Archived: Bridge House

Updated 31 August 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 was 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.

We inspected Bridge House on 26 June and 4 July2018. The inspection was announced. We gave 24 hours’ notice of the inspection visit because the service is small and people are often out during the day. We needed to be sure they would be in. The inspection team consisted of two adult social care inspectors.

Before the inspection we reviewed all the information we held about the service, which included statutory notifications submitted to Care Quality Commission (CQC) by the registered manager. Statutory notifications include information about important events which the provider is required to send us. We contacted the commissioners of the relevant local authorities, the local authority safeguarding team and other professionals who worked with the service to gain their views of the care provided. The feedback we received did not raise any concerns about the service.

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 the inspection we reviewed a range of records. This included two people’s care records and medicines records. We also looked at two staff recruitment files, including supervision, appraisal and training records, records relating to the management of the service and a wide variety of policies and procedures.

People were not verbally able to communicate with us, however we spent time observing and interacting with people in the communal areas of the service. After the inspection we spoke with four relatives of people who used the service. In addition, we spoke with the registered manager, operations manager, two acting senior support workers and four support workers.

Updated 31 August 2018

This inspection took place on 26 June and 4 July 2018 and was announced. We gave 24 hours’ notice of the inspection visit because the service is small and people are often out during the day. We needed to be sure they would be in.

Bridge House is a care home. People in care homes receive accommodation and nursing or personal care as a 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 provides personal care to a maximum of seven people who have a learning disability. At the time of the inspection there were six people who used the service.

At the last comprehensive inspection in November 2015 we found the service was meeting requirements and was awarded a rating of Good. At this inspection we found the service had deteriorated and we rated the service as Requires Improvement.

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

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.

The inspection highlighted that at times there were insufficient staff deployed to meet the needs of people who used the service and to ensure they all engaged in meaningful activity.

On the first day of our inspection we found cleanliness to be poor, particularly in bathrooms and shower rooms. We also found the stairway to be dusty, dirty and in need of cleaning.

We found parts of the home were not safe. We found loose blind cords and a bedroom window restrictor which was easily overridable. We informed the registered manager about the poor cleanliness and safety concerns who told us they would take immediate action to rectify these. When we returned for our second day of the inspection we found that action had been taken to address the issues around cleanliness and safety.

The provider had identified that people’s needs were changing and the premises were no longer suitable for its intended purpose. People’s mobility had deteriorated and some were having difficulty with using the stairs. They were in the process of looking for a bungalow for people. However, in the interim some areas of the service and furniture had got into a poor state of repair. The service did not have a window cleaner and all windows were very dirty. Walls were scuffed and paintwork chipped. The service needed redecoration. Externally plants and shrubs had become overgrown and were covering windows.

We found some furniture and soft furnishings to be worn and in need of repair or replacement Externally, there was seating in the form of a table and bench, however this was unsuitable for people who used the service. We pointed out our findings to the registered manager.

When we returned for our second inspection visit we found that furniture had been repaired and where needed replaced. The windows had been cleaned and a window cleaner was to visit once a month to keep on top of these. After the inspection we were informed that new garden furniture had been delivered.

The inspection of this service identified that some audits undertaken by the registered manager and provider were ineffective as they did not pick up on the areas we identified as needing improvement.

During this inspection we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Relatives told us people were safe at Bridge House. Staff understood the risks associated with people's care and how these were to be managed. Systems were in place to ensure people received their prescribed medicines safely.

Procedures were in place to protect people from harm. The registered manager and staff understood their responsibilities to keep people safe. Staff had received safeguarding training and were aware of the signs which might indicate someone was at risk.

People's relatives told us staff had the skills to provide the care and support peopled required. New

staff received effective support when they started working at the service. Staff completed the on-going training they needed to be effective in their roles. Staff confirmed they received regular supervision and an annual appraisal.

People were supported to have a good diet which met their needs and preferences. People were supported to access health professionals to maintain their health and wellbeing.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Staff understood people's different ways of communicating and how to make people feel valued. Relatives told us the staff were kind and caring and treated people with dignity and respect. The service recognised the importance for people of maintaining close family relationships and provided the support required to make this happen.

People's care plans included the appropriate information to help ensure care was provided in a person centred and safe way.

Relatives told us the registered manager and staff were approachable and could speak with them if they had any concerns.

Staff enjoyed working at the service and told us they were supported by the registered manager.