Archived: Bedford Care Home

Updated 6 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The unannounced inspection took place on 17 May 2016. The inspection team consisted of three adult social care inspectors from the Care Quality Commission (CQC), and four specialist advisors (SPA), two of whom were pharmacists, one specialised in falls management and one in auditing and clinical governance.

Before this inspection we reviewed the previous inspection report and notifications that we had received from the service. We also made contact with the local authority commissioners of service to ascertain their views of the home. Prior to our inspection we were provided with a provider information return (PIR); this is a document that asked the provider to give us key information about the service, what the service does well and what they improvements they are planning to make.

During the inspection we observed care delivery within the home. We spoke with six people who used the service, two relatives 17 members of staff and two professional visitors. We looked at 14 care files, six staff files, medication records, audits, meeting minutes, the training matrix and other records kept by the service.

Updated 6 July 2016

The unannounced inspection took place on 17 May 2016. The last inspection, which was a focused inspection, was undertaken on 30 December 2015. At this inspection we found there had been breaches of four regulations of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to staffing, safe management of medicines, assessing and mitigating risks to people using the service, need for consent, safeguarding and depriving people of their liberty without lawful authority. We found during this inspection that improvements had been made to meet the relevant regulations.

Bedford Nursing and Residential Home is a large care home with 180 beds that is operated by BUPA. The home is divided into six different units, each with 30 beds. Astley and Lilford care for people who require personal care and support, Croft and Kenyon look after people with mainly physical nursing needs and Pennington and Beech care for people with dementia care nursing needs. The home is situated in a residential part of Leigh that is not far from the town centre.

There was a manager at the home who was in the process of registering with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission 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.

At the inspection we found a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This breach related to safe administration of medicines.

Despite significant improvements in the area of medicines there were still some inconsistencies across the units and some issues with administration and disposal of medicines.

Appropriate safeguarding policies and procedures were in place at the home and staff were aware of the reporting procedures and signs to look for. Staff were aware of the whistle blowing policy and felt confident to report any poor practice they may witness.

Staffing levels at the home had improved, due to a significant reduction in reliance on agency staff as a result of recruitment of permanent staff.

Staff were recruited safely via a robust recruitment procedure. Staff induction was thorough and training was on-going for all staff. Supervisions had not taken place for some time, but plans were in place to implement a programme of supervisions and appraisals.

Appropriate risk assessments were in place and falls management had improved considerably. Health and safety measures were in place at the home.

People were given a choice of food and staff were aware of people’s preferences and particular dietary requirements.

Care plans were person-centred and included relevant health and personal information. Reviews of care were undertaken regularly and records were complete and up to date.

The service had made some efforts to make the environment suitable for people living with dementia or some level of confusion. However, the environment would benefit from being more dementia friendly.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).

People we spoke with told us staff were caring and kind. We observed that staff responded quickly to people’s needs, gave explanations of what they were doing and were reassuring.

Efforts were made to include people who used the service and their relatives in reviews of care.

Staff were beginning to undertake training in end of life care to allow people to spend their last days in the place of their choosing.

There were some activities on offer and plans in place to increase the number and relevance of activities in the near future.

Care plans included a lot of individual, personal information to assist staff to care for people appropriately.

There was an appropriate complaints policy in place and complaints were responded to in a timely way.

Staff support had improved with the new acting manager now in post. Plans were in place to ensure all staff were supported with regular supervisions and team meetings.

Quality audits were now taking place although there was still some room for improvement in collecting meaningful data.

Areas such as falls and accident monitoring were now being looked at in more depth and incidents of falls with injury had reduced.