Bridge House Care Home

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

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.

The registered manager and nominated individual promoted an open and honest culture throughout the home. The provider had made several improvements at the home which improved the quality of care people received. One staff member told us were happy with everything and the home was running at it’s best. Staff were aware of their responsibilities of recording and reporting incidents. Falls were reviewed at meetings with senior staff to identify mitigation measures or changes to prevent recurrence.

Relatives were very complementary about the home and staff team; they spoke about changes that had been made which benefited the home and the people living there.

The provider regularly reviewed their systems and utilised external agencies to complete audits to determine if improvements could be made. Monthly analysis and audits were completed to identify patterns, trends or leaning which could further improve the home. The provider acted on feedback they received to further improve the home.

People’s needs were met at Bridge house. People and their relatives felt involved in planning their care and reviewing when needed. One relative told us, “The staff appear to be totally open when discussing the care of [my relative] and are willing to listen to family thoughts/suggestions."

The registered manager informed us they obtained information from people as well as people close to them, this ensured people were supported in a way they wanted. Staff were aware of people’s needs and how to keep people safe. One staff member told us, “There are risk assessments in place, as a team, we manage risks really well. I have no concerns.” The registered manager told us they undertook a resident of the day programme, where they focused on one resident at a time, this allowed them to review their care package and ensure any relevant changes had been included.

The registered manager and staff worked with health care professionals to ensure people’s care and support needs were met. Overall, we received positive feedback from health professionals about the team’s engagement with their services. We observed health professionals visiting people throughout our visits. One visiting professional told us, “Communication between the acute service and The Bridge has improved and they now contact the service early with any requests allowing appropriate planning for the day. Another professional told us, “Staff are always helpful - they know the residents and are able to provide quality handovers to the team when we visit. The residents seem happy - I really like the fact the staff have been utilising the day centre and the residents come downstairs to eat together."

The provider had a range of systems in place to ensure the safety of people and a smooth transition. The systems ensured people’s needs and risks were captured. Care plans contained information about people’s needs and how they wanted to be supported. Risk assessments were also in place to ensure action was being taken to mitigate risks; where needed, appropriate referrals were made to other health professionals.

People felt safe living at Bridge House. Relatives also felt their loved ones were safe at Bridge House Care Home. One relative said, “[Relative] has lived at Bridge House for 5 years and she is very happy with all aspects regarding the safety of the home, from door security to room security.”

Staff had good knowledge of how they would respond to different incidents and any safeguarding concerns. The staff felt confident that their concerns would be addressed, and if not what action they would take. One staff member told us, “I would go to the senior and the senior would report to the deputy. If the senior didn’t do anything about it, I would go to the deputy myself.”

The atmosphere in the home felt warm and friendly. We observed staff throughout our visits to be kind and caring towards people. During our observations, we observed how a staff member supported a person in line with their support plan to reduce their anxieties and challenges they were displaying towards others.

Safeguarding concerns were appropriately reported to the local authority when required and follow up actions completed. There was a clear safeguarding policy in place which guided staff about different types of abuse and how to raise a concern to ensure people were safe. Staff completed safeguarding training as part of their training programme.

Care plans and risk assessments were in place and were reviewed regularly. Care records contained information on known risks to people and plans to mitigate them. People’s care plans were regularly reviewed and in response to any change in needs. The provider ensured everyone had a personal emergency evacuation plan which included instructions on how to safely evacuate people during emergencies.

People and relatives told us they felt their needs and risks were being managed appropriately. One person told us, “A hoist was needed for [my relative] and the staff knew exactly how to use it to keep him safe, the risk of pressure sores was high but, thanks to the special mattress on his bed he had not had one in all the time he has been at Bridge House.”

Staff had good knowledge and understanding of people’s need and potential risks they may pose. Staff utilised risk assessments to ensure they supported people to manage their risks.

Staff were aware of people’s limitations and support measures, for example we observed a staff member reminding a person about their walking aid when they kept walking without this. Safe moving and handling techniques were observed during our assessment. People who required modified diets received these in line with their risk assessments.

Staff had the facilities and equipment to deliver care safely. The nominated individual informed us there were planning on undertaking some work on replacing the furniture within the home.

People and their relatives did not raise any concerns with the environment. People and relatives were positive about the environment and what was on offer for their loved ones at the home. On the ground floor there was a café, cinema, bar, day centre, kitchen and hairdresser. Relatives could use this space to spend time with their loved ones at the home.

The environment for people was spacious, visibly clean and well maintained. The environment including people’s rooms, had a welcoming and homely feel and had been personalised to meet their preferences and needs. Communal areas were well decorated. We did not observe any hazards that would pose a risk to anyone at the home. There was appropriate fire evacuation equipment in required areas to support people to evacuate during an emergency.

The environment was safe, regular audits and checks to maintain the building and equipment were completed regularly. Safety checks for equipment in the building and certificates were available and all in date. The home operated a call bell system, during our visits we tested the call bell system and saw staff responded to the alarm within good time.

The home had robust recruitment processes to ensure the safe recruitment of staff. All staff completed an induction when they started, this consisted of online training, face to face training and shadow shifts. Staff found the induction and management helpful as they started their role. One staff member said, “The training is pretty good, we do online training and also do face to face training. If I need support, I will mention this to the manager who will resolve this.” Staff also had the opportunity to complete regular supervision and attend team meetings.

We received no concerns from people or relatives about the staffing levels. People felt there was enough staff on shift. One person told us that all they had to do was press their call bell and a member of staff attended very quickly. Relatives spoke highly of the staff and the care they provided. One relative said, “Staff are well trained, new staff are supported by more experienced staff and by management.”

The registered manager spoke about a dependency tool they used to determine staffing levels for each floor. This was a live document and was updated as the needs of the home and people changed. Staff felt there was sufficient staffing levels on each floor. Staff also felt the registered manager and nominated individual were approachable. The registered manager informed us they operated an open door policy and were available to staff as and when needed.

During our observations, we found the staffing levels were in line with people’s needs. There was a call bell system in place which peoples used if they required staff. We observed staff responding to call bells in a timely manner.

The provider had an Infection Prevention and Control policy in place. Appropriate systems were in place to ensure safe infection control standards were maintained.

People and relatives raised no concerns in relation to infection prevention and control. One relative described how clean the home was, they said. “From the entrance to the bathrooms, everywhere is so clean, well decorated and light.” Another relative said, “I am really impressed with how bright and clean it is, it is more like a hotel than a care home.”

Staff completed training in infection prevention and control. There was a domestic team within the home who were aware of their roles and responsibilities. Cleaning schedules were completed.

We observed the home to be visibly clean and free from any malodours during our site visits. We saw housekeeping staff carrying out their roles to ensure the environment was clean.

There were processes in place to ensure the safe and effective use of medicines. Audits around medicines use were completed routinely but had not identified the area for improvement that we found during our inspection. Some people were prescribed a variable dose i.e. 1 or 2 tablets to be given when required at regular intervals. The time of administration had been recorded, but on some occasions not the quantity given. Where people were prescribed a variable dose of medication robust records were not always in place. This meant that records did not always accurately reflect the treatment people had received. Detailed guidance specific to each person on how to administer medicines prescribed as and when people required them, known as “PRN” was available to staff. These were person-centred and clear.

People were given their medicines safely and in a timely manner. This was recorded on their medicines administration record (MAR). One person told they knew what medication they was taking and they always received it and understood why it had been prescribed.

Staff interacted kindly with people whilst conducting the medicines administration round. Care plans were detailed and ensured staff knew how to support people’s individual needs. One relative told is they were very happy with the medication their relative received, both orally and topically and that it was given at the right time. Staff told us they had completed a training and induction process for medicines management. Training in medicines administration was refreshed annually. Competencies for the administration of medicines were assessed regularly to make sure staff had the necessary skills. Staff told us they had access to information which supported them to manage medicine’s safely and effectively. The registered manager was aware of what action to take if there was any concerns in relation to medication.