Bedford Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Care plans were largely detailed and explained how people wanted to be supported, though some contained inconsistent or contradictory information. We identified some gaps in monitoring charts, used to document completion of personal care tasks, repositioning and that regular checks of people had been completed. Further work was needed to ensure information was provided or displayed in a way which all people could understand. However, we noted some positive examples of this, especially in people’s communication care plans. The provider sought people and relatives views about the care and support provided. Meetings were held every 3 months and surveys circulated each year.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives provide mixed feedback when asked if they had been involved in the care planning process. Comments included, “I’ve no idea what [a care plan] is”, I know of them [care plans], but don’t know if I have one”, “We have had input and discussions about what [relative] can and can’t do and their ongoing needs” and “Yes, I helped to do all that [care planning].”

We reviewed 9 people’s care plans. Overall, we found these were detailed, with some good information for staff on how to provide care and meet people’s needs. However, we did identify some issues across those reviewed, such as inconsistent or contradictory information and the wrong use of gender and/or people’s names, for example using he or him, when the person was female, or referring to a person by their surname instead of their first name.

In regard to inconsistent and contradictory information, examples included in one person’s care plan their emergency evacuation plan stated they required the assistance of 1 staff member, whereas all other documentation stated they needed the assistance of 2 staff. This person’s next of kin was listed as their daughter in one section and their granddaughter in another. Another person’s repositioning needs within their care plan were listed as being 1 hourly on some documents and 2 hourly on others. For a 3rd person, their care plan stated they ate independently. Observations of this person during the assessment process, showed the required ongoing prompting and support to eat. Each person’s care plan contained an ‘about me’ document, where person centred information such as background, life and work history, likes and dislikes and what was important to that person was documented. We found the completion of this document to be variable. Some were very detailed, others contained scant information. However, this had been identified by the provider. We identified a number of gaps in monitoring charts. These include repositioning charts, oral and personal hygiene charts and ‘check ok’ charts, used to confirm staff had checked people’s wellbeing at regular intervals. For example, one person required 2 hourly repositioning. As such, there should be 12 entries per day on their repositioning chart. We looked at records between the 4 and 9 July 2024 and found only 6 or 7 per day had been recorded. The frequency of repositioning ranged from between 2 and 8 hours. This person’s skin remained intact, which suggested this was a record keeping issue. This same person’s oral care chart only contained 4 entries between the 1 and 10 July 2024. As a result of the inconsistent record keeping, we were unable to confirm people’s needs had been consistently provided in line with their care plan.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

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

People and relatives views were sought through meetings and questionnaires. The provider shared meeting minutes and survey results with us. Meetings were held quarterly, with surveys circulated annually. Although we saw evidence they had occurred, none of the people and only 4 of the 9 relatives we spoke with could remember attending meetings or completing any questionnaires. Relatives did confirm staff communicated with them when they visited, and involved them in their relatives care. The home created and circulated a quarterly newsletter, which included information about any activities and events completed, along with short biographies about selected staff and people living at the home. People and relatives told us they would speak to either a staff member or management if they had any concerns or complaints. Comments included, “I have had cause to raise some concerns and I spoke to the manager. It was dealt with promptly and followed up as well” and “I would speak to the person in the office”. Three sets of relatives stated they had raised some concerns with staff but had yet to receive any response. The concerns were related to oral hygiene, hair dressing and the laundry. From reviewing the provider’s complaints system, we noted these issues had not been escalated to management, which we fed back as part of the assessment process.

The provider also sought the views of staff via an annual survey. The last one had been circulated in October 2023. The survey covered a range of questions including whether staff were proud to work for Advinia, if management keep them informed, if they were provided with training and supervision and felt supported and listened to. For each question, staff had to choose ‘agree’, ‘neither agree or disagree’ or ‘disagree’. Overall responses were positive, with 80% either being ‘agree’, or ‘neither agree/disagree’. The main issues identified related to the validation of staff and career development. We saw an action plan had been put in place to address any areas of concern.

The home had links with a local advocacy service, with information about this displayed within the home. This information was in an easy read style, to ensure it was accessible to as many people as possible.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People and relatives provided mixed feedback when asked if information was provided in a way they could understand. One person told us they would ask if unsure or didn’t understand something, another said they didn’t tend to receive much information and hadn’t noticed the information posters on the wall. We looked at information displayed within the home, such as the complaints process and information about safeguarding, as well as observing staff practice, to check if the provider was meeting the Accessible Information Standard (AIS). The AIS tells organisations what they have to do to help ensure people with a disability or sensory loss get information in a way they can understand it. It also says that people should get the support they need in relation to communication. An ’easy read’ complaints poster had been created. However, this contained limited visual imagery, but the font size had been increased. As such, it was accessible for people with a visual impairment, but less so for those with a cognitive impairment. On units which catered for people living with dementia, rather than use picture menu’s which most people would be able to understand, we noted menus were handwritten and not easy to read.

We observed staff interacting with a person with a hearing impairment. Although staff explained what they intended to do, before commencing any care tasks, the person had difficulty hearing them and expressed this. However, no alternative communication methods were used to ensure the person understood what was going to happen. We also found no clear communication guidance for staff to follow, to help when supporting this person. For a person for whom English was not their first language, their care plan contained some good information for staff to support communication, for example using closed questions, which the person was able to answer with one word responses. Their care plan also referred to family involvement with communication and the use of an interpreter if required. We did note this person’s care plan contained limited information relating to culture or heritage or what was important to the person.

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