CQC report explained · a nursing home
What the CQC found at Bridgewood Mews
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2022
Inspected but not rated; inspectors found strong COVID-19 infection controls during an outbreak.
This was an announced, targeted inspection on 21 January. Inspectors looked mainly at infection prevention and control, visiting arrangements and staffing pressures linked to COVID-19.
The home was managing an outbreak. Inspectors found visitor checks, up-to-date infection control guidance, regular observations where people could not socially distance, extra cleaning and staff allocated to separate floors.
Inspectors were assured that the home was using protective equipment safely, arranging testing, managing admissions and outbreaks, and meeting COVID-19 vaccination requirements for staff and visiting professionals.
The service was inspected but not rated. This means the visit did not give an overall rating or a full rating for the five areas of care.
Infection control
The home had an up-to-date infection control policy and audits showed that actions had been taken to maintain standards.
“The infection control policy was up to date. We reviewed audits which reflected actions had been taken to maintain the standards within the home.” from the report
Managing infection risks
The home used regular observations, extra touchpoint cleaning and separate staff teams to reduce the risk of infection spreading.
“The home managed risk in relation to infection well, where people were unable to social distance, regular observation checks were recorded and increased touchpoint cleaning was undertaken.” from the report
Visiting arrangements
During the outbreak, essential care givers could visit inside and other visitors were offered garden visits.
“Other visitors were offered garden visits to see residents to reduce the risk of infection inside the home.” from the report
COVID-19 safeguards
Inspectors were assured that the home used protective equipment safely, arranged testing and met vaccination requirements for relevant staff and visiting professionals.
“The service was meeting the requirement to ensure non-exempt staff and visiting professionals were vaccinated against COVID-19.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing infection outbreaks and preventing infections from spreading between floors?
- 02What visiting arrangements are in place now when there is an outbreak?
- 03How do you check that staff and visiting professionals meet the current COVID-19 vaccination requirements or have an exemption?
- 04What measures are in place if COVID-19 causes staffing pressures?
- 05When was the home's wider care last fully assessed and rated?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not provide an overall rating or assess the other care areas. This explanation was written from the published report of 11 February 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, April 2019
Rated Good in every area; inspectors found safe, kind and personalised care, with some records and feedback processes needing improvement.
This was an unannounced, planned inspection on 7 March 2019. One inspector and an expert by experience visited the home. They spoke with four people, four relatives and staff, and observed care and activities.
Inspectors found people were safe and the home was well staffed. Staff were trained to support complex physical and mental health needs. People received personalised care, had choices about daily life and were supported to communicate, eat and drink well, access healthcare and take part in activities.
The home was clean and accessible, although some areas needed redecorating. One risk assessment was unclear, and meeting records did not clearly record people's, relatives' or staff views. The managers said these points would be addressed.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. It had also been rated Good at the previous inspection published on 8 September 2016.
Good staffing and safety
People and relatives said there were enough staff. Staff had safeguarding training, recruitment checks and procedures for learning from incidents.
“People felt safe at the home which they said was well-staffed.” from the report
Staff understood complex needs
Staff received specialist training and worked with external professionals to meet people's physical, mental health and communication needs.
“Staff had additional training to ensure they understood the complex needs of some of the people using the service.” from the report
Communication and choice
The home supported people to express themselves using sign language, specialist communication support and first-language support where needed.
“Members of the staff team used Makaton and British Sign Language and people had the support of external communication specialists to ensure their voices were heard.” from the report
Personalised daily life
Care plans recorded individual preferences and goals. People chose their meals, personal care and activities, and were supported to be more independent.
“People had individual programmes of activities to suit their needs.” from the report
Kind and respectful care
People and relatives described staff as kind and respectful. Inspectors saw staff protect privacy and encourage independence.
“People and relatives said the staff were kind and respectful.” from the report
Complaints were acted on
People and relatives knew how to complain. Inspectors found complaints were investigated and used to improve care records.
“Complaints were investigated thoroughly and action taken to put things right.” from the report
One unclear risk assessment
needs fixingOne risk assessment did not clearly explain what staff should do if a person chose to mobilise independently. The acting manager said it would be updated.
“One risk assessment, identified at the inspection visit, needed improvement as it was unclear from reading it how staff should respond when a person decided to mobilise independently.” from the report
Meeting records did not show people's views
minorMinutes from people's, relatives' and staff meetings did not clearly record what people had said. Managers said this would be corrected in future.
“However, people's and relatives' views were not clearly represented in the minutes.” from the report
Some areas needed decorating
minorSome people and relatives thought parts of the building needed improvement. Managers said upgrading work was scheduled after consultation with people using the home.
“Some people and relatives thought the premises needed redecorating in some areas.” from the report
No registered manager at the visit
minorThe home did not have a registered manager when inspectors visited. The acting manager had applied for registration and was going through the process.
“At the time of our inspection visit the home did not have a registered manager.” from the report
- 01Has the risk assessment about independent mobilisation been updated, and how are staff told what action to take?
- 02Has a registered manager now been appointed and registered with the CQC?
- 03How do you record people's, relatives' and staff views at meetings now?
- 04Which decoration and upgrading work identified in the report has been completed?
- 05How do you gather feedback from people who cannot take part in the usual survey because of communication challenges?
This was an unannounced planned inspection of the whole care home, covering all five CQC questions and both the premises and care provided. This explanation was written from the published report of 18 April 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 Bridgewood Mews
4 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- April 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 11 February 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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