Newbridge House

We found the following examples of good practice.

¿ Visitors to the home had their temperatures taken prior to entering the home and sanitised their hands. Personal protective equipment was available for visitors to use.

¿ Measures were being put into place to re-introduce visits as soon as practicably possible. Whilst visiting had been restricted the provider had ensured people continued to have contact with their family members through garden visits using a visiting pod, social media, video and telephone calls. The management team had maintained regular contact with relatives to keep them informed about the wellbeing of their family member.

¿ Arrangements had been introduced for staff to appropriately social distance as much as possible, during breaks and they used an area of the home to change their clothes and store personal belongings safely before entering the home.

¿ People who had tested positive for Covid-19 self-isolated in line with current guidance.

¿ Staff were supported by the management team through periods of anxiety with regular phone calls to check on their wellbeing.

¿ Clinical waste and laundry were handled in line with government guidance.

Newbridge House is a ‘care home’ without nursing and is registered to provide accommodation and support for 30 people. At the time of our inspection, there were 27 people living at the service. People living at Newbridge House were older people, some of which were living with dementia.

People’s experience of using this service:

People were happy living at Newbridge House, felt safe and enjoyed their lives there. They received personalised care and support which met their needs and preferences. Each person had a care plan which included the information required.

People received care, support and empathy from staff. This was particularly good when people were at the end of their lives. The service ensured people received the care and support they wished for. Relatives praised the care, understanding and support given to family members. They spoke of staff having compassion, love, kindness and empathy.

Risks to people’s health, safety and well-being were assessed and acted upon. Accidents and incidents were analysed to identify any patterns or trends. People were protected from potential abuse by staff who had received training and knew how to raise concerns.

Where specialist advice was sought, the service contacted the appropriate professionals.

People received their prescribed medicines safely and enjoyed a variety of meals offered. The building had been adapted in places to make life easier for people living with dementia.

Staff were safely recruited which ensured they were suitable to work with vulnerable people. Staff undertook training and supervision in their roles to care for people properly. Staff were motivated in their roles and enjoyed their jobs. They felt listened to and that their opinions mattered. They worked together to give positive outcomes to the people they were looking after.

People were supported by kind and caring staff who worked hard to promote independence and a sense of well-being. Positive and trusting relationships had been built up and staff knew people and their families well. People were treated with privacy and dignity and spoken to in a respectful way. The service ensured people were not discriminated against and promoted equality and diversity.

There was strong leadership at the service and a ‘family feel’ atmosphere. The registered manager was respected and well thought of by staff. There was an open and positive culture where people and staff could raise any issues or concerns. The service had received many positive compliments on the care people had received.

There were effective quality assurance systems in place to assess, monitor and improve the quality of the service provided. People, relatives and professionals’ views were regularly sought and acted upon.

Rating at last inspection:

At the last inspection on 20 September 2016 the service was rated good in all areas and as an overall rating.

Why we inspected:

This was a planned comprehensive inspection based on the last report rating.

Follow up:

We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Newbridge House is registered to provide accommodation for up to 30 people with dementia who require personal care and support. On the day of the inspection there were 29 people living at the home. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe and relatives told us they were reassured that their families members were protected from harm. Staff were knowledgeable about how to identify and report the risk of potential abuse. Staff were available to support people when needed and were calm in their approach. People were kept safe by staff who supported them to manage risks. People told us they received their medicines at the right time and could ask for pain relieving medicines when required.

People and relatives told us they felt staff had the skills and knowledge to meet their care and support needs. Staff received training relevant to their role and felt supported by the registered manager. People were asked for the consent before care was provided and staff understood the importance of acting in people’s best interests. People were happy with the food and drink provided and had access to healthcare when required.

People felt staff were friendly and supported them in a caring way. People were involved in decision about their care and support and staff knew people and their personal preferences well. People were supported by staff in a way that maintained their privacy and dignity and staff promoted people’s independence where possible.

People and their relatives contributed to the planning of their care and support. Where people’s needs changed staff were able to identify this and action was taken to ensure people received up to date care. A programme of activities was available and people were encouraged to follow their interests. People knew who to contact if they were unhappy about any aspect of the care and support. There was system in place to manage complaints which staff were aware of.

People told us they were happy living at the home and felt able to express their views about the care they received. Relatives and healthcare professionals had been invited to give feedback about their experiences of the home. Staff felt the home was well managed and were supported by the registered manager. The provider was involved in the management of the home and there were systems in place to monitor the quality of care provided.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. We used the evidence we collected during our inspection to answer the five questions.

Is the service safe?

From our observations and the information we saw set out in care plans, policies, procedures and audits the provider's safety monitoring systems were robust. The staff showed that they had a clear understanding of their role in providing care and in safeguarding the people they supported. The staff demonstrated that they knew the people well and worked to provide the best possible level of care and support.

We saw evidence that when people lacked the capacity to make decisions on important areas of their lives, best interests, safeguarding and deprivation of liberty discussions had taken place.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The registered manager told us there was no current deprivation of liberty safeguards orders in place. They showed us the work they were undertaking in the light of the new legislation. They told us about the meeting they attended to ensure their information and knowledge was kept up to date.

The staff rotas showed that the management had taken people's care needs into account when making decisions about the number of staff required, the skills and experience staff would need. The night time staffing levels and on call system showed that the provider had taken steps to ensure the staffing provision was safe out of main hours.

There were systems in place to ensure management and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This meant that people were benefiting from a service that was taking on board lessons learnt.

We saw that the provider had made considerable improvements to the record keeping systems. Staff had been retrained and constant monitoring of compliance was in place. All records were kept and stored securely.

Is the service effective?

People's care needs had been assessed and detailed care plans were in place. There was evidence that people and their families were involved in the assessments of their needs and care plan reviews as much as possible.

The staff we spoke with told us how people were encouraged and enabled to maintain their skills and abilities. People we spoke with told us that the staff really cared for them and they said that they enjoyed living at Newbridge House.

All care, activity plans and risk assessment were reviewed regularly. We saw evidence in care plans and found from talking with people who used the service and their relatives, that the care provided was constantly adapted to meet people's needs.

We saw evidence that people were supported by a wide range of health and social care professional. This meant their health and welfare needs were being met.

Is the service caring?

The people we spoke to who lived at the home told us they were very happy there. One person said: "The staff all go out of their way to help us, coming here was the best thing that has happened to me." Another person said: "All the staff look after me ever so well, and the food is brilliant.'

The staff we spoke with told us they were committed to provide a good caring service to support and look after the people so they could have a good life. They demonstrated that they were aware of potential risks, people's rights and their responsibilities. Staff showed people respect and maintained people's dignity at all times.

Is the service responsive?

We found that care plans were person centred and contained detailed information about people's choices and preferences. We saw in the notes we looked at by the registered manager, how important it was to get to know people and learn about their little idiosyncrasies. We saw that people's health and support plans were regularly updated to reflect people's changing needs.

There was evidence of regular support provided from external social care and health professionals when needed. This meant that people's health and welfare was regularly reviewed and monitored.

The staff and people who lived at Newbridge House said that if they had any concerns, they could always talk with the manager, they would always listen and address anything they raised.

The staff said they received regular training which was very good and equipped them with the knowledge to meet people's support needs.

Is the service well-led?

Newbridge House had a clear management structure in place. The registered manager, deputy manager and the staff we spoke with were knowledgeable about the people who used the service, changes to legislation and developments in care provision.

The people we spoke and the staff told us that the senior staff were always around to give advice and support. There were systems in place to provide feedback to staff about changes and developments.

All the staff we spoke with said they understood their responsibilities around safeguarding people's welfare. They all said that if they witnessed poor practice they would report their concerns. They had worked with the people who lived at the home for some time and really enjoyed their work. They told us there was a good team spirit and everyone pulled together and helped one another. They said that they felt they were supported and involved in the development of the service.

At the time of our inspection 30 people lived at Newbridge House. During our inspection we spoke with seven people who lived there, two relatives and eight staff.

Everyone we spoke with was complimentary about the overall service, the care provided and the staff. One person who lived there said, 'It is a very good place. We are well looked after'. A relative told us, 'It is very good here. I have no concerns with the care or the staff. They are well looked after'. All staff we spoke with told us that they enjoyed their work and that they felt that the people who lived there were well looked after and were safe.

During the time we spent with people, we saw that staff treated them with respect and dignity. All people we spoke with told us that choices were offered and their views had been taken into consideration. We saw that people's needs had been assessed by a range of health professionals including specialist doctors and district nurses. This meant that staff had enabled people to have their health care and safety needs monitored and met.

People had been provided with varied food and drink options to prevent malnutrition and dehydration. One person who lived there said, 'The food is really lovely. I never leave anything it is so good'.

We found that staff were provided with guidance and support to meet people's needs and to keep them safe. One person who lived there said, 'The staff are all very good. They know what they need to do'. A relative said, 'The staff are excellent'.

We saw that complaints processes were in place for people who lived there or their relatives to use if they were not happy with the service provided.

Inconsistencies and gaps in record keeping meant that people may not be protected from the risks of unsafe or inappropriate care.

People we spoke with told us they were involved and consented to the service they received. They told us they were happy with the service.

Records showed that the care staff delivered was person centred. One person said, 'Staff know what my needs are and I like it here'.

People told us they felt safe living in the home. Records showed that safeguarding procedures were in place and staff knew how to keep people safe and how to report any harm.

Staff we spoke with told us they were supported by managers and received training, supervision, appraisals and attended staff meetings. One relative said, 'Staff are very kind and friendly'.

Records showed that the provider completes audits as part of monitoring service quality. People who use the service were able to share their views, which led to changes by the provider.