Bridge House Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to care and treatment records, staff recruitment, training and development and environmental standards.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. However, the provider had not always shared information quickly and appropriately.

The provider was working with the local authority safeguarding and quality team to address issues raised with them.

We reviewed information in relation to those people deprived of their liberty (DoLS). A review of the DoLS tracker showed 20 people were either subject to a DoLS or an application had been made to the supervisory body. Of the 13 authorisations in place, only 3 had been notified to CQC. This information is required by law. The new manager advised this would be followed up and all necessary information provided.

People and their relatives told us they were safe living at Bridge House. We were told, “Yes I do feel safe, there is always someone there to help me”, “Yes, very safe, I sleep better, as I don’t like being on my own” and “I would say so, [relative] hasn’t said she isn’t safe and hasn’t expressed any worries.” People said they had formed friendships with other residents and saw this as a key part of making it home from home.

Management policies and procedures were in place to help protect people and uphold their rights. The majority of staff had completed training in safeguarding, Mental Capacity Act and the deprivation of liberty safeguards (DoLS).

The provider did not always work well with people to understand and manage risks. Records did not always reflect care was provided so people’s needs were met, and they were kept safe.

We reviewed the records for several people who were at risk of developing pressure sores due to the frailty of their skin, reduced mobility and poor nutrition and hydration. We found records were not always complete and additional monitoring had not been carried out as outlined within the care plan.

We looked at 5 care plans in relation to pressure care. The waterlow pressure care tool for 1 person was incomplete and 2 records had not been kept under review. Repositioning charts, to show people received regular pressure relief, were not consistently completed or at regular intervals as detailed within the assessment.

Records for those people at nutritional risk were also incomplete. We found the Malnutrition Universal Screening Tools (MUST) were not kept under review. Consistent recording of people’s food and fluid intake and regular monitoring of weight was not undertaken as outlined within the care plans. It was unclear from the care plans what action had been taken to support those people who had lost weight. We noted one person was at risk of choking. A risk assessment had been completed, however there was no further information to guide staff on how to manage a choking incident.

Care plans were in place for those people with poor mobility. However, on one file the falls risk assessment had not been kept under review. We also observed one person being assisted without the use of a walking aid, which they had been assessed for. Without accurate and complete records there was a potential risk people’s current and changing needs may not be identified and acted upon.

Environmental risks were monitored with checks to the premises and equipment. An up-to-date fire risk assessment had been carried out, action required to improve fire safety had been addressed. This is also referred to further in this report under the safe environment section.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Bridge House provides spacious accommodation. Aids and adaptations had been provided to meet people’s physical care needs. Whilst looking around the internal and external areas of the home we found rooms need redecorating, curtains in bedrooms needed rehanging, bed sheets and carpets were stained, and bulbs were missing from wall lights. Externally windows needed repainting, guttering was blocked, and the gardens were overgrown. There was also a lack of outdoor furniture and seating for people to use. The manager provided a copy of the home’s improvement plan, which incorporated findings from the local authority quality review, including a programme of redecoration to address environmental concerns. During our visits we saw work men were at the home carrying out some decoration. On our second visit we also saw the lawn in the enclosed garden had been cut and furniture provided.

Servicing records were in place for mains supplies and equipment. However, we found the 5-year electrical report, dated September 2023, identified ‘a list of deviations that required action before a satisfactory certificate could be supplied'.This was requested but not provided.

An up-to-date fire risk assessment and compartmentation survey had been completed in January 2025. A further assessment was carried out by the fire service in March 2025. Work required to ensure compliance with fire safety had been addressed. Considering the turnover in staff further fire drills were required to ensure all staff, throughout the day and night, were aware of the evacuation procedure to follow in the event of an emergency.

People’s relatives told us, “It seems to be clean and tidy; but [relative] hasn’t got a light in her bathroom. [Relative] also needs a litter bin to put the towels in when she washes her hands” and “They are doing it up and painting, as it was very tired looking.”

Consideration should also be given to providing a dementia-friendly environment with appropriate signage, to help people orientate themselves as well as promote their independence.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development.

Not all pre-employment checks were in place prior to new staff commencing their employment ensuring their suitability for work. However, records did include relevant information to show international staff were eligible to work in the UK.

People and their relatives felt staff had the skills to carry out their roles. One person told us, “Yes, I think they know what they are doing, I can call on them when I need them.” We reviewed the programme of training and development provided for staff. A range of online courses were provided. We found 8 staff had completed between 7 and 15 courses in one day. This did not demonstrate effective learning opportunities were provided. A further record listing ‘good practice’ training covering specific areas of health care. There was no evidence these topics had been completed by staff. We were told plans were in place to deliver face to face training.

Staff records provided little evidence of meaningful induction and supervision, as outlined within the homes policy and procedure. A new staff member said they had completed an induction, adding, “I had 3 days shadowing. No face-to-face training. 20 online modules in 3 days.” Staff spoken with told us they had not had supervision for some time, but this was being reintroduced by the new manager. We were told, “Not that regular before but we’ve had it now” and “I have had it once, it was supportive.”

We received a mixed response from people, their relatives and staff about the staffing levels provided. Staff told us, “Mornings are still an issue, people are waiting to get up. This is why the buzzer was going off in the mornings” and “Not safe at night. Level of need in terms of mobility is high, fire risk, how would we evacuate.” We were told staffing levels were kept under review. A dependency tool was utilised to determine the number of staff required to support people’s physical needs. However, this did not explore their social and emotional needs.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

Following a recent visit by the local authority concerns, were found in relation to infection control, particularly around the laundry. Areas requiring improvement had been added to the home’s improvement plan.

During our visit we reviewed the issues identified within the laundry. One of the laundry machines remained out of use. We were told repairs were scheduled. The laundry was found to be tidy, and clothing organised and ready to be returned to people’s rooms. Staff told us improvements were being made, and that further staff were to be recruited so sufficient cover was provided throughout the week. A review of rotas showed designated domestic staff were available throughout the week. The home was generally tidy. Redecoration and the removal of carpeting will help to improve standards within the home.

People and their relatives said the home was regularly cleaned. Comments included, “My room is on the first floor, they tidy my room every day. I have no complaints about the home”, “It is kept clean and tidy; they clean my room every day. The home is well looked after” and “They are always cleaning, the chairs and things like that.”

Policies and procedures were in place to guide staff and training in infection prevention and control had been undertaken by the majority of staff. Personal protective equipment, such as gloves and aprons were worn by staff when completing care tasks.

The home had been inspected in September 2024 and had received a food hygiene rating of 5, very good.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People and their relatives told us staff made sure they had their medicines as prescribed. We were told, “Yes, the staff look after it, the medication is mostly taken with my breakfast, I take them with a drink. They always remember to give me my medication”, “I take tablets the staff bring them to me, at the same time each day” and “[Relative] takes medication, statins and for blood pressure. They always give it to her at the same time.”

Medicines were mainly managed safely. People had enough stock of their medicines to make sure that they did not miss any doses. There was an effective stock control system which showed that medicines were given to people as prescribed and all medicines could be accounted for. When there were changes to peoples’ medicines or doses of their medicine the changes were made accurately and in a timely manner.

Arrangements were made to ensure they were supplied as liquids or crushable tablets if people had difficulty swallowing or if they needed to be given covertly by hiding them in food or drinks. When medicines were prescribed to be given ‘when required’ or a choice of dose they were not always managed safely, and this was an area of medicines management that needed some improvement.

Medicines were mainly stored safely however the maximum fridge temperature was not always recorded and when it was there were two occasions where the temperature was too high for the safe storage of insulin.

Creams were stored safely and there was information recorded to ensure that staff applying creams knew where to apply them although the records about the application of creams were not always completed clearly.