Right at Home Bedford

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People’s care plans were not always reflective of their needs and preferences. However, people and relatives felt staff were kind and caring. Staff told us they felt supported.

This service scored 60 (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 told us the staff were kind and caring. A relative said, "I have found all the staff very pleasant, helpful, and most importantly, caring." A person said, "They are very nice and polite and treat you the way you would expect."

Staff spoke kindly and respectfully about people. For example, a staff member told us they loved their job, were grateful for all the people they supported being in their lives and that the people they cared for made their days better.

Most people and relatives we spoke with told us they had not seen their care plan. This increased the risk of care plans not always being reflective of people’s needs and preferences. However, overall, people and relatives felt staff knew people well. For example, a person said, "I haven't seen a care plan, but they know exactly what to do, and it fits my routine well."

The provider acknowledged people's feedback about not having up-to-date copies of their care plans and told us they would improve this. In addition to training more staff to support the development of care plans, the provider told us they would ensure care plans were shared with people as soon as they had been reviewed and updated. We will check for improvement at our next assessment. However, A staff member gave us an example of how they ensured people were treated as individuals; they told us they had put picture cards in place for a person who found speaking difficult and used this to support them with their shopping. A staff member told us that as part of their role, they supported people with their care needs to avoid social isolation and help people pursue their hobbies.

People not having copies of their care plan meant the provider had not worked in line with their person-centred care policies, and improvement was needed. However, we found care plans contained information about people's past lives, experiences and hobbies, which promoted people being treated as individuals.

We received varied feedback regarding how well people's independence, choice, and control were supported. For instance, one relative mentioned the importance of cultural considerations in how the staff assisted their loved one with their hygiene and their preference for the gender of the assisting staff, but this had not been documented in the care plan. Another individual reported that a staff member needed to be more balanced in ensuring their safety and allowing the person to take more positive risks. However, one person expressed that they could request for staff to intervene only when necessary, allowing them to do as much as they could on their own. Additionally, a relative expressed satisfaction with the care provided, especially considering their initial concerns about entrusting their relative to a care agency. They told us they found the staff to be very responsive to both the needs of the care receiver and the family's needs.

Staff feedback about how well people's care plans supported their independence was mixed. For example, one staff member told us care plans were not always current and reflected what people could do for themselves. However, another staff member said, "Care plans have all the information we need, and individuals are supported to make their own decisions." The provider told us they would take action to review people's care plans. We will check for improvements at our next assessment.

The provider had not always effectively operated their person-centred care policy and ensured that person-specific care plans were in place to promote independence. For example, people's care plans did not always state what they could do for themselves and where staff needed support. Where people had more specific needs for participating in planned activities or were known to refuse support with aspects of their care, care plans did not always provide staff with information about how to best meet these needs.

We had mixed feedback from people and relatives on how often the provider sought feedback to ensure they were happy with their care arrangements. For example, two relatives told us they had only been asked to complete a survey at the time of our assessment and not prior to that, whilst another relative told us the provider had carried out more regular reviews and sought feedback verbally and more formally.

We gave feedback to the provider about not all people and relatives feeling they had been asked for feedback until the time of our assessment. The provider told us that our assessment activity had coincided with their annual surveys. However, there was no evidence from a previous survey for us to review. We will seek feedback from people and relatives in this area again at our next assessment.

Staff overall felt supported by the provider. For example, a staff member told us they felt they would get a quick response if they had to raise concerns. A manager told us that although they felt that the office staff were overstretched, they felt “100% supported”, The provider too felt a lack of management staff had a negative impact on service delivery, however, they told us they were actively trying to recruit. The provider told us they arranged regular meetings with staff and showed their appreciation to staff by providing food and refreshments during these meetings.

The provider had not always assessed health risks to staff. For example, we identified a person who smoked when staff arrived to deliver care. However, there were no risk assessments in place around this. The provider acted on our feedback and introduced guidance in the person's care plan in line with their policy to manage these risks. The provider had appropriate policies in place that covered staff training, induction, and ongoing support.