Bridge House

Updated 18 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 22 and 23 November 2018 and was unannounced. The inspection team consisted of two inspectors and two experts by experience. An expert by experience is a person who has personal experience of caring for older people and people living with dementia.

Before the inspection we reviewed information available to us about this service. The registered provider had completed a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts; share your experience forms and notifications that had been sent to us. A notification is information about important events which the provider is required to send us by law.

We used the Short Observational Framework for inspection (SOFI). The SOFI is a way of observing care to help us understand the experience of people who were not able to talk to us.

We spoke with 14 people and seven relatives of people. We spoke with the registered manager, a deputy manager, one domestic staff member, two lifestyle co-ordinators, two registered nurses, one bistro staff member, five carers and one volunteer. Additionally, following our inspection we obtained feedback from other health care professionals.

We reviewed care records for seven people, looked at six staff files and reviewed records relating to the management of medicines, complaints, training and how the registered persons monitored the quality of the service.

Updated 18 January 2019

We inspected this service on 22 and 23 November 2018. This was an unannounced inspection. Bridge House nursing home is registered to provide accommodation for up to 71 older people and prepared to accommodate individuals living with dementia and require personal or nursing care. At the time of the inspection there were 70 people living at the service.

Bridge House is a 'care home.' People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The CQC regulates both the premises and the care provided, both of which we looked at during this inspection.

At the last inspection on 18 April 2016, the service was rated good. At this inspection, we found the service had improved to outstanding.

There was a registered manager in post. 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 service was exceptionally well-led. All staff showed a passion and commitment to providing the best support to enable people to have full lives. The management team and staff shared common values about the aims and objectives of the service. These were based on people being supported to live full and enjoyable lives and engaging with the community they lived in to reduce social isolation. Regular quality audits and checks were completed so improvements were continually recognised and there was effective follow up action which made sure people received a high-quality service.

People at Bridge house received exceptional person-centred care and support. The management and staff team understood what was important to people living at the home and acted upon this to improve people’s quality of life. Management and staff worked closely and with people and their families to ensure each person lived as good a life as possible. People played an active part in the running and development of the home. A motivated management and staff team came up with new ideas to enhance people's quality of life and provide benefit to people.

People were supported to retain an active presence in the local community and to maintain their personal interests and hobbies. An activities team alongside care staff all worked together to organise an imaginative and rich programme, providing every opportunity for people to take part in activities that were meaningful. People had opportunities to maintain and develop relationships with visitors to widen their social networks. There was a sense this was people's home which people were proud of. People were supported to actively use their skills and interests in the decoration of the different spaces within their home environment.

Food and drink were provided to a high standard and people could choose what to eat and drink, as well as decide on times of their meals. People who lived at the home and their relatives could voice their views and opinions. The registered manager listened to what people had to say and took action to resolve any issues. The management team reviewed incidents and concerns to look for opportunities to improve policies and practices for the future. There were systems in place for handling and resolving complaints which focused upon opportunities for learning lessons.

People who lived at the home and all staff were actively encouraged to contribute to the evaluation of the care and support provided and make recommendations for improvement. The management team and staff worked together as a team with a passion to learn about and aim for best practice, with people very much at the heart of the services they received in their home.

People were supported to make safe choices in relation to taking risks in their day to day lives, which helped people to maintain their own levels of independence. This was because staff made sure people had the equipment and aids they required to meet their needs. Staff had been suitably trained and understood how to support people in a way which protected them from harm and abuse. People benefited from positive risk taking which improved their morale and quality of life.

Staff received regular training which provided them with the knowledge and skills to meet people's needs in an effective, responsive and personalised way. The management team supported staff to gain additional knowledge to promote a greater awareness and understanding of the diverse needs of people whom they provided with care and support. Staff had used their knowledge in practice on many occasions to support people in gaining additional equipment, aids and specialist advice which had a significant impact on enhancing people's well-being.

The service worked in partnership with other health care organisations, local school and a local hospice. The registered manager provided free of charge training for other health care providers and pioneered a toddler group that was interacting with people living in the home.