Beda Homecare Ltd trading as Home Instead Bedford

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

People, relatives and staff all told us the service was caring, supportive, and distinctive. People said the staff went the ‘extra mile’ to make sure they received the care they needed and wanted. The service played an active role in the local community to benefit people who used the service and beyond. There were effective systems in place to monitor and improve people’s quality of care and continue to develop the service. Staff worked in partnership with other services to meet people’s holistic needs. The provider had an exceptionally effective audit and governance system in place to provide oversight of service quality. Action was taken promptly where required to improve the quality and safety of the service. Staff felt extremely well supported in their role and there was a positive culture at all levels.

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

The staff training, supervision and support systems fully enabled staff to progress within their roles, and to achieve their full potential. There was a shared commitment to all staff working cohesively with 1 shared goal. Staff had an excellent understanding of the provider’s values and the vision of the organisation. The provider’s stated aim was ‘to empower older people to live their best lives by providing exceptional care and support. We are dedicated to fostering well-being, independence, and happiness through care that is respectful, compassionate, safe and built on trust’ and staff were well aware of the providers values. A staff member told us, “[Provider] is more than an employer, they make time to get to know the staff and always has time for us. They are always supportive and care about us. We continually are rewarded and recognised for our work.” Another member of staff commented, “I feel the culture of Home Instead is caring, compassionate, and very friendly, also trustworthy. We want to provide the highest quality of care to everyone with dignity and respect. We are trained in a way to go above and beyond for our clients. We are all caring and passionate about our jobs and clients. I feel we work as a team which I feel makes us the best.” Another staff member told us, “I believe Home Instead vision is to provide excellent personalised care to the local community, so they can lead fulfilled lives in safe and familiar surroundings. Home Instead do this by trying to match staff with clients based on personality and interests, by allowing a good amount of time for each visit so it isn’t rushed, and by giving care professionals regular visits with the same clients so they can build a rapport and get to know their needs and preferences.”

The service had effective systems in place to ensure everybody understood and promoted the service’s vision, values and strategic goals. Minutes from meetings, showed that discussions had been held in respect of dignity, respect, human rights, inclusiveness, equality and non-discrimination. We saw these areas were continually monitored and there were effective processes in place to address any issues or shortfalls, quickly and appropriately. Staff recruitment focused on ensuring staff demonstrated empathy, a person-centred approach and values fitting for their roles. The managers set out clear professional boundaries and expectations for staff and reinforced these through training, supervision and quality monitoring.

Leadership was visible, the provider, registered manager, and the support staff team were experienced and working towards a common goal to provide exceptional quality care. Staff were complimentary about the management of the service and said the management team were exceptionally kind, caring and compassionate. One staff member said, “We're always encouraged to be our best-selves and improve our skill sets. Anyone in the office would be happy to listen to any new ideas to further improve the service and the team meetings are a great platform for sharing our enthusiasm.” Another member of staff told us, “I feel 100% supported by management and the leadership is excellent. I absolutely feel valued and listened to and know everything I do is extremely appreciated.”

The provider actively promoted and enabled staff to deliver exceptional care, spend quality time with people, take their own initiative to benefit individuals and be compassionate care givers. We saw evidence that the provider created opportunities outside of their contractual obligations to support people's wellbeing. For example, they organised parties and events for people they supported n the staff team. This demonstrated the providers commitment to ensure staff and people were supported holistically. Staff knew how to raise concerns and access support and there were relevant procedures in place. Staff had various meetings and communications to keep them updated, and ensured they felt included. Everyone told us they were confident in the management of the service and that it was exceptionally well-led. The management team were knowledgeable about people’s individual care needs, the running of the service and their priorities for maintaining care quality and developing the service. The provider was committed to continually motivating the staff team and recognising their commitment to their role. For example, staff had time off for religious celebrations and the different religious holidays were included in the weekly newsletters to raise awareness with the wider team and to show support.

The management team promoted an open and transparent culture. They encouraged staff to raise issues and concerns so these could be known and addressed. Staff were confident they could always speak to senior managers when they needed to and felt listened to and supported. One staff member said, “If I felt something wasn't right, I would speak up. We are encouraged to keep the office informed of anything that doesn't seem right as we are the ones in the field delivering the care. The overall culture is honest, fair, open and transparent.” Another member of staff commented, “I always speak up if I believe something isn’t right; be it another care professional or a client and I know it will be dealt with, respectfully.”

The provider had appropriate policies and procedures in place to support and promote staff raising issues. The registered manager investigated concerns in a sensitive and timely manner. They identified and acted on lessons from these to continue to improve the service. The management team encouraged feedback on a frequent basis from the staff team.

The service worked towards an inclusive and fair culture by improving equality and equity for staff. They embraced and valued staff differences, such as those related to gender, race, ethnicity, age, disability and professional backgrounds. For example, staff members from diverse backgrounds felt valued and respected because the provider had implemented strategies that promoted cultural diversity and understanding. Staff gave us examples of how they were valued and supported and their achievements celebrated. For example, 1 staff member informed us, “I was nominated by the office team for the Home Instead national care professional of the year award, for the care of my client. I also received a beautiful testimony from the specialist nurse which I was really touched by because I felt I was just doing my job, but they saw this to be so much more.” Without exception, staff told us they were fully supported by the registered manager and provider. A staff member said, “‘The culture is caring and compassionate and we are all treated equally.” Another member of staff commented, “We care about what we do and are passionate about getting it right for our clients as well as our company.” We received feedback from an employment specialist who supported people with a mental health diagnosis to seek paid employment. They told us, “From my first contact with Home Instead l found them approachable. They were keen to hear more of what we do and how they could offer a working opportunity to a person with a mental health diagnosis. We have been offered pre-application informal meetings, opportunities to sit with people in their interview as the staff have demonstrated supportive care and understanding of mental health and will not exclude a person because of this. They look at a way of maintaining an inclusive approach, so none are discriminated against.”

Staff completed surveys so they could give their views, and staff were also able to send feedback via the care app on their mobile phone. Feedback from staff was listened to and acted on and we saw the provider completed a ‘you said we did’ chart that described the actions the provider had taken following feedback from staff. For example, staff had wanted more personal development and career progression within the organisation. The provider had reviewed the Personal Development Plan (PDP) process and put more focus on development goals. Specialist courses had been introduced using the NHS Nurse to give staff more expert knowledge of various conditions. We saw from the minutes of the staff meetings they were fully informed of what was happening in the service and any incidents were shared for lessons learnt. The provider encouraged an open-door policy where staff could feel comfortable sharing concerns and suggestions with leaders. There were recognition programs that celebrated positive behaviours, compassionate care, and teamwork. The service had an equality, diversity and human rights policy in place looking to ensure employees and people using the service were not discriminated against.

People and their relatives were exceptionally complimentary about the leadership of the service. They were confident in the quality of the service and knew who the management staff were and who to contact should they need to. Staff told us the service maintained very high care standards and that people were very well looked after. One staff member told us, “The care we provide is always checked, double checked and monitored to make sure we get it right so that people always get the best care.” We received feedback from a health professional who stated, “They have been very responsive and are keen to learn about each individual and their condition. They have sourced their own external training to benefit our patients, such as Papworth, to be taught how to use a cough assist machine. They get to know their patients well and attend all important care reviews and are able to contribute and bring useful information.”

The service had robust quality assurance and quality monitoring systems in place, using outcome-based audits and welcoming feedback from everybody involved with the service. For example, monitoring of care notes, feedback from people, medication, call delivery, incidents, and safeguarding. The provider collated this evidence monthly as an office team to analyse. We saw there were actions plans in place to address any areas that needed further improvements, and we saw actions were taken swiftly. Best practice was shared throughout the team, identifying what had worked well for each person, or what had not worked well. Every quarter the provider held a governance meeting to examine the results, and this was used to drive any actions that they may take to improve the service. There was a strong emphasis to continually strive to improve and implement innovative systems in order to provide a high-quality service. For example, the provider had sourced a train the trainer qualifications in using cough assist and NIPPY machine (a machine helps people breathe) alongside specialist training via Papworth Hospital to upskill the team to be able to deliver support to a person who was living with a debilitating condition and wanted to stay at home.

There were strong links with the local community and the service worked in partnership with key other agencies. For example, the registered manager informed us that they had trained 2 staff members to be able to deliver the ‘Love 2 Move’ armchair exercise. They delivered free sessions at the local TIBBS dementia foundation and also at the local Multiple sclerosis (MS) therapy centre. One person said, “Having them has changed my life. They will take me out to Dementia groups, medical appointments and to church. It’s really important and makes a huge difference.”

We saw numerous examples of collaborations between the service and other agencies. For example, with local fire stations, Dementia Friends talks, volunteering at Carers Dementia Triage, health care talks at local colleges, advice hubs on local markets and they also sponsored Bedfordshire cricket club. The registered manager informed us that 2 staff had been trained by a nail cutting training provider so they could offer nail care services to people. The provider was committed to promoting a person-centred ethos for the people it supported. They wanted to ensure that people could develop social, communication and life skills and to make their own life choices. They were supportive of other services and involved in networking to promote best practice and share initiatives. The registered manager had been asked to write a blog for skills for care to share their journey into delivering delegated heath care tasks and was in a steering group who were trying to roll out delegated health care in domiciliary care. Future plans included establishing family support hubs, exercise classes for people affected by dementia, recipe books to open up dialogue on different cultures, supporting women at Bedford Women’s Centre and school community initiatives.

We received overwhelmingly positive feedback from the health and social care professionals who worked with the service. One said, “The care team are always quick to liaise with myself if they need any advice/support or additional training and ensure that their skills and knowledge are both up to date and correct. We have a rolling training programme in place so if new carers start the team will contact me to arrange a training session.” Another told us, “I completed a home visit with 2 of the Home Instead dedicated carers for 1 of my palliative patients earlier this year. The carers had identified a gap in their knowledge and had asked me to provide some training in the use of a suction machine to ensure they could confidently and competently meet the patient’s needs. I found the team to be extremely responsive to the patients changing needs and had a fantastic rapport with both patient and their informal carers. The carers were immediately responsive to the patient’s needs, responding to them independently throughout my teaching session.”

The service was transparent, collaborative, and worked in partnership with key organisations to support care provision, service development and joined-up care. There were excellent avenues of communication with other health professionals such as the occupational therapist, district nurses, Tibbs dementia foundation, social workers and the palliative care team. One person has night care support from another care provider and Home Instead staff attended joint reviews and communicated about changes to care and did a handover at the beginning of each change of staff. The management team worked alongside the specialist nurse teams supporting people with complex care needs at home. Staff also attended Multi Disciplinary Team (MDT) meetings and accessed training in people’s homes delivered by the specialist nurses. Staff shared feedback on people who were navigating the memory assessment process, liaising with the dementia specialist nurses who were trialing medication doses.

The registered manager told us they closely reviewed and monitored all accidents and incidents. Records showed timely action was taken to reduce the likelihood of repeat incidents to ensure people received safe care. There was a particularly strong emphasis on continuous improvement and finding new ways to improve the care people received. The management team encouraged staff to suggest ideas for improvement and innovation and spent time listening to them. One staff member told us, “We are always asked for our opinions, ideas and thoughts. If you have an idea they listen and take it on board.” For example, a staff member had asked for long cuff latex gloves as clothing was getting wet when supporting people to shower and these had been purchased. The service recognised and celebrated when staff made extra efforts to provide special care and shared this for others to follow. For example, the provider had introduced the ‘Star of the month’ initiative to celebrate staff outstanding practice. We saw feedback to the registered manager who was part of a peer-to-peer support group for Home Instead managers. It read, “Your willingness to share your extensive expertise, coupled with your ability to provide thoughtful and practical solutions to challenges, sets a great example of collaboration and mutual support. Your proactive approach to sharing best practices, staying ahead of regulatory updates, and presenting innovative ideas, such as the Whzan box to lower hospital admissions enhances the way we support our clients and reflects your ongoing commitment to drive excellence. Your contributions directly align with our mission to enhance the lives of ageing adults and their families and to pioneer greater professionalism within care work, ensuring every client receives the highest quality support.”

There were robust and effective systems in place to support learning, innovation and improvement across the service. The service invested in staff training, development and qualifications to build on their capabilities. The registered manager produced regular staff newsletters and used these to keep staff informed about any service developments, promote good practices and to praise their performance. The management team were highly committed to improving the service they provided and had introduced a number of initiatives to help make improvements. These included introducing the use of The Whzan Blue Box which is a portable digital health device that helps care professionals remotely monitor people’s health. The registered manager told us that since they had commenced using The Whzan box, it had reduced respite care home admissions and hospital admissions by 10%. The staff also used the box for any post-fall situations to provide better information to the paramedics and 111 to help them decide if the person could stay at home and not be admitted to hospital. The registered manager also told us about other initiatives introduced to help support people and improve their quality of life. For example, they were in the process of placing robotic pets in the homes of some people living with dementia to offer them companionship and support. The service took part in a trial to offer sensors to people who wanted to try them. The sensors track movement in the home and resulted in additional care being identified for 2 people. Service improvement plans were in place to make sure the service continually improved in line with best practice. It was inspiring to see how the service was supporting people to live their best lives, and the outcomes people had achieved thanks to the management and staff teams’ dedication to continuous improvement and innovation.