Bridge House (Somerset)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Processes were in place to ensure risks associated with closed cultures were identified and mitigated, and lessons were learnt to continually identify and embed good practice. There was an open and honest culture within the team, with channels to ensure clear communication. Accidents, incidents, or safeguarding concerns were reviewed, with learning shared at team meetings. Learning scenarios were completed by the team to promote learning. One member of staff told us, “We figure it out, what went wrong, look at what could be changed, what happened, why it happened, it’s all shared in team meetings.”

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. Relatives commented on the reduction in incidents their loved ones experienced since living at the home.

There was a commitment to minimising the use of restrictive interventions. The registered manager gave examples of how restrictions had been reduced. Appropriate processes were followed where it was deemed necessary to use restrictive physical intervention. This had been agreed by professionals and staff described how it was used as a last resort, for the minimum time. One staff member told us, “We always aim for the least restrictive option, we think about what we would want.” Documentation was completed when a restrictive intervention was used. Appropriate applications were completed to authorise a person being deprived of their liberty.

People had risk assessments and care plans in place to guide staff. However, we found 1 example of a person who had a SALT (Speech and language therapist) eating plan in place, a corresponding choking risk assessment had not been completed. Another person had been involved in an incident in a vehicle, and a corresponding risk assessment had not been completed. We did not find these shortfalls had impacted on people's care as staff knew people well, and the concerns identified were rectified during the assessment.

Risk assessments were in place for areas such as specific health conditions, mobility, personal care and Personal Emergency Evacuation Plans (PEEPS). Care plans and risk assessments were in the process of being transferred over to an electronic care planning system. All care plans and risk assessments were being reviewed as part of this process.

The service supported people to engage in positive risk taking and provided many examples of this.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service made sure there were enough qualified, skilled and experienced staff. They worked together well to provide safe care that met people’s individual needs.

There was a training programme in place. Staff had received training in areas such as, first aid awareness, medication management, infection prevention and control, fire awareness, training on people with a learning disability and autism and safeguarding.

Staff received additional training to meet people’s needs such as diabetes, epilepsy and catheter care. A relative told us about their loved one’s health condition and commented, “The staff have been well trained to handle it.”

Staff told us there were enough staff available to meet people’s needs. One staff member told us, “Staffing levels are ok, they are a nice team, everyone is lovely.” There were systems in place to ensure there were enough staff available to meet people’s needs and safe systems were in place to recruit staff.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Generally, medicines were managed safely, and people received them in the way prescribed. Where people were prescribed medicines on a ‘when required’ basis, there was not always a protocol in place informing staff of when to administer the medicines. Medicines risk assessment had not always been recently reviewed and risk assessments for paraffin based creams and the risk of fire had not always been completed. We discussed the medicines concerns with the deputy manager who told us they would address them.

Medicines were stored safely and securely. There was a robust process in place for training for new staff and a signing-off process for medication administration in addition to annual competencies. There were regular audits of people’s medicines.