We carried out a review of the data available to us about Bridge House Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bridge House Residential Home, you can give feedback on this service.
Bridge House is a residential care home providing personal and support for up to 30 people, some of whom live with dementia. Accommodation is provided over two floors, accessed via a passenger lift. All bedrooms are single with en-suite facilities. At the time of the inspection there were 30 people living at the home.
People’s experience of using this service and what we found
People and their visitors spoke positively about the care and support provided. People told us they were actively encouraged to follow activities of their own choosing. Activity staff provided a range of opportunities for people. Staff were said to be kind and respectful, this was supported by our observations.
Management systems were in place to monitor and review the standard of care and support provided. The views of people had been sought and acted upon. Any complaints and concerns were recorded and responded to, where necessary information was shared with relevant parties. No issues were raised us with by external agencies we contacted.
Sufficient numbers of staff were available throughout the day and night. Recruitment checks had been carried out when appointing new staff. Staff spoken with felt the team worked well together and were supported by the registered manager. A range of training and development opportunities were in place to support the team.
Care plans and risk assessments were available to guide staff on the care and support people wanted and needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s prescribed medication was managed safely. The service benefitted from good support in meeting the health care and medication needs of people from the local GP and supplying pharmacist.
We found the home to be clean and tidy. Internal and external safety checks were completed to the equipment and premises to help keep people safe. Redecoration was planned to enhance areas of the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 5 December 2019).
Why we inspected
We received concerns in relation to the management of the service and the recruitment of staff. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained unchanged. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bridge House Residential Home on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
The home had developed a designated unit to support up to seven people. Admissions were to be made for people who were medically fit for discharge from hospital and required a period of isolation as well as those requiring end of life care, who are Covid-19 positive.
The unit is situated on the first floor and is accessible via a key coded door. A clear pathway had been identified allowing easy access when admitting people to the unit, whilst minimising risks to those living in the home. All bedrooms are single with an en-suite shower room. Aids and adaptations were in place to assist people, where needed.
To minimise the risk of cross infection, a designated team of staff had been identified to support the unit. Staff had access to all necessary personal protective equipment (PPE) and had completed relevant training in infection control procedures and the donning and doffing of PPE. Suitable arrangements had been made for the disposal of waste and the laundering of dirty clothing and bedding.
In partnership with the hospital discharge team, admission arrangements had been agreed so people were transferred safely between services.
Arrangements for visitors were kept under constant review in line with current guidance. Appropriate arrangements would be made for those visiting people at the end of their life. Alternative arrangements were available for people to maintain contact with family and friends.
The service continued to have support from the community nursing team as well as GP services.
We were assured that this service met good infection prevention and control guidelines as a designated care setting.
Further information is in the detailed findings below.
We found the following examples of good practice
Staff confidently demonstrated the use of PPE and hand sanitising stations were readily accessible before entering and in the home.
The home was well ventilated and clean; regular cleaning procedures were in place to minimise the risk of infection.
The service engaged with a regular testing programme and staff were positive in their approach to supporting people with this process.
Areas for improvement
Whilst we were assured about the providers whole-service approach to IPC, we recommend the provider explores better technological solutions to ensure people living in the home can stay in regular contact with their relatives and friends.
Bridge House is a residential care home providing personal and support for up to 30 people, some of whom live with dementia. Accommodation is provided over two floors, accessed via a passenger lift. All bedrooms are single with en-suite facilities. At the time of the inspection there were 29 people living at the home.
People’s experience of using this service and what we found
Prior to this inspection we had received a number of concerns about the management and care of people living at Bridge House. It was acknowledged a series of changes in ownership of the service had impacted on standards within the home. However, during this inspection people and staff told us and our findings showed the new owner had been proactive in identifying and taking action to make any improvements needed, as detailed throughout this report. No further concerns were raised with us.
People, their visitors and staff spoke positively about the management of the service. We were told managers were approachable and supportive. People also spoke about the kindness of staff and how they were cared for in a way they wanted and needed.
Auditing systems were in place providing oversight of the service. The management team were clear about how they wanted to develop the service further to enhance the experiences of people. Plans were in place to address this.
Staff had been safely recruited to work at Bridge House. There was a programme of induction, training and supervision to support staff personnel development. This was confirmed by staff we spoke to. Whilst there had been some turnover in staff, people, we were told this was now more settled. We found sufficient numbers of staff were available to support people in a timely manner.
We saw and people told us activities were provided. Further opportunities were being planned for to provide further variety to people’s day. People’s enjoyed regular visits from family and friends, who said they were made very welcome.
A programme of improvements were being made to enhance the standard of accommodation as well as create a more ‘dementia friendly’ environment. We have made a recommendation about the implementation of the Accessible Information Standard (AIS).
Aids and adaptations were provided to aid people’s mobility and promote their safety. Relevant maintenance and safety checks were undertaken to ensure the premises and equipment were kept safe. Hygiene standards were maintained to help minimise the risk of cross infection.
People’s nutrition and hydration needs were met. A choice of meals and refreshments were offered throughout the day. Kitchen staff had a good understanding of the people’s dietary needs. The kitchen was clean, organised and all equipment was in good working order.
People received their prescribed medicines in a safe way. People and their visitors told us they had access to a range of health care professionals to help maintain their health and well-being.
Relevant authorisations were in place where people were being deprived of their liberty. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Care records reflected the individual needs, wishes and preferences of people. Staff spoken with had a good understanding of people’s and how they wished to be supported. Staff were described as respectful and provided care in a kind and caring manner.
Staff aware of the procedure to follow with regards to safeguarding people from harm and had confidence the management team would respond quickly to any issues brought to their attention. Systems were in place for recording and responding to complaints.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published January 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
The inspection was prompted in part due to concerns received by CQC and the local authority about the care and safety of people living at the home and the management of the service. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective, responsive and well-led sections of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.