CQC report explained · a nursing home
What the CQC found at Bridge House Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- The inspection included infection prevention and control measures under the Safe question. The report does not give a separate Safe rating in the text provided.
- Effective?
- Good
- People’s needs were assessed and care plans gave staff clear guidance. Staff supported people with consent, healthcare, food and drink, and received training and supervision.
- Caring?
- Good
- No separate Caring rating or detailed Caring findings are given in the report text provided.
- Responsive?
- Good
- No separate Responsive rating or detailed Responsive findings are given in the report text provided.
- Well-led?
- Good
- The new manager had introduced audits and checks, communicated with people and staff, and worked with health and social care professionals. Some DoLS notifications had not been sent promptly, but this was corrected after the inspection.
What inspectors found, October 2022
Rated Good; inspectors found improved consent arrangements, effective support and stronger management, with some records and notifications still being improved.
This was an unannounced follow-up inspection on 30 August 2022. One inspector spoke with people, care workers and managers, observed care, reviewed three care plans, two staff files and other records, and checked further evidence afterwards.
The home was rated Good overall. Inspectors found that people’s health, nutrition and care needs were assessed and supported. Staff received training and supervision. The home had made its environment more suitable for people living with dementia.
The home had improved since its previous inspection in 2019, when it was rated Requires Improvement and had breached the consent regulation. Inspectors found it was no longer in breach. The manager had also introduced more checks and audits to monitor care.
The report says some DoLS notifications had not always been sent to CQC promptly, although this was corrected after the inspection. The home also planned to gather more information before admission and review its menus more often.
Consent and best interests
The home had improved its use of legal safeguards for people who could not make some decisions. Applications, conditions and capacity assessments were being tracked and reviewed.
“The provider applied for DoLS for those people who required being deprived of their liberties to remain safe” from the report
Staff skills and support
Staff received regular training, supervision and appraisals. Extra support and qualifications were available for staff who needed them.
“Staff received regular training in relation to their role such as dementia, health and safety, moving and handling, infection control and food hygiene.” from the report
Health and nutrition
People were supported to attend healthcare appointments. Staff monitored weight, eating and drinking and followed specialist advice.
“Staff supported people to see healthcare professionals when needed, including both specialist health services and regular healthcare such as dentist visits.” from the report
Dementia-friendly setting
The home used signs, colours and photographs to help people recognise rooms and move around. The report also found the home and garden were well maintained.
“The provider adapted the environment to be dementia friendly with the use of colours for bathroom and bedroom doors and pictorial signs to help people navigate.” from the report
Improved management checks
The manager had introduced a wider range of audits covering areas such as medicines and health and safety. Staff understood their roles and said they felt supported.
“Since they began their role they spent time reviewing the service and making improvements such as to audits and checks of the quality of care.” from the report
Late DoLS notifications
minorThe provider had not always told CQC promptly about the outcomes of DoLS applications. The report says this was put right after the inspection.
“However, the provider had not always sent CQC notifications of the outcomes of DoLS applications promptly but they rectified this after this inspection.” from the report
Pre-admission information
minorThe manager said the assessment process was being reviewed so that more person-centred information could be collected before someone moved in.
“The registered manager told us they were reviewing their assessment process to gather more person-centred information prior to admission” from the report
Dining experience
minorThe home planned to ask people for more feedback about meals and use it to review the menu more often.
“The registered manager told us they planned to improve the dining experience further by gathering feedback from people on the provision of meals and food” from the report
- 01How do you now track and report the outcomes of DoLS applications, and when was this last audited?
- 02What extra information do you collect before someone moves in to make sure their personal needs and preferences are understood?
- 03What feedback have people given about the meals, and what changes have been made to the menu?
- 04How often are medicines, health and safety, and care quality audits completed, and what happens when an issue is found?
- 05How do you make sure specialist healthcare advice is added to care plans and followed by staff?
This was an unannounced follow-up inspection that checked the previous consent concern and infection prevention and control under Safe; the report says ratings for key questions not inspected carried over from the previous inspection. This explanation was written from the published report of 6 October 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
Bridge House Care Centre was rated Requires Improvement; care was kind and mostly safe, but legal safeguards and leadership needed improvement.
This was an unannounced planned inspection on 24 July 2019. Inspectors spoke with people, relatives, staff, managers and other professionals. They observed care and checked care plans, staff files, medicines records, rotas and quality checks.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough staff, good risk management, safe medicines handling overall, kind staff, personalised care and activities that helped people stay connected with others.
The home was rated Requires Improvement for Effective and Well-led. Some people were deprived of their liberty without the correct legal safeguards. Staff recruitment records had unexplained gaps, some 'when required' medicines instructions were incomplete, and quality checks had not found all these problems.
The overall rating fell from Good at the previous inspection. The provider breached Regulation 11 about consent. CQC required an action plan, said it would monitor progress with the provider and local authority, and planned to inspect again.
Kind and respectful staff
Staff built good relationships with people and showed empathy. They respected people's choices, privacy and dignity.
“Staff were kind, caring and empathetic. They made an effort to get to know people well and build up good relationships.” from the report
Good risk management
Individual risks, including falls, pressure ulcers and malnutrition, were assessed and managed with detailed instructions for staff.
“Risk management plans were thorough and included detailed instructions about care tasks, use of equipment and how factors such as people's health conditions affected the level of risk” from the report
Food and drink
People received enough food and drink, with meals that reflected their preferences and cultural needs. Snacks and drinks were available when wanted.
“People received a variety of nutritious meals. Menus reflected people's requests, preferences and cultural needs.” from the report
Activities and community links
People could take part in activities, outings and religious or community events. The home also supported individual interests.
“People had opportunities to access the community. This included trips to a local garden centre and seaside outings.” from the report
Liberty safeguards
seriousTwo people had DoLS applications waiting for authorisation, but the home had not put urgent safeguards in place. In one case, an application was made a month after the person started using the service.
“People were sometimes deprived of their liberty without the correct legal processes being in place.” from the report
Incomplete recruitment records
needs fixingAll three staff files checked had significant unexplained gaps in employment history. The manager collected the missing information after inspectors raised it.
“all three of the staff whose files we reviewed had significant unexplained gaps in their work history” from the report
PRN medicines information
needs fixingSome records for medicines taken only when needed did not state the maximum dose that could be taken in a day. CQC recommended reviewing the guidance and records.
“there was not always detailed information about medicines prescribed to be taken only when required” from the report
Limited personal information
minorCare plans did not contain much information about people's life history, hobbies, interests or needs linked to cultural and other diverse backgrounds.
“care plans did not contain much detail about people's life history, hobbies and interests or needs relating to diverse characteristics such as cultural background” from the report
- 01How do you now make sure every person whose liberty is restricted has the correct legal authorisation in place?
- 02How do you check that records for medicines taken only when needed state when they should be given and the maximum daily dose?
- 03What checks are now made on employment gaps before new staff begin work?
- 04How do you record each person's life history, hobbies, cultural background and other interests in their care plan?
- 05What action was included in the improvement plan requested by CQC, and what progress has been made?
This was an unannounced comprehensive inspection covering all five key questions, the premises and the care provided; the report does not describe any areas as outside the inspection. This explanation was written from the published report of 5 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Bridge House Care Centre
5 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- October 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodEffective: Requires improvementWell-led: Requires improvement
- February 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Goodup from Requires improvementSafe: GoodCaring: Requires improvement
- February 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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