The service was inspected on August 2016, where we found the service was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) 2010. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Bridges Healthcare Limited’ on our website at www.cqc.org.uk.
We undertook a focused inspection in February 2017 in relation to the breaches of regulation we identified at our previous inspection of September 2016. We found that the service had followed their action plan and had made improvements. We could not however change the overall rating of the service because to do so required a record of consistent good practice.
We undertook an announced comprehensive inspection on 14 September 2017. We gave the registered manager 24 hours’ notice as we needed to be sure they would be available for the inspection. At this inspection we found that the service had sustained the improvements put in place following our previous inspections of September 2016 and February 2017 and met the legal requirements.
The service had a registered manager. 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.
Staff handled and administered people’s medicines to them in a safe way. Staff had been trained and assessed in the safe administration of medicines and they understood and followed the organisation’s medicines policy.
Risks to people were assessed and detailed risk management plans put in place for staff to follow to keep people safe from avoidable harm. Staff understood risks associated with people and knew what the actions to take to reduce such risks.
Thorough recruitment checks took place before staff were allowed to work with vulnerable people. Staff understood how to recognise signs of abuse and how to protect people from the risk of abuse. Staff also knew and were encouraged to whistle blow if necessary to keep people safe.
Sufficient staff were deployed that ensured people needs were met in a timely way. People told us staff had sufficient time to safely support them. Staff confirmed time allocated to them to support people was sufficient. People also told us and the call monitoring system confirmed people received their care visits as planned.
The registered manager and staff understood their responsibilities within the Mental Capacity Act 2005. Staff were supported through effective induction, supervision, appraisal and training to provide effective service to people. People were supported to eat and drink appropriately and to meet their dietary and nutritional requirements. People were supported to arrange appointments to ensure their health needs were met. Relevant professionals were involved to ensure people received appropriate support and care that met their needs.
People were treated with kindness and their dignity respected by staff. People told us staff were caring and considerate towards them. Staff understood people’s needs, preferences and cared for as they wanted. People and their relatives were involved in planning their care and in day-to-day decisions about their care. Care plans were reviewed and updated regularly to reflect people’s changing needs. Staff told us they were updated with changes in people’s care.
People received care tailored to meet their individual needs. Staff encouraged and enabled people to do what they can do for themselves to keep them active and maintain their independence.
People and their relatives were given opportunity to share their views about the service. People knew how to complain. The registered manager investigated and responded to complaints and concerns appropriately.
Regular spot checks and audits took place to assess and monitor the quality of the service provided. Where required, action plan developed to improve on areas of shortfall. The service ensured that lessons were learnt from incidents.