Bedford Care Home

Overall, people received safe care from staff who were well trained and received supervision and support in line with the provider’s policy. Feedback from people, relatives and staff regarding staffing levels was mixed. We found the current system being used for determining how many staff should be deployed to meet needs, was not wholly effective and needed to consider this more holistically. The discharge to assess process was not being carried out as effectively as it could be. However, the provider was already aware and taking steps to address this. Risks to people were assessed, with plans in place for how these would be mitigated. Accidents, incidents and complaints were logged and reviewed consistently, with actions documented and learning considered and shared with the wider staff team. The provider had safe systems for appropriate and safe handling of medicines. Where shortfalls were identified during the assessment, staff acted responsively, making the necessary improvements.

People were supported to stay well and access medical professionals as and when required. People received enough to eat and drink, with modified diets, such as soft or pureed meals being provided in line with guidance. Staff documented people’s food and fluid intake, although this was not always done in a timely way.

Staff were described as kind and caring and people said they were treated with dignity and respect. However, our observations showed staff’s interactions with people were largely task orientated, with staff not having the time to provide a more personalised approach. Information about people’s life history, likes, dislikes and interests in their care records was variable in quantity and quality. This had been identified by the provider. People had communication care plans, which explained their needs and preferences. Observations showed these were not always adhered to. Further consideration was needed to ensure the environment on some units was suitable and supported people’s needs and wellbeing. Feedback regarding activity provision was mixed. Although a daily activity schedule was advertised on each unit, these were not being facilitated consistently.

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.

People, relative’s and staff told us the home was well led and they found the current manager to be approachable. Members of the management team were a visible presence across the home and staff felt comfortable speaking up and raising any concerns. A range of audits and governance processes were used to monitor the safety and effectiveness of the care and support provided. Any required actions had been logged and outcomes recorded. The provider also used an overarching improvement plan, to log both internally identified issues and those identified by external stakeholders. Monthly meetings were held to collate and analyse any patterns and trends in accidents, incidents, falls, and other areas. These were used to support learning and drive improvements.