Bridge House

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 service 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.

A review of incident documentation confirmed incident and accident reviews were carried out and there was a clear process for sharing learning with staff. Staff understood about safety events, recorded them in detail, and told us incidents and accidents were discussed during handovers and team meetings.

People reported feeling safe. One person told us, “I know we have a joke, but the staff help me to feel safe”.

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.

The provider worked closely with health and social care professionals, such as social workers and GPs to help people work towards personal goals and maintain health and well-being, ensuring a coordinated approach to care.

Processes were in place to share important information about people. For example, people had hospital passports which are documents that ensure healthcare staff understand how best to support the person, including communication methods, likes, dislikes and daily routines.

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 had robust systems in place to identify, review and escalate safeguarding concerns promptly to appropriate agencies, and shared the outcomes with staff.

Staff had received safeguarding training, understood how to identify different types of abuse and the process for escalation.

At the time of the assessment there were no people with a Deprivation of Liberty Safeguard (DoLS) in place

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. This can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the provider was able to identify when people were potentially being deprived of their liberty, complied with the basic principles of the Act, and made applications or/and urgent authorisations in a timely manner.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were detailed, person‑centred and updated in line with people’s preferences and changing needs. Support strategies were in place, and any changes were shared promptly with staff for example, during staff handovers and using the services computer system.

Staff had appropriate training to manage risks. knew people well, understood their behaviours and triggers and how to de-escalate these.

One person told us they were supported to be involved during fire drills as they found the siren sound triggering. This involvement reduced their anxiety about drills and promoted their awareness of fire safety to themselves and others.

People were involved in decisions about positive risk-taking, and staff understood individual preferences and communication needs. One staff member told us, “If [person] is going shopping, I will ask which shop they're going to and how they are getting there and back. I’ll suggest alternative route options that may be safer, if needed”.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Robust internal and external health and safety checks were completed weekly to monitor the safety of the premises, utilities, and equipment.

Control of Substances Hazardous to Health (COSHH) items including cleaning products, were stored correctly and risk assessments were in place.

People’s bedrooms reflected individual preferences and were personalised and secure.

The local fire authority had carried out a recent assessment and not identified any concerns in relation to fire risk.

The provider had installed CCTV in communal areas to support safe care and had the correct signage displayed both indoors and outdoors.

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.

We observed staff throughout the assessment and reviewed rotas, which evidenced sufficient staff cover was always available. Contingency plans were in place and staff were always willing to cover shifts at short notice. Agency staff were not used at the time of the assessment.

Staff had completed training relevant to their role and had received regular supervisions and appraisals.

Staff were recruited safely into the service. This included requesting and receiving references from previous employers and Disclosure and Barring Service (DBS) checks. DBS checks are carried out to confirm whether prospective new staff had a criminal record.

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.

People were supported to keep their rooms clean and tidy, and staff had regular cleaning tasks to complete to ensure high levels of hygiene were continuously maintained. The service presented as extremely clean, fresh and newly decorated. Staff were able to tell us how to prevent the spread of infection, for example, through regular hand washing, using personal protective equipment (PPE) and safely isolating people if they had an infection which was contagious to other people.

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.

Policies, procedures and audits were in place relating to medicines. Staff completed mandatory medicines management training and checks were carried out regularly to ensure competency.

Medication Administration Records (MAR) charts were completed thoroughly, and ‘as and when’ (PRN) guidance was in place.

People were supported to become independent with their medication administration, and appropriate risk assessments were in place to support this.

We identified one area of concern relating to occasional gaps in the signing in of medication. This was discussed with the registered manager and assurance was provided.