Bridgeside Lodge Care Centre

Bridgeside Lodge Care Centre is a residential care home that provides long-term specialist nursing care for up to 64 adults. The home supports elderly people, some of whom have dementia, and younger people, aged 18-65, who have acquired neurological conditions including spinal injuries. On the day of our inspection there were 61 people living in the home.

People’s experience of using this service and what we found

People who lived at this home received exceptionally high-quality, personalised care and support from an extremely well-led service.

The atmosphere and premises were exceptionally welcoming, positive and exceptionally well maintained. Feedback from people who used the service, their relatives, healthcare professionals and staff was consistently and overwhelmingly positive the home exceeded people's expectations.

People and their relatives praised the staff for their exceptional care and kindness. Staff were engaging and considerate, and treated people with the utmost respect.

Staff were extremely committed to providing care that was compassionate and provided the best outcomes for people. The managers and staff team had a strong approach to providing individualised care, that promoted people's dignity.

There was a positive culture and staff were very proud to work for the provider. Staff were empowered to achieve the best outcomes for people through an extremely supportive teamwork approach to their work.

The management team provided strong leadership and proactively considered how they could continuously. enhance the service. There was clear leadership and visions and values for the service, that ensured people were at the heart of everything they did.

Staffing levels were sufficient to meet people's needs safely, Risks to people had been fully assessed and mitigated to help keep people safe.

Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

The managers of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised

Medicines were administered safely to people and staff following safe infection prevention.control practices. Where incidents occurred, the provider had a system in place to review and learn from these to prevent reoccurrence.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection we rated this service Outstanding. The report was published on 5 December 2017

Why we inspected

This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe, and Well Led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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We found the following examples of good practice.

The home had created opportunities to maintain fun and recreational social events and activities for residents during lockdown. For example, by extending testing and screening to visiting musicians allowing live music performances for residents, such as over Christmas.

Where testing was not feasible remote activities were started and sustained such as an intergenerational collaboration with the Old Vic theatre and a local Primary School, with workshops including “Get writing”, “Get Moving” and “Get Singing”.

The home had learned from a previous wave 1 outbreak of Covid-19 and implemented more rapid and extensive testing that was in addition to minimum standards and requirements. The home's proactive approach led to rapid identification of the likely initial source of infection and swift and effective measures to limit infection spread.

Bridgeside Lodge Care Centre is a residential care home that provides long-term specialist nursing care for up to 64 adults. The home supports elderly people, some of whom have dementia, and younger people, aged 18-65, who have acquired neurological conditions including spinal injuries. On the day of our inspection there were 58 people living in the home.

At the last inspection on 14 May 2015, the service was rated Outstanding in the Caring and Responsive domains. At this inspection we found the service remained Outstanding.

There was a registered manager in place at the time of the 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.

Bridgeside Lodge Care Centre provides outstanding care and support to people who live there. The registered manager, with proactive support from the provider’s management team, had worked towards ensuring exceptional and continuously improving standards of care at the home. Together, they had thought about all aspects of the service provided and since the last inspection they had introduced new progressive ideas and initiatives to create a high quality of life for the people who used the service.

These initiatives included the introduction of innovative work aids, such as, an instant IPad care planning and recording system, adopting the FISH philosophy, a technique promoting fun at work to make staff alert and active in the workplace and embedding “People Like Me”, an initiative in which staff and people who used the service were encouraged to make positive connections based on shared interests. The effect of these innovations was that staff had spent less time on completing their daily care notes and had more time and opportunities for building meaningful and positive relationships with people. Consequently, people told us they were feeling happy and safe at the home as staff always had time for them.

External professionals gave us consistently positive feedback about the support provided at the home, its management team and the staff who worked there. They said they had enjoyed working in partnership with the home as it always provided exceptional care to all people who used the service and the staff went the extra mile to ensure people’s care needs had been met

The care and support provided at the home was holistic and enabled staff to meet even the most complex needs of people who used the service. There was a clear strategic vision from the management team that enabled the home to continuously improve and build significant links with the local community and external health and social care professionals. For example, there was an “end of life” project that aimed at ensuring that people received the right and chosen end of life care. Another example was the ReSpect project, which aimed at formulating individualised and personalised recommendations for a person’s clinical care in a future emergency in which they would be unable to make or express choices. Staff were well trained and they continuously worked towards improving their knowledge and skills to care for people effectively.

Other partnership initiatives promoted by the home supported people in creating and sustaining positive links with the local community. These included a partnership between Bridgeside Lodge and local nursery schools and the celebration of a recent event, the Regents Canal Festival, where other members of the community were invited and participated.

The registered manager was highly regarded by people using the service, their relatives, the staff and external health and social care professionals. They all gave exceptionally positive feedback about the manager. This included the manager’s outstanding and tireless leadership skills which contributed to the excellent care provided by the Bridgeside Lodge. The work and contribution of the registered manager to the development and the continuous high standard of care at Bridgeside Lodge had been appreciated and recognised and she had been shortlisted as a finalist for Care Manager of the Year 2017 by the British National Care Awards.

Person centred care was embedded in day-to-day life at the home. Each person using the service was treated as an individual and staff worked towards bringing everyone using the service together as a part of the home’s family-like community. People and their relatives were actively involved in various aspects of the service provision. There were regular service surveys and well attended family and friends meetings that were used as a platform for new ideas and discussions about on-going service matters. The complaints policy and procedure was rarely used by people and their relatives as, they said, all raised issues were immediately dealt with by staff and the management team.

Staff at Bridgeside Lodge were committed to building meaningful relationships with people who used the service. They were genuine, compassionate, committed to high quality care and went the extra mile to support people. People frequently referred to care staff as “kind and caring” and they consistently commended staff knowledge and competences. Family members we spoke with applauded the ways in which people's quality of life had improved since they moved into the home.

The home provided an outstanding end of life care programme and people experienced dignified and pain-controlled death. Family members told us about the sincere support they received from the staff during final moments of their relatives’ life and how this support helped with their grieving process.

People’s support needs and preferences were assessed and their care was planned before they moved into the home. A tried and tested admission process enabled people to overcome their initial anxieties and settle in their new environment quicker. People’s care was planned in a person centred way and reflected their current needs and personal preferences. People and their family members were involved in the process and they were satisfied with the care and support provided at the Bridgeside Lodge.

The home provided safe care at all times. There was a robust recruitment procedure in place therefore only suitable staff were employed at the home. Any safeguarding concerns were dealt with immediately and according to the home’s policies and procedures. Risks to the health and wellbeing of people who used the service were assessed and there were various systems in place to ensure people lived in a safe environment. Medicines were managed safely according to the home’s policies and procedures. We observed that immediate actions were taken to address any issues related to medicines management and administration. People confirmed that they felt safe and comfortable with staff who supported them.

Staff had excellent knowledge about people’s dietary needs and the safety measures that needed to be put in place to enable people to have an enjoyable and dignified dining experience. Staff worked closely with other professionals to ensure people remained in good health and any changes to their wellbeing were quickly addressed.

People had access to meaningful activities which were provided by the dedicated activities organiser and the staff team. People were encouraged to contribute to the activities programme and various initiatives introduced at the home promoted connectivity between people who use the service, staff and the local community.

Staff told us they felt supported by their team and the management team at the home and evidence showed that they received regular individual and group supervision and a yearly appraisal of their skills.

We tracked the care for eight people who use the service and looked at the care plan records of 12 people who use the service.

We spoke with a relative about the care their mother was receiving. They said they were happy with the care. They told us that staff usually answer the call bells promptly and meals were good. They also told us that their mother had arrived at the home with pressure sores acquired at her family home. We were told that these were "1000 times better". We observed that this person's mother had been provided with a pressure relieving cushion to sit on.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

We found that people were at risk of receiving inappropriate care and treatment as the provider did not complete and maintain accurate and up to date records.

We found that people's rooms had been personalised and that people's preferences of whether they wanted to sleep with the light on or off, door open or closed were supported and reflected in their care plan records.

We accompanied staff during their routine checks. Some people's welfare was checked on hourly and other people were seen more frequently. We found that staff demonstrated a good knowledge of people's individual needs and spoke about them in a very caring way.

We found that the provider submitted notifications of allegations of abuse and informed us of what steps they had taken in each instance. We also found that the provider routinely informed the Local Authority of any safeguarding concerns.

We found that there were enough staff to meet people's needs.

We used statistical information and analysis to inform our inspection and we followed-up with the service and others where we identified issues.

We saw that many of the people were engaged with reading books and newspapers or watching television while some others were taking part in an entertainment activity. We saw that some people were sitting on the wheelchairs while having their meals. We discussed this with the people and the manager. Some of these people told us that they wanted to use their wheelchairs but we did not get a response from the others. The manager told us risk assessment had been completed for all the people but this was not always the case in the files we checked.

All the people we spoke with felt that they were safe in the home. People using the service and their relatives told us that staff were polite and friendly.