Bridge House

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

People were safe and were protected by staff who understood their responsibilities and how to keep them safe. People were protected from risks by very detailed, regularly updated risk assessments. The provider encouraged staff to be innovative and empowered them to access additional training and professional development. Safe recruitment practices were followed. There were enough staff available to meet people's needs. Staff received training to enable them to carry out their roles effectively. However, we found some gaps in mandatory training and some areas of the homes needed updating and maintenance. We discussed this with the provider, who took immediate action to address these concerns.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they had no complaints about the service. People and relatives were confident any concerns and complaints would be recognised and investigated.People were given feedback from complaints and told the outcome of safeguarding investigations.

Staff were aware of how to respond to accidents and incidents which included how to record and report incidents.

The provider had policies in place which were readily accessible to staff. Accidents and incidents were monitored monthly by the registered manager to ensure any triggers or trends were identified. Where necessary, appropriate referrals were made to healthcare professionals.

We saw examples of care and support being planned and organised with people, together with partners and communities, in ways that ensured continuity. The provider was responsive to meeting their needs to ensure continuity of care was facilitated, and people were involved in discussions about their care.

The provider had processes in place to ensure safe systems, pathways and transitions were maintained. This included an initial needs assessment at the start of a service being provided.

The provider had successfully worked with partners, and they had been involved in discussions with them about people's care needs. We did not receive any formal feedback from any of the partners we contacted about Bridge House.

The provider had processes in place to ensure safe system, pathways and transitions were maintained. This included an initial needs assessment at the start of a service being provided.

People who used the service continued to feel safe with the support they were receiving. We asked people if they felt safe, and they told us they definitely felt safe. Comments included, “Oh yes, I feel safe here” and “It’s like a family; you have ups and downs, but then you would have them in a family setting.”

People were protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated, or neglected. Staff spoke confidently about how they would protect people by raising concerns immediately with the management team. Staff said they were confident the registered manager and provider would take prompt action to safeguard people. Staff had a good understanding of whistleblowing and felt they would be protected from being identified should they raise any concerns.

During the site visit, we saw kind and respectful interactions between people and staff. Staff were seen to offer people choices and seek consent before supporting them. The atmosphere in the home felt warm and open, and this was reflected in comments from people and relatives.

There were effective systems, processes, and practices to make sure people were protected from abuse and neglect. These were followed, and the provider worked closely with the local safeguarding authority and other professionals to help investigate concerns and to protect people from abuse. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The service was aware of the need to submit applications for people to assess and authorise that any restrictions in place were in the best interests of the person. The registered provider met the requirements of the legislation. The registered manager and staff were aware of their responsibilities in respect to consent and involving people as much as possible in day-to-day decisions. Staff were also aware that where people lacked the capacity to make a specific decision, then best interests would be considered.

People told us they were happy with the care and support staff provided and their needs were met. People were involved in the assessment of their needs and the management of their risks where able. People believed staff would respond to their needs quickly and efficiently, especially if they were in pain, discomfort, or distress.

Staff promoted people's safety and independence. People’s care plans were regularly reviewed and in response to any change in needs.

During our visit, we saw how staff supported people to do the things they wanted to do safely. 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.

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's risks were assessed at regular intervals or as their needs changed.Risk assessments were detailed, and person centred. Information for staff to help avoid or reduce the risk of harm was recorded and reviewed. Staff were kept up to date with changes in people's care during handovers and team meetings.

People told us they liked their home and were free to decorate their room how they wanted. While the people we spoke to expressed they were happy with the environment, our assessment found elements of care did not meet the expected standards.

Staff told us the houses were clean and homely but in need of updating. One staff member commented, “We know the houses need updating, but anything that is a health and safety risk, the provider gets sorted straight away."

Parts of the service needed some repair and re-decoration; some kitchen units, tiles, flooring, and bathroom fittings needed replacing and updating, which could pose a risk to people as cleaning of these areas would be more difficult. The registered manager agreed areas of the services needed updating and repair and told us they would take immediate action to address these concerns.

Environmental risks had not been fully mitigated. The provider had not completed some key health and safety checks, including checks connected to legionella and asbestos. The environmental checks had not identified that the areas in need of repair could pose a risk to people as cleaning of these areas would be more difficult. We spoke to the management team, and they said they would take immediate action to ensure these issues would be addressed.

People we spoke with told us there was enough staff on duty. One person commented, ”The staff are lovely; it’s like one big happy family.” People we spoke with were aware of who to contact if they required support. One person said, "I would phone the staff if needed." While people said they were happy with the staffing, our assessment found elements of care did not meet the expected standards.

Staff felt well supported in their roles and received relevant training. Staff told us there were safe staffing levels at the service. The staff told us they had the training, information, and support they needed. They were able to tell us about the different training courses they had completed and how training had supported them in their work. Staff explained they took part in regular individual and team meetings with their line manager to discuss their work and the service. One staff member said, “They offer a lot of training, plenty of supervision. I have learnt so much working here.” While staff said they were happy with the support and training, our assessment found elements of care did not meet the expected standards.

There were enough staff available to respond to people in a timely way. We observed people did not have to wait long for support from staff when they needed this. Communication was not rushed, and staff had enough time to support people’s needs. Staff knew people well and supported them in a kind and caring way. People appeared to have a good relationship with staff and were relaxed in their presence. Staff were vigilant when people were moving around or undertaking activities and made sure people remained safe.

There were safe recruitment processes in place. Effective systems were in place to ensure safe staffing levels were maintained. Staff received the support they needed to deliver safe care. This included supervision, appraisal, and support to develop. Records showed staff received training relevant to their role. However, there were some gaps in mandatory training. We discussed this with the provider, who took immediate action to address this concern.

People did not share any concerns about infection control. People told us they were involved in cleaning and household chores. While the people we spoke to said they were happy with the environment, our assessment found elements of care did not meet the expected standards.

Staff said they had received appropriate training in infection prevention and control and were aware of safe hygiene practices. While the staff we spoke to had no concerns about the infection and prevention control systems we found elements of care did not meet the expected standard.

We observed some areas of the service needed repair or replacement and therefore, could not be effectively cleaned. Staff completed regular cleaning with appropriate products. However, their efforts were compromised by the poor state of repair of the home which meant some touch points were difficult to clean effectively.

Infection control systems were in place. However, some areas of the service needed repair or replacement and therefore, could not be effectively cleaned. This was discussed with the registered provider who said there was a service improvement plan in place, and they would take action to ensure the service was well maintained.

People told us they thought medicines were managed well.

The staff were able to explain about how they managed people's medicines safely. Staff told us they received training and competency assessments to ensure they were safely administering medicines. We reviewed staff audit checks of the medicines held at the service. These checks were thorough. The staff told us they had received training to understand how to safely manage medicines.

The management team carried out various checks to ensure medicines were being safely administered, for example, regular medicines audits were taking place to monitor and address any administration errors. There were some gaps in staff training and competency to administer medicines. However, the provider had a scheduled plan of training in place.