26 June 2018
During a routine inspection
Bridge House 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 personal care to a maximum of seven people who have a learning disability. At the time of the inspection there were six people who used the service.
At the last comprehensive inspection in November 2015 we found the service was meeting requirements and was awarded a rating of Good. At this inspection we found the service had deteriorated and we rated the service as Requires Improvement.
The service had a newly 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 persons.’ Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The inspection highlighted that at times there were insufficient staff deployed to meet the needs of people who used the service and to ensure they all engaged in meaningful activity.
On the first day of our inspection we found cleanliness to be poor, particularly in bathrooms and shower rooms. We also found the stairway to be dusty, dirty and in need of cleaning.
We found parts of the home were not safe. We found loose blind cords and a bedroom window restrictor which was easily overridable. We informed the registered manager about the poor cleanliness and safety concerns who told us they would take immediate action to rectify these. When we returned for our second day of the inspection we found that action had been taken to address the issues around cleanliness and safety.
The provider had identified that people’s needs were changing and the premises were no longer suitable for its intended purpose. People’s mobility had deteriorated and some were having difficulty with using the stairs. They were in the process of looking for a bungalow for people. However, in the interim some areas of the service and furniture had got into a poor state of repair. The service did not have a window cleaner and all windows were very dirty. Walls were scuffed and paintwork chipped. The service needed redecoration. Externally plants and shrubs had become overgrown and were covering windows.
We found some furniture and soft furnishings to be worn and in need of repair or replacement Externally, there was seating in the form of a table and bench, however this was unsuitable for people who used the service. We pointed out our findings to the registered manager.
When we returned for our second inspection visit we found that furniture had been repaired and where needed replaced. The windows had been cleaned and a window cleaner was to visit once a month to keep on top of these. After the inspection we were informed that new garden furniture had been delivered.
The inspection of this service identified that some audits undertaken by the registered manager and provider were ineffective as they did not pick up on the areas we identified as needing improvement.
During this inspection we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Relatives told us people were safe at Bridge House. Staff understood the risks associated with people's care and how these were to be managed. Systems were in place to ensure people received their prescribed medicines safely.
Procedures were in place to protect people from harm. The registered manager and staff understood their responsibilities to keep people safe. Staff had received safeguarding training and were aware of the signs which might indicate someone was at risk.
People's relatives told us staff had the skills to provide the care and support peopled required. New
staff received effective support when they started working at the service. Staff completed the on-going training they needed to be effective in their roles. Staff confirmed they received regular supervision and an annual appraisal.
People were supported to have a good diet which met their needs and preferences. People were supported to access health professionals to maintain their health and wellbeing.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.
Staff understood people's different ways of communicating and how to make people feel valued. Relatives told us the staff were kind and caring and treated people with dignity and respect. The service recognised the importance for people of maintaining close family relationships and provided the support required to make this happen.
People's care plans included the appropriate information to help ensure care was provided in a person centred and safe way.
Relatives told us the registered manager and staff were approachable and could speak with them if they had any concerns.
Staff enjoyed working at the service and told us they were supported by the registered manager.