We carried out a review of the data available to us about The Bridge Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Bridge Care Centre, you can give feedback on this service.
The Bridge Care Centre is a care home providing personal and nursing care for up to 40 adults. People accessing the service are living with a neurological disorder and or a physical disability. At the time of inspection 24 were staying at the service.
The Bridge Care Centre is a large, purpose built home providing accommodation over four separate units, each supporting up to ten people and all having their own adapted facilities.
People’s experience of using this service and what we found
People and their relatives were happy with the care and support they received from the service. One person said, “I am definitely safe and well cared for here.” One relative said, “[Person] feels safe. This is the most responsive team [Person] has had, they [Staff] are empathetic, very intuitive at recognising and trying to understand [Person’s] needs.”
Staff supported people to be as independent as possible whilst ensuring they remained safe and well. There was a proactive approach to assessing and managing risk which allowed people to rebuild their life whilst living with neurological disorders and physical disabilities. One health professional said, “Staff interact genuinely with people, they are very motivated to provide the best possible care and achieve people’s outcomes.”
Medicines systems were organised, and people were receiving their medicines when they should. The service was following national guidance for the receipt, storage, administration, prompting and disposal of medicines.
Staff were skilled and knowledgeable in the care and support people required. They provided flexible care and support in line with a person's needs and wishes. Staff worked alongside a range of health professionals to provide people with a better quality of life, supporting them to develop in areas such as communication, social interaction and independence.
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.
The management structure in the service ensured people and staff had access to, and support from, a competent management team and specialist therapists. The provider monitored quality, sought people's views and planned ongoing improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 5 September 2019).
Why we inspected
We received concerns in relation to the management of people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Bridge on our website at www.cqc.org.uk .
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Bridge Care Centre is a residential nursing home providing personal and nursing care to people affected by neurological disorders and physical disabilities. It is a detached, 40 bedroom purpose-built care home with accommodation in four separate units, each with ten bedrooms. Eight people were using the service when we inspected.
People’s experience of using this service and what we found
People said they were happy living at the home and that staff provided kind and caring support. Relatives also spoke positively about staff. People were supported to maintain their independence and were treated with dignity and respect.
Medicines were managed safely. Risks to people were assessed and addressed. The provider ensured the service had safe staffing levels and had robust recruitment processes.
Staff were supported with received appropriate training, supervision and appraisals. 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. People received effective support with eating and drinking.
People received personalised support based on their assessed needs and preferences. Staff supported people to access activities they enjoyed. The provider had an effective complaints process.
People, relatives and staff spoke positively about the leadership provided by the registered manager. A range of quality assurance audits were carried out to monitor and improve standards. The service worked effectively in partnership with external professionals and agencies.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 25 September 2018) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Bridge Care Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service provides care for people affected by neurological disorders. The home is a detached 40 bedroom purpose built care home in Middlehaven, Middlesbrough. Accommodation is within four separate units each with ten ensuite bedrooms. At the time of our inspection three people were living at the service.
When we inspected the service the manager was going through the process of becoming a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered person’s'. 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.
This was our first inspection of the service since it registered with the Care Quality Commission (CQC) in August 2017.
We identified a range of discrepancies in medicine records. We found risk assessments were not always available to give guidance to staff as to how to help keep people safe.
We found that the service did not have clear governance systems in place. The issues we found during this inspection with record keeping, risk assessments and medication had not always been identified and addressed.
We found that some staff did not always have the required up to date training they needed to meet the needs of the people supported by the service. Nurses did not always have the regular training they needed or their competency checked.
We saw that where some people were unable to make some decisions for themselves some decisions made in their best interest were not recorded. We noted that one person’s family member had signed their care plan without having the legal authority to do so.
Policies and procedures were in place to protect people from harm such as safeguarding and whistleblowing polices. Staff knew how to identify and report suspected abuse.
Safe recruitment practices were in place. Pre-employment checks were made to reduce the likelihood of employing staff who were unsuitable to work with vulnerable people.
Staff told us that they were supported through supervision. Most staff said felt they could approach the management team if they had any issues.
The premises were spacious and tidy however the furniture available to people did not help enable them to become more independent.
Learning took place following reviews of accidents and incidents where themes and trends were addressed.
People had access to a range of healthcare such as GPs, hospital departments and dentists.
We observed that staff members were kind and caring towards people in their interactions with them however we also saw that people were left in front of a television with minimal staff intervention from staff for long periods of time. We received mixed feedback on care staff from relatives.
Staff told us that activities were very limited due to the complex needs of people supported. We have made a recommendation about activity provision within the service.
People’s privacy, dignity and independence were respected. The policies and practices of the home helped to ensure that everyone was treated equally. End of life care procedures were in place.
Meetings for staff took place. The manager told us that the people supported were unable to engage with team meetings. People supported were unable to express their views about the service provision and management.
Relatives told us they had had difficulty in developing a positive relationship with the manager of the service.
We were informed that feedback was sought to monitor and improve the service however the manager told us this was carried out by the provider and that they did not yet know the outcomes of any surveys carried out with families and people who had used the service.
Most staff were positive about the management team and confirmed they were able to raise concerns. A clear complaints policy and procedure process was in place.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which related to safe care and treatment; staffing; and having good governance systems in place.
You can see what action we told the registered provider to take at the back of the full version of the report. You can read the report, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk