17 May 2016
During a routine inspection
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.