This inspection took place on 26 and 27 March, 2018 and was announced. Bridgewell House is owned and managed by Bright Futures Care Limited.
Bridgewell House is a ‘care home’. People in ‘care homes’ receive accommodation and nursing or personal care as single package under one contractual agreement. Bridgewell House is registered to provide care and support to young adults who are living with learning conditions, a disability, Mental Health Conditions or Sensory Impairment. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Bridgewell House can support up to six people, at the time of the inspection there was five people living at the home.
The home is situated in a residential area of Stockton Heath, Warrington. Bridgewell House is a large detached property which provides accommodation over two floors. Each bedroom comes with en-suite facilities; there are two large communal rooms, two large kitchen areas and a large garden area at the back of the house.
At the previous inspection which was conducted in February 2015, Bridgewell House was rated ‘Good’ in the safe, effective, responsive and well-led domains. The ‘caring’ domain was rated ‘outstanding’.
At this inspection we found the service remained 'Good', with the caring domain continuing to be rated as ‘outstanding’.
At the time of the inspection there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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.
The registered manager had a number of different systems in place to assess, monitor and continually improve the standard and quality of care being provided. This meant that people who were being supported were receiving safe, compassionate and effective care.
‘Accidents and Incidents’ processes were reviewed during the inspection. Each person had an ‘incident’ reporting book and the relevant care records were updated as and when an accident/incident occurred. All staff were aware of the incident reporting procedure and the importance of completing and updating records. We identified that an analysis of accidents/incidents was not been carried out to establish trends and patterns.
We have made a recommendation regarding the analysis of accidents and incidents within the home.
Medication was administered by staff who had received appropriate training. Medication that needed to be given ‘as and when’ (PRN) was being prescribed however, protocols were not in place. Medication protocols outline to staff the circumstances in which this should be given. We discussed this with the registered manager so these could be put in place.
Care plans and risk assessments were in place. They contained up to date and relevant information for each person who was being supported. Each person had a designated key worker who was familiar with the varying levels of support needs and risks which needed to be managed.
Recruitment was safely managed. Staff personnel files demonstrated that safe recruitment practices were in place. All staff who were working for the registered provider had submitted an application form, sufficient references had been obtained and disclosure and barring system checks (DBS) were in place.
The registered provider operated within the principles of the Mental Capacity Act 2005 (MCA). People had been appropriately assessed and the relevant Deprivation of Liberty Safeguards (DoLS) had been submitted to the relevant local authority.
Staff expressed that they were fully supported in their roles. Staff had received the necessary induction training, regular supervision and appraisals were taking place and extra training was provided to further equip staff with specialist skills and abilities.
Staff supported people to make their own decisions around their own nutrition and hydration. Choices, preferences, likes and dislikes were taking in to account and extra support was being provided by external healthcare professionals in relation to weight management and balanced diets.
People were treated with a great amount of dignity and respect. The care being provided was regarded as ‘outstanding’ and people’s equality and diversity needs were considered from the outset.
Care plans were individually tailored and a ‘person centred’ approach to care was evident throughout the inspection. Staff were familiar with people’s support needs and always provided care and support in a respectful and dignified way.
The registered provider had a formal complaints policy and procedure in place. At the time of the inspection there were no formal complaints being reviewed. People and relatives we spoke with expressed that they would feel comfortable and confident speaking to the staff team and managers about any issues of concern.
Health and Safety audit tools were safely monitoring and assessing quality and standards of the home. This meant that people were living in a safe and well maintained environment.
Policies and procedures were reviewed during the inspection. All policies contained the correct information and guidance for staff to follow. Several policy review dates had expired however the registered manager explained that there was going to be overhaul of all policies and procedures in the coming months.
Staff were knowledgeable around the area of ‘safeguarding’ and ‘whistleblowing’ procedures. They were familiar with the internal reporting procedures. Staff had completed the necessary safeguarding training and there was an up to date safeguarding policy in place.