Bridge House Care Home

Updated 4 May 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors, a pharmacy specialist, 2 assistant inspectors 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 service.

Service and service type

Bridge House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Bridge House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection the service did not have a manager registered with the Care Quality Commission. There was a manager in place who was in the process of application to CQC for registered manager status. This means that the provider was 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. Inspection activity started on 15 February 2023 and ended on 29 March 2023. The inspection visit was delayed due to an infectious outbreak at the service. We visited the service on 9 March 2023 and 16 March 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We observed care and support in communal areas. We spoke with 18 people who used the service and 8 relatives about their experience of the care provided. Many of the people using the service at the time of our visit were not able to tell us about their experience of care at the home but we made observations of care in communal areas.

We spoke with 9 members of staff including the manager, a nurse, senior care staff, care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included seven people’s care records and multiple medication records. We reviewed a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 4 May 2023

About the service

Bridge House is a residential care home providing personal and nursing care to up to 66 older people. At the time of the inspection there were 45 people living at the home. The care home accommodates people across three separate floors, each of which has separate adapted facilities. The first floor supports people who need residential support. The second floor supports people who need nursing care. The third floor supports people who are living with dementia.

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

Some improvements were needed to make sure the management of medicines was safe. The service had systems and processes in place to do this and some improvements were made during the inspection. Staff were recruited safely and there were enough staff to meet people’s needs. Issues around high agency use were being addressed by the appointment of new staff. The service was working with the authorities to address some safeguarding issues and were actively learning from previous issues. Staff received safeguarding training and knew what to do if they thought someone was at risk. All but 1 of the people and relatives we spoke with felt safe at the home. One person said, “I have been happy here from Day 1, I do feel well looked after.” A relative told us when asked if they thought their family member family member was safe, “Yes, I do, (person) is well looked after and has not had any accidents. (Person) is nervous and anxious and is more settled than (person) has ever been.” Risks to people’s health and safety had been assessed and new systems were being introduced to improve risk management. Some people told us staff did not always respond to the nurse call system in a timely way.

We have made a recommendation about the management of some medicines.

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.

Since the last inspection there had been a number of management changes at the service. The current manager had been in post for approximately 4 months. People told us they had seen improvements since the new manager started. One said, “I am much more confident with the new manager.” The manager and nominated individual recognised that auditing of quality and safety was not up to date in all areas. They had introduced a new schedule to address this, but it was not operational at the time of the inspection.

People gave mixed responses about how involved they felt in their relative’s care. Some said they had been involved whilst others had not. Similarly, some people felt they were asked for their opinions of the service whilst others did not. People did appreciate the opportunity to be involved in meetings about the service. Staff were engaging with health and social care professionals to improve the quality of service.

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 good (published 4 March 2022). The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions safe and well led.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. Risks associated with infection outbreaks were generally well managed, but some improvement was needed.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.