Background to this inspection
Updated
6 January 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, to check the previous breaches of the regulations had been complied with and to provide a rating for the service under the Care Act 2014.
We inspected Bridge House on the 23 and 24 November 2016. The first day of the inspection was unannounced. On the first day of the inspection the inspection team consisted of one adult social care inspector and an ‘expert-by-experience’. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience who assisted on the inspection had experience of caring for older people. On the second day of the inspection there was one adult social care inspector.
Before the inspection we contacted some of the healthcare professionals who provided funding for the care of some of the people who used the service. They informed us they had no concerns about the service.
Before our inspection we looked at the previous inspection report and notifications that were sent to us by the registered manager to inform us of any incidents and significant events.
During the inspection we spoke with six people who used the service, three relatives, the regional manager, the registered manager, the deputy manager, four care assistants, the chef, the kitchen assistant and the activities organiser.
We looked around all areas of the home, looked at how staff cared for and supported people, looked at food provision, three people's care records, eight medicine administration records and the medicine management system, three staff recruitment and training records and records about the management of the home.
Updated
6 January 2017
We inspected Bridge House on the 23 and 24 November 2016. The first day of the inspection was unannounced. There were 24 people using the service at the time of the inspection.
We last inspected Bridge House on 3 September 2015 where we found there were three breaches of the Regulations of the Health and Social Care Act 2008. These were in relation to the unsafe management of medicines, risks in relation to people’s health and well-being not always identified and sufficient staff not provided at all times to meet the needs of the people who used the service. During this inspection we found the previous breaches in the Regulations had been met.
Bridge House is presently registered to care for up to 40 people who require residential care. Due to one wing of the home having recently been demolished, the provider was in the process of applying to the Care Quality Commission (CQC) to vary the number of people they can be registered for. Bridge House is a large detached building situated in spacious grounds. Accommodation is provided on two floors and all bedrooms are single occupancy with an en-suite shower and toilet. There is level access to the front of the home, a lift to the first floor and wide corridors that enable wheelchair access. There is adequate parking in the grounds at the front of the home. The home is within easy reach of local shops, public transport and the motorway network. Bury Town Centre is only a short distance away.
The home had a manager registered with the CQC who was present on the day of the inspection. A registered manager is a person who has registered with the CQC 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.
We found that suitable arrangements were in place to help safeguard people from abuse. Staff knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred. Staff were able to demonstrate their understanding of the whistle blowing procedures (the reporting of unsafe and/or poor practice).
We found people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.
We saw people looked well cared for and there was enough equipment available to ensure people's safety, comfort and independence were protected. A range of activities were provided and people who used the service told us they enjoyed the activities and looked forward to them.
People's care records contained enough information to guide staff on the care and support required. The records showed that risks to people's health and well-being had been identified and plans were in place to help reduce or eliminate the risk. We saw that people were involved and consulted about the development of their care plans.
People told us they received the care they needed when they needed it. They told us they considered staff were kind, had a caring attitude and felt they had the right skills and knowledge to care for them safely and properly. We saw that staff treated people with dignity, respect and patience.
Procedures were in place to prevent and control the spread of infection and risk assessments were in place for the safety of the premises. All areas of the home were secure, clean, well maintained and accessible for people with limited mobility; making it a safe environment for people to live and work in.
We saw that appropriate environmental risk assessments had been completed in order to promote the safety of people who used the service, members of staff and visitors. Systems were in place for carrying out regular health and safety checks and equipment was serviced and maintained regularly. Procedures were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and water supply.
The medication system was safe and we saw how the staff worked in cooperation with other healthcare professionals to ensure that people received appropriate care and treatment.
Staff were also able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.
People were provided with a choice of suitable and nutritious food and drink to ensure their health care needs were met. We saw that food stocks were good and people were able to choose what they wanted for their meals.
To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of the running of the home and there were opportunities, such as resident/relative meetings for people to comment on the facilities of the service and the quality of the care provided.