CQC report explained · a nursing home
What the CQC found at Bridge House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe, staffing and recruitment systems had improved, and medicines were managed more safely. One pressure sore risk assessment was missing, and some incident records did not have the required sign-off.
- Effective?
- Requires improvement
- The home had improved its environment, staff training and care planning, but further dementia-related adaptations were needed. One person using bed rails did not have a documented mental capacity assessment, and people said the food had declined after the head chef left.
- Caring?
- Good
- People and relatives described staff as kind, caring and respectful. Staff supported independence, privacy and involvement in care.
- Responsive?
- Good
- Care plans reflected people's preferences, communication needs and life histories. People were offered daily activities, including one-to-one options, and complaints systems were in place.
- Well-led?
- Good
- The management team had improved audits, monitoring and learning systems. People, relatives and staff said managers were open, approachable and willing to listen.
What inspectors found, December 2022
Rated Good overall; inspectors found safe and caring support, but the effectiveness of care still required improvement.
This was an unannounced comprehensive inspection on 17 and 18 November 2022. Inspectors spoke with people, relatives and staff, and reviewed care plans, medicines records, staff files and management records.
The home was rated Good overall. Safe, caring, responsive and well-led were rated Good. Effective was rated Requires Improvement, meaning care and support did not always achieve good outcomes or was not fully consistent.
Inspectors found improvements since the previous inspection in premises, medicines, recruitment records, staff training, mental capacity records and quality monitoring. The home was no longer in breach of the regulations identified at the previous inspection.
Kind and respectful staff
People and relatives said staff were caring and showed genuine interest in people's wellbeing. Staff supported people at their own pace and respected privacy.
“People and their relatives told us staff treated them with respect and dignity.” from the report
Personalised care
Care plans recorded people's abilities, preferences, routines and communication needs. They were reviewed monthly.
“Care plans were individualised and included information about how people would like their care to be delivered.” from the report
Activities and rehabilitation
The home offered group and one-to-one activities each day. Physiotherapists and occupational therapists supported people in an on-site rehabilitation area.
“The home had recently employed an activity co-ordinator and facilitated activities either in a group setting or on a 1:1 basis daily.” from the report
Improved management
The management team introduced better audits and trackers to monitor care records, medicines checks, weight loss and other areas of quality.
“The registered manager had quality assurance systems in place.” from the report
Safer medicines processes
Controlled medicines were securely stored, daily checks were completed and clearer instructions were available for medicines given when needed.
“Documents to help staff to administer 'when required' (PRN) medicines were now in place” from the report
Further dementia adaptations needed
needs fixingSignage had improved, but more changes were still planned to help people living with dementia find their way around and use the environment safely.
“Although improvements had been made, the registered manager's action plan highlighted more development was needed to ensure the service fully met the needs of the people living with dementia.” from the report
Missing mental capacity assessment
needs fixingOne person had bed rails but there was no documented mental capacity assessment for this decision. The manager agreed to review this and complete an assessment.
“We identified one person who had bed rails in place, however there was not a documented mental capacity assessment in relation to this.” from the report
Food service was unsettled
minorPeople said the food had declined after the head chef left. The home was recruiting a replacement at the time of inspection.
“People told us since the head chef recently left, the food had declined” from the report
Some records needed better completion
needs fixingOne pressure sore risk assessment was missing. Some incident and accident forms did not have the required reference and manager sign-off, although staff had reviewed the incidents.
“Unique referencing and manager sign off had not always been recorded as per the providers form.” from the report
- 01What further dementia-friendly changes have been completed since the inspection, including signage, memory boxes and contrasting colours?
- 02Has the mental capacity assessment for the person using bed rails been completed and recorded?
- 03Has a new head chef been appointed, and what feedback have residents given about the food since the inspection?
- 04How are staff now checking that every pressure sore risk assessment is in place and up to date?
- 05How does the new incident tracker record actions taken and confirm that managers have signed each incident record?
This was an unannounced comprehensive inspection covering all five key questions and checking whether improvements from the previous inspection had met legal requirements. This explanation was written from the published report of 13 December 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, November 2021
Rated Requires Improvement; inspectors found risks in staffing, medicines, the building and management systems.
This was an unannounced focused inspection on 21 and 22 September 2021. Inspectors looked at Safe, Effective and Well-led because of concerns about medicines, nursing care and staffing. They spoke with people, relatives and staff, and reviewed care, medicines, recruitment and management records.
People said they felt safe and staff were caring. Infection control, safeguarding, care planning, activities and work with health professionals were positive. However, staffing was sometimes too low, call bells could be unanswered for several minutes, and medicines were not always managed safely.
The building was not well adapted for people living with dementia. The provider's checks and action plans had not led to all the required improvements. The overall rating fell from Good at the previous inspection to Requires Improvement.
People felt safe
People said they felt safe, and staff understood how to recognise and report abuse or neglect.
“People felt safe in the home and liked the staff who supported them.” from the report
Person-centred care
Care plans reflected people's routines, preferences and needs. They were reviewed monthly.
“Plans were person centred and contained information covering a summary of daily routines, including how the person would like their care to be carried out.” from the report
Infection control
Inspectors were assured that the home used protective equipment, supported safe visits and had arrangements for preventing and managing infection outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Links with health professionals
The home worked with occupational therapists, physiotherapists, GPs and the local authority. It also had an in-house rehabilitation area.
“The team worked closely with the local social and health professionals.” from the report
Staffing and call bells
seriousPeople and staff said staffing was sometimes insufficient. Records showed people could wait seven to eight minutes for call bells to be answered.
“People reported due to short staffing, call bells can take a long time to be answered.” from the report
Medicines management
seriousMedicines were not always stored, recorded or checked safely. Problems included missing information for medicines given when needed, expired medicines and incomplete controlled-drug checks.
“People's medicines were not safely managed.” from the report
Recruitment checks
seriousSome staff files did not show that required checks about previous work with vulnerable adults had been completed before employment.
“The provider had not obtained all required information prior to deploying staff to work at the service.” from the report
Dementia-friendly building
seriousThere was not enough signage or colour contrast to help people living with dementia find bedrooms, toilets and other areas.
“The premises was not suitable for people living with dementia.” from the report
Weak oversight
seriousAudits and action plans did not consistently lead to completed improvements. There was no effective system to identify themes, monitor risks and check that actions were finished.
“The provider had not embedded an effective system to assess, monitor and improve the quality and safety of the service provided.” from the report
- 01What staffing level is being provided on each shift now, and how quickly are call bells currently answered?
- 02What checks have been completed to make sure all staff recruitment records are complete?
- 03How are medicines awaiting disposal, 'when required' medicines, blood glucose equipment and controlled drugs checked now?
- 04What changes have been made to signage and colour contrast for people living with dementia?
- 05Which actions from the August 2021 improvement plan are now complete, and how is completion being checked?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 3 November 2021 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 Nursing Home
6 rated inspections over 7 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2021Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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