Archived: Bridge House

This comprehensive inspection took place on 15 and 21 February 2018 and was unannounced on the first day.

At the last inspection in November 2015, the service was rated Good. At this inspection we found the service remained Good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Bridge House’ on our website at www.cqc.org.uk’

The service had a registered manager in post at the time of our inspection. 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.

People continued to feel safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly.

Staffing was not provided continually over a 24 hour period; staff were in the service for six hours each day. The commissioners were aware of the staffing arrangement, which they confirmed met the needs of the people who used the service. Robust recruitment processes continued to be in place.

People continued to receive their medicines in a safe manner and received good healthcare support. People received a nutritious and balanced diet and their dietary needs and choices were met.

Infection control systems were in place. However, we found not all the houses were well maintained or kept clean.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Risks continued to be assessed and recorded by staff to protect people. There were systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

People told us they had good relationships with the staff. They said they were caring and kind. Staff respected people’s privacy and dignity and promoted their independence.

The service had an open culture which encouraged communication and learning. People who used the service, health care professionals and staff were encouraged to provide feedback about the service and it was used to drive improvement.

There were policies in place that ensured people would be listened to and treated fairly if they complained about the service.

We saw that the registered manager who was also the registered provider continued to monitor and audit the quality and safety of the service and that people who used the service were involved in the development of the home and were able to contribute ideas.

Further information is in the detailed findings below

At the time of this inspection seven people were living at Bridge House. We spoke with five people living at the home to obtain their views of the support provided. In addition, we spoke with two assistant managers and two support staff about their roles and responsibilities.

We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found.

Is the service safe?

All of the people spoken with said they felt safe living at Bridge House.

People said, 'I feel safe here', 'we are all OK, I like it here, I'm safe' and 'they [staff] look after us, they are good.'

People told us their privacy and dignity was respected. They said,' staff are nice, they are polite' and 'staff always ask me what I want and are respectful.'

People told us there were enough staff available to support them.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, relevant policies and procedures were in place. Appropriate staff had been trained to understand when an application should be made, and how to submit one.

We found that risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

Is the service effective?

People's health and care needs were assessed with them and their, and they were involved in writing their support plans.

People had monthly support review meetings with staff. People told us 'I have a care plan, I sit with staff and we look through it every few weeks.'

Staff were provided with training to ensure they had the skills to meet people's needs.

People told us they were happy with the care and support staff provided and their needs were met. It was clear from our observations that staff had a good understanding of people's care and support needs and they knew how to meet them and avoid unnecessary risks.

Other professionals and individuals were involved in regular meetings and reviews with each individual to ensure their care and support was still appropriate.

Is the service caring?

During our inspection we saw people were very comfortable in the presence of staff. We observed staff giving support to people throughout the inspection and they were respectful and treated people in a friendly and supportive way.

We spoke with five people and they all confirmed that they were happy with the care and support provided. They said, 'staff are nice', 'I like it here', 'I like to stay here, I get all the help I need', 'I can talk to staff about any worries, they are very good' and 'the staff are first class here.'

People's preferences and interests had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service on a daily basis. People were assisted to access the community, appointments at local health services and took part in day trips and holidays further afield.

People knew how to make a complaint if they were unhappy and said they would tell the manager. They commented, "I would speak to the staff, I'm fine though, I'm happy.'

Is the service well-led?

The service worked with other agencies and services to make sure people received their care in a joined up way.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. People who used the service were asked for their views about their care and support and these were acted on. We saw evidence that the provider carried out annual satisfaction surveys. Feedback was analysed and the provider, took appropriate action. We saw that the results of the surveys were very positive.

People said they had regular 'house meetings' were any issues or concerns and plans for the running of the home were discussed and acted upon.

Staff told us they were clear about their roles and responsibilities. Discussions on best practice, improved ways of working and incidents reviews were common throughout one to one supervisions with a manager, formal team meetings and informal discussions.

We found that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's needs were identified in care plans. Records showed that people had been involved in the care planning process. People told us that they had regular access to healthcare professionals.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The provider had an effective complaints system available. All of the people we spoke with said they had no complaints or concerns about the home.