Bridge House Residential Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People’s needs were assessed and included consideration of their physical, mental health, and social needs. We were told information gathered would then be used to inform the development of care plans. A review of people’s records identified on-going reassessment was not always completed ensuring information was current.

We received a mixed response from people and their relatives about their involvement in the development and on-going review of their plan. People told us, “Yes, if it is necessary, they ask”, “Yes, they talk to me about my care” and “Not here, only asked me in hospital.” People’s relatives said they had not been consulted with. One relative told us, “I haven’t had a sit-down consultation, but they phone me if [person] has to go into hospital. They could do with a monthly review, on their condition and progress.”

The manager spoke about the initial assessment process they would complete prior to people moving into the home, which would involve people and their families ensuring their needs and wishes were reflected.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff worked well across teams and services to support people. Assessments of people’s needs were shared when people moved between different services.

Due to changing health and care needs, plans were being made to support several people to move to alternative accommodation. Following a voluntary suspension, the service was now taking new admissions to the home. The manager was mindful a thorough assessment and handover was required to ensure a smooth transition on admission to or discharge from the home.

Staff said the handover records were helping to improve communication across the team and co-ordinate support needs and appointments planned each day.

Staff worked with a range of health care professionals to help met people’s current and changing needs. A GP visited on a weekly basis and where necessary, referrals were made to other health care agencies, such as community nurses and speech and language therapists, so additional advice and support could be sought. The manager had also arranged for the occupational therapist to reassess those people who require the use of moving and handling equipment and was looking to register people with a local dentist so their oral care could be addressed.

People were supported to manage their health and wellbeing and live healthier lives.

As already identified, accurate and complete records were not maintained in relation to people’s current and changing needs. This information helps to quickly identify where additional support maybe required. Staff told us they were kept informed of any changes through the shift handover. These were recorded and provided an overview of people’s needs and issues staff needed to be aware of.

Opportunities for physical activity were being improved with the recent appointment of an activity worker. One person told us, “Since [activity worker] came we have bingo and quizzes, and we play with bats and balloons.” Other people said there were activities ‘now and again’ and there were occasional singers and birthday parties. People said they rarely left the home. Further opportunities needed exploring taking into consideration people’s hobbies and interests.

People were encouraged and supported to have a healthy diet. People said the meals were good. All but one person said there was a variety of meals, and they were always had a choice. Comments included; “We get plenty to eat, three meals a day. The lunch varies every day, and it is always very nice and plenty of it. There are snacks and drinks on offer morning and afternoon” and “Yes, it’s quite nice, I like an English breakfast now and then. We get plenty to eat, we get snacks morning and afternoon and some biscuits and a cup of tea for supper. If you don’t like the meal for that day, you can ask for something else.”

People and their relatives said staff supported them in meeting people’s health care needs. People confirmed they were registered with a GP, who visited the home each week. People also spoke about other health care professionals seen. Comments included, “I have a chiropodist, the optician comes here, and I see the hairdresser” and “I see a chiropodist and an optician came, and I got some new glasses.”

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Peoples’ rights and decisions around consent were understood and respected by staff and the service.

The manager had reviewed arrangements where people were being deprived of their liberty. Appropriate applications had now been submitted to the supervisory body to ensure lawful authorisations were in place. We saw people were supported by independent advocates or solicitors ensuring their rights were protected.

People’s care records included mental capacity assessment relating to people’s ability to give informed consent about specific decisions, such as day to day care and the administration of medication. Where people were not able to express their wishes and feelings, staff would consult with relatives and other agencies, so decisions were made in their best interests.

Staff told us a recent face to face training course covering the Mental Capacity Act and Deprivation of Liberty safeguards had been held. One staff member confirmed they had attended and said, “The training was good.”