Bridge House Nursing Home improved from Requires Improvement to Good overall, having remediated previous breaches in medicines management, recruitment, premises suitability, and governance. The service remains Requires Improvement for Effective due to ongoing gaps in dementia environment adaptations and incomplete mental capacity assessments for certain interventions.
Concerns (4)
moderate
Consent / capacity
: “We identified one person who had bed rails in place, however there was not a documented mental capacity assessment in relation to this.”
minorCare planning: “One person who was found to be at risk of pressure sores did not have a risk assessment in place.”
minorRecord keeping: “Unique referencing and manager sign off had not always been recorded as per the providers form.”
minorOther: “The registered manager was aware further signage and other improvements are required in order to best support people's orientation around the home.”
Strengths
· Infection prevention and control guidance was followed effectively, with people reporting they felt safe living at the service.
· Medicines management significantly improved; controlled drugs stored securely, PRN protocols in place, and daily stock checks completed.
· Staff recruitment processes were thorough, with all necessary evidence including employment history and DBS checks in place.
· Care plans were person-centred, reviewed monthly, and included input from relevant people and professionals.
· Strong positive culture among staff, with open and transparent management and an open-door policy.
Quality-Statement breakdown (25)
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Learning lessons when things go wrongGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
effective: Adapting service, design, decoration to meet people's needsRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood