Archived: Bridgewood House

Updated 19 November 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors, a specialist nurse advisor, a pharmacist inspector and four experts 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. Two experts by experience attended the inspection and spoke with people to gain their views and opinions of the home. The other two experts by experience supported this inspection by carrying out telephone calls to people’s relatives following the on-site visit.

Service and service type

Bridgewood House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection we looked at information that we had received about the service and formal notifications that the service had sent to the CQC. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed the action plan the provider sent us following the last inspection. This is an action plan where the provider tells us how they plan to improve the service in response to our concerns. We used all of this information to plan our inspection.

During the inspection

We spoke with 14 staff including the service manager, registered manager, clinical lead, the hospitality manager, the facilities manager, four nurses, three team leaders, one care staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 23 people living at the home, two healthcare professionals and two relatives that were visiting at the time of the inspection. We looked at 13 people’s care records, 12 risk assessments, six people’s medicine records, 10 staff files and other paperwork related to the management of the service including staff training, quality assurance and rota systems.

After the inspection

We spoke with 18 relatives and five care staff by telephone.

Updated 19 November 2019

About the service

Bridgewood House is a residential care home providing personal and nursing care to people aged 65 and over, some of whom may be living with dementia. The home is registered to provide care to 70 people. At the time of the inspection there were 53 people using the service.

The home is a modern purpose-built building covering three floors. There are six units, two on each floor, named after local parks and the home refers to each unit as a 'park'. One park provided nursing care and the other five parks provided residential care with no nursing. We have referred to the units as ‘parks’ throughout this report.

People’s experience of using this service and what we found:

Records relating to people’s care was inconsistent across the home. Some people’s risks assessments provided staff with clear guidance on how to minimise the risks. However other risk assessments failed to document risks. Accidents and incidents were not adequately recorded. Medicines were not well-managed and we could not be assured that people were receiving their medicines safely.

Complaints were not well documented and often failed to note outcomes. Relatives told us they did not have faith in the complaints’ procedure.

Management oversight, including auditing processes did not identify the issues found at this inspection. There was a failure to address the issues found at the last inspection around managing risk, medicines management and good governance, and a failure to implement changes to improve the quality of care.

People told us that they felt safe living at Bridgewood House. They said that staff were kind and caring and treated them with dignity and respect. Whilst we observed some caring interactions between staff and people, we also observed some interactions which indicated that people were not always treated with dignity and respect.

There were a wide range of activities for people and people were actively encouraged to go out on day trips or to day centres. People told us that they were happy with the activities that were offered at the home.

People had a choice of food and were consulted about what they wanted to eat each day. People were provided with food that was culturally relevant to them.

Staff told us they felt supported in their role and received regular supervision. However, there had been no annual staff appraisals completed.

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.

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 3 August 2018). The service remains rated as requires improvement.

This service has now been rated requires improvement for the last two consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve the quality of care. At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified three breaches of regulation around safe care and treatment, complaints and good governance. The failings found are detailed in the main body of the report.

With regards to the breaches for regulations 12 (safe care and treatment) and 16 (complaints), please see the action we have told the provider to take at the end of this report.

We are taking enforcement action and will report on this when it is completed. Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bridgewood House on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.