleeding. We noted that risk assessments for people receiving blood‑thinning medicines did not provide clear guidance to staff on the actions required following a fall, but staff showed they knew what to do to manage this risk effectively. Staff demonstrated an understanding of how to escalate concerns and worked collaboratively with external healthcare professionals, including district nurses, GPs and specialist services. A person with fragile skin and an increased risk of pressure damage was supported appropriately. District nurses were involved, clinical guidance was followed, and appropriate pressure‑relieving equipment, including a specialist mattress, was provided. Staff supported the person with regular repositioning and monitored their condition to reduce the risk of deterioration.

Another person had a condition that increased their risk of falls and required close supervision. Staff followed a risk management plan, which included ensuring appropriate footwear, maintaining a safe bed height and keeping the environment free from hazards. Staff monitored medicines for side effects that could increase falls risk, and incidents were recorded and reviewed to support learning and prevention.

People and their relatives told us they felt safe using the service. A person said, “The care manager and I discussed my needs and the risks I face. My mobility is the main problem and I use a wheelchair. Staff know how to support me safely.” A relative told us, “[Person] is absolutely safe. They have had no accidents, and staff are always close by.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

The service was modern, well‑maintained and purposely designed to keep people safe while also promoting comfort and independence. The building was newly developed and dementia‑friendly, with clear signage, calming décor and thoughtfully arranged communal areas that reduced confusion and supported orientation. Multiple dining rooms, some staffed with trained waitresses, promoted dignity and supported safe and positive mealtime experiences.

Robust environmental checks were undertaken. These included regular servicing of equipment, comprehensive cleanliness routines and prompt identification and management of any emerging risks. People told us they felt safe living in the home, and relatives also expressed confidence in the environment. A person commented, “The environment is absolutely beautiful with lots of facilities to use.”

Care equipment, including moving and handling aids, was serviced appropriately, and up‑to‑date records were maintained. Staff demonstrated a clear understanding of how to maintain a safe environment and how to respond promptly and effectively to any hazards.

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.

A person said, “There are always staff around. When I use the buzzer, they come immediately. I have never had to wait too long.” Another person told us, “I think they have enough staff. I don’t need a lot of care, but when I do need help and I call, they come quickly. I spend most of my time in the communal areas and I see many staff around.”

A staff member said, “There are 4 carers and 1 senior. Some days are fine, like today. Some days we would need 5, but the seniors do step in to help.”

We observed that staff were available to support people during mealtimes, activities and within communal areas. Staff responded promptly to call bells, and we saw them regularly checking on people in their rooms to ensure their wellbeing. Staffing levels were discussed during daily flash meetings and adjusted when required. The registered manager, deputy manager and care managers were visible and hands‑on, providing direct support with care when needed. The service used a dependency tool to determine required staffing levels, and the staffing in place on both days of our visit aligned with the levels indicated by this tool.

Staff were supported when they first began to work at the service. Records showed new staff received a structured induction that included training relevant to their roles and shadowing experienced colleagues. Staff told us they felt well supported and had access to regular supervision, team meetings and annual appraisals to reflect on their practice and develop their skills. Training records showed staff had completed mandatory training as well as additional courses to support people’s specific needs.

Recruitment processes were safe and thorough. Pre‑employment checks were completed before new staff started working at the service, including references and Disclosure and Barring Service (DBS) checks, to ensure only suitable individuals were employed.

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.

Staff followed established infection control procedures and demonstrated a good understanding of how to prevent the spread of infection.

Relatives spoke positively about the cleanliness of the home. A relative told us, “The home is always clean and they follow procedures.” Another said, “It is spotlessly clean – like a hotel.” During our observations, the environment was clean, well maintained and free from odours.

Staff had received training in infection prevention and control and followed safe practices, including hand hygiene, the use of personal protective equipment (PPE), and adherence to cleaning and decontamination protocols. Regular audits took place to monitor standards and identify any areas for improvement. These were reviewed by the management team and used to ensure IPC measures remained robust and effective.

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.

There were systems and processes to support the safe management of people’s medicines, and people received their medicines as prescribed. We identified 1 medication error, which the registered manager addressed promptly. This had not caused harm to people. Staff used an electronic medicines administration record (eMAR) system to record the administration of medicines, including controlled drugs, ‘as required’ (PRN) medicines and transdermal patches. Senior staff monitored the eMAR system throughout the day to ensure doses were not missed. Where assessed as safe, people were supported to manage their medicines independently. Risk assessments and care plans were in place to guide staff in the safe administration of medicines.

For people who experienced distress or agitation, behaviour support plans and PRN protocols were in place. These included information about known triggers and de‑escalation strategies to support consistent care. Medicines were stored securely and in accordance with legal requirements and manufacturers’ temperature guidance. Staff had received medicines training and competency assessments, and regular medicines audits were completed and reviewed by the management team.