Bridge House

Updated 23 May 2018

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, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive, unannounced inspection. It took place on 11 April 2018.

The inspection team consisted of one 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.

Prior to the inspection, we looked at previous inspection reports. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events, which the service is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During this inspection, we spoke with two people using the service to gain their views about the service. We spoke with four members of staff on the day of our visit. They included the registered manager, one acting deputy manager, one acting team leader and one support worker. We also observed the interactions between people who used the service and staff throughout the day.

After our visit we sought feedback from relatives and health and social care professionals to obtain their views of the service provided to people. We received feedback from one relative.

We reviewed two people’s care files, which included care plans, health records, risk assessments and daily care records. We looked at three staff recruitment files, a selection of policies, procedures and records relating to the management of the service.

We asked the provider to send us more information about staff training. The provider sent the information to CQC in a timely manner.

Updated 23 May 2018

Bridge 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. At the time of our inspection, Bridge House was providing care services to four adults with mild, moderate or complex learning disabilities, autism and mental health, some of whom had additional behaviours that challenged services.

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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager at the service. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People continued to feel safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly.

People's needs and choices continued to be assessed and their care provided in line with up to date guidance and best practice.

People were supported to maintain a healthy diet and all health needs were met with the support from staff.

People continued to have access to healthcare services and were involved in monitoring their health needs.

Staff understood how to prevent and manage behaviours that may challenge the service.

People had developed positive relationships with staff and there was a friendly, calm, relaxed atmosphere within the home. Staff knew people's likes, dislikes and preferences well and supported them to engage in activities of interest.

People continued to be treated with dignity and respect and staff ensured their privacy was maintained. People were encouraged to make decisions about how their care was provided.

Medicines continued to be managed safely and people received their medicines as prescribed.

Staffing levels ensured that people's care and support needs were continued to be met safely and safe recruitment processes continued to be in place.

People continued to be supported by staff who had the right skills, knowledge and experience.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS applications had been made to ensure that people were only deprived of their liberty, when it had been assessed as lawful to do so.

There were policies and systems in place that ensured people would be listened to and treated fairly if they complained about the service.

The service was kept clean and hygienic. People were protected by the prevention and control of infection.

There were systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

The organisation's visions and values centred around the people they supported, which ensured their equality, diversity and human rights were respected.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve.

Further information is in the detailed findings below.