• Care Home
  • Care home

Archived: Three Bridges Nursing and Residential Home

Overall: Good read more about inspection ratings

Nook Lane, Latchford, Warrington, Cheshire, WA4 1NT (01925) 418059

Provided and run by:
St Andrews Care GRP Limited

Important: The provider of this service changed. See old profile

All Inspections

16 and 18 December 2015

During a routine inspection

This inspection was unannounced and took place on the 16 and 18 December 2015.

The service was previously inspected in May 2014. Two breaches of legal requirements relating to notification of incidents and records were identified. We undertook a follow-up inspection in September 2014 and found that improvements had been made to address the breaches.

Three Bridges Nursing and Residential Home provides accommodation and personal and nursing care for up to 53 older people, some of whom have dementia care needs. It is located in Latchford, a suburb of Warrington in Cheshire. The service is provided by St Andrews Care GRP Limited. At the time of our inspection the service was accommodating 46 people.

Three Bridges Nursing and Residential Home is a two-storey building with all resident accommodation on the ground floor. The home has 53 single rooms (four of which have ensuite facilities), four lounges (two of which lead onto a patio), a central conservatory that overlooks the sensory garden), two dining rooms and accessible bathroom and toilet facilities throughout the home. The home has car parking to the front and large gardens to the sides and rear.

At the time of the inspection there was a registered manager at Three Bridges Nursing and Residential Home. 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.

The registered manager was present during the two days of our inspection and engaged positively in the inspection process. The manager was observed to be friendly and approachable and operated an open door policy to people using the service, staff and visitors.

People living at Three Bridges Nursing and Residential Home were observed to be comfortable and relaxed in their home environment and in the presence of staff. People spoken with were generally complimentary about the standard of care provided.

We found that the needs of people using the service had been assessed and planned for so that staff understood how to provide person centred care and to keep people safe from harm.

The provider had established a programme of induction and ongoing training to ensure people using the service were supported by competent staff. Additional systems of support such as supervision, appraisals and team meetings were also in place.

The registered manager and staff had access to training in the Metal Capacity Act 2005. The manager demonstrated an awareness of the Deprivation of Liberty Safeguards and the need to ensure that people using the service were looked after in a way that does not inappropriately restrict their freedom.

We observed interactions between staff and people to be positive, responsive to need and caring. We also noted that people’s choices were respected and that staff communicated and engaged with people in a compassionate manner.

People using the service had access to a range of individualised and group activities and a choice of wholesome and nutritious meals.

Records showed that people also had access to GPs, chiropodists and other health care professionals (subject to individual need). Medicines were ordered, stored, administered and disposed of safely.

Systems to monitor key aspects of the service, obtain feedback on the standard of care provided and to respond to safeguarding concerns and complaints had been established.

1 September 2014

During an inspection looking at part of the service

We considered all the evidence we had gathered under the outcomes 'notifications' and 'records'. This helped us to answer one of the five questions we always ask:

' Is the service safe?

We found that the provider 'Bondcare St Andrews Limited' had taken appropriate action to ensure that all important events that affect the welfare of people using the service were reported to the Care Quality Commission. This helped to ensure people were adequately protected from the risks of unsafe or inappropriate care and treatment.

We also found that the provider had taken appropriate action to improve storage systems and the maintenance of records. This helped to safeguard records and ensure people were adequately protected from the risks of unsafe or inappropriate care and treatment.

13, 14 May 2014

During a routine inspection

We undertook an inspection of Three Bridges on 13th and 14th May 2014.

During our two day inspection we spoke with the regional manager, acting manager, deputy manager, seven staff, four relatives, two social workers and eight people who used the service. We also encouraged other people using the service to participate in our visit using their preferred methods of communication.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Policies and procedures had been developed by the registered provider (Warrington Community Living) to provide guidance for staff on how to safeguard the care and welfare of the people using the service.

The acting manager and staff spoken with demonstrated awareness of the Mental Capacity Act and the circumstances when it was necessary to apply for authorisation to deprive a person of their liberty and to ensure the correct safeguards were in place.

Likewise, staff spoken with also demonstrated a sound awareness of the different types of abuse and the action that should be taken in response to suspicion or evidence of abuse.

A safeguarding log was in place. This highlighted that there had been seven safeguarding referrals since January 2014. Safeguarding records prior to January 2014 could not be located to provide an overview of incidents and action taken. A compliance action has been set against Regulation 20 of the Health and Social Care Act 2008 in regard to missing records and the provider must tell us how they plan to improve.

Examination of the training matrix for the service together with the training statistics summary record highlighted a number of gaps in training across a range of subject areas for newly appointed and some existing staff.

We noted that a new e-learning system was being set up for mandatory training. Likewise, a range of training courses had been booked by the provider for staff to nominate themselves to attend. Systems were also in place to monitor the outstanding learning needs of staff and when refresher training was due.

Staff spoken with confirmed they had attended team meetings periodically and received supervision and appraisal sessions. Staff reported that the quality and frequency of supervisions had improved since the new management team had started working at Three Bridges and clinical supervision had been introduced to support nursing staff.

Upon reviewing records we noted that the provider had not always notified CQC of notifiable incidents and copies of some notifications were not available for reference. This is a requirement of the Care Quality Commission (Registration) Regulations 2009. A compliance action has been set in regard to this matter and the provider must tell us how they plan to improve.

Is the service effective?

We spoke to eight people who lived at Three Bridges Residential and Nursing Home during our inspection. Comments received from people using the service included: 'This place is like my Tina Turner record 'Simply the best better than all the rest'. The standard of care is superb'; 'Everything is fine. I'm very satisfied and the staff are so kind and friendly'; 'I'm getting fed and I'm well cared for. What more could I ask for' and 'The standard of care and meals are good. I have no reason to complain.'

Records highlighted that there had been three complaints since March 2014 and that the complaints had been listened to and acted upon. Complaint records prior to this date could not be located. A compliance action has been set in regard to records and the provider must tell us how they plan to improve.

No complaints or allegations were received from people using the service during our visit however some people expressed concern regarding the limited range of activities. We discussed these concerns with the acting manager who reported that the service was in the process of recruiting an activities coordinator to cover the absence of the post holder.

Is the service caring?

People living at Three Bridges Residential and Nursing Home who were spoken with were complimentary of the staff team. Comments received from people living at Three Bridges Nursing and Residential Home included: 'All the carers are very kind'; 'The staff are so kind and friendly' and 'The new management team and staff are approachable and friendly people.'

We also spoke with the relatives of four people who were supported by the service. All feedback received was positive and confirmed the service was responsive and caring to the needs of the people using the service.

Is the service responsive?

Files viewed contained a range of assessment and care planning information which included a plan of care that outlined individual needs and risks; aims and objectives; and details of the level of support / intervention required by staff. Monthly evaluation records had also been completed which provided evidence that care plans had been kept under regular review.

We observed staff carrying out their duties and responsibilities with confidence and skill, in good humour and in a relaxed and positive manner.

People spoken with were complimentary of the staff team. Comments received from people living at Three Bridges Nursing and Residential Home included: 'All the carers are very kind'; 'The staff are so kind and friendly' and 'The new management team and staff are approachable and friendly people.'

We noted that some parts of the home remained in need of redecoration and refurbishment. We were informed by the regional manager that a rolling maintenance and refurbishment programme for Three Bridges Residential and Nursing Home had been agreed to enhance the internal and external environment.

For example, we received confirmation that dementia care unit would have all community areas redecorated and refurbished over the next three months to include improved signage; new floor coverings; themed colour schemes, dementia specific wall art, reminiscence items and tactile materials.

A programme of redecoration is also planned for the rest of the home over the coming twelve months.

Is the service well- led?

Since our last inspection, a number of concerns were identified by the local authority's contracts monitoring team following an unscheduled review during December 2013. Concerns regarding: the management and leadership of the home; care standards and culture; communication and record keeping and training and staffing were identified.

The home was issued with an action plan by the local authority to ensure on-going improvements were made and significant progress has been noted across all areas requiring improvement. This had included the appointment of a new regional director and a home manager to provide leadership and direction. We received assurance from the regional director that the acting manager would apply for registration with the Care Quality Commission upon satisfactory completion of the organisation's probationary period.

The provider has established a comprehensive internal quality assurance system and had developed systems to involve and obtain feedback from people using the service and / or their representatives.

15 April 2013

During a routine inspection

People using the service at Three Bridges Residential and Nursing home confirmed that they were treated with respect and their dignity was maintained. People also told us that they were satisfied with the standard of care provided and were of the opinion that staff understood their needs.

Comments received from people using the service and their relatives included: 'I am being looked after well'; 'I have always been treated in a respectful manner and the staff are attentive and kind'; 'We can follow our own routines, the care is good and the meals are nice'; 'My husband's experience of the care he has received here has been good overall'; 'The staff are very pleasant and the standard of care is okay' and 'The staff do a superb job and are caring individuals.'

Systems were in place to offer protection to the people who use the service from abuse and people spoken with confirmed that they felt safe and had no concerns regarding the care provided.

No complaints were received from the people using the service during our visit to the service but some people continued to express concern regarding a lack of social activities. The management team reported that plans were in place to recruit to this post as a matter of priority.

16 May 2012

During a routine inspection

People spoken with reported that they were generally satisfied with the standard of care and treatment provided at Three Bridges and confirmed they were given appropriate information and support regarding their care or treatment. Comments received included; 'The staff are very kind and treat me with respect'; 'It's not a bad place to live. The staff do the best they can and are always courteous' and 'I received information on the home when I moved in.'

Some residents spoken with during the visit expressed concern regarding a lack of social activities. The regional manager informed us that the two activities coordinators were on maternity leave and that action would be taken to address this issue as a matter of urgency.

People informed us they felt safe living at Three Bridges and were observed to be relaxed in their home environment and in the company of the staff team. For example, comments received from two people included: 'The staff are generally helpful and reliable' and 'So far I have been satisfied with the care I have received here. The staff are nice people.'