Archived: Bedford Care Home

Updated 27 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 17 and 18 March 2017 and was unannounced.

The inspection team consisted of three adult social care inspectors and a medicines inspector from the Care Quality Commission (CQC), a specialist adviser (SPA) who was a Pharmacist and an Expert by Experience. An Expert by Experience is a person who has experience of using or caring for someone who uses health and/or social care services.

Before commencing the inspection we looked at any information we held about the service. This included any notifications that had been received, any complaints, whistleblowing or safeguarding information sent to CQC and the local authority. We also contacted the quality assurance team at Wigan Council.

During the course of the inspection we spoke to the registered manager, the head of care and twenty staff members, which included nurses, house managers and care assistants. We also spoke to seventeen people who lived at the home and six visiting relatives.

We looked around each of the six units within the home and viewed a variety of documentation and records. This included ten staff files, seventeen care plans, Medication Administration Record (MAR) charts, meeting minutes, policies and procedures and audit documentation.

Updated 27 June 2017

We carried out an unannounced inspection of Bedford Care Home on 17 and 18 May 2017. This was the first inspection of Bedford Care Home since it had been re-registered with the Care Quality Commission in January 2017. The re-registration had taken place as a business entity to reflect changes to the providers named responsible people. This did not create any changes to the overall registration of the home.

Bedford Care Home is a large care home with 180 beds operated by Bupa. The home is divided into six different units, each with 30 beds. Astley and Lilford units cater for people who require personal care and support, Croft and Kenyon units look after people with mainly physical nursing needs and Pennington and Beech units care for people with dementia care nursing needs. The home is situated in a residential part of Leigh close to the town centre. At the time of the inspection there were 161 people living at Bedford Care Home.

At the time of the inspection the home had a registered manager. 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.

We found the home to be clean with appropriate infection control processes in place. The home employed 17 housekeepers working across units with detailed cleaning schedules in place. The laundry was housed in a central area separate to the units and had robust systems in place to ensure cross contamination of soiled and clean laundry did not occur. We saw infection control audits were completed regularly and toilets and bathrooms contained appropriate hand hygiene equipment and guidance, with personal protective equipment (PPE) readily available and worn by all staff when necessary.

Each person we spoke with told us they felt safe. Relatives were also satisfied with the safety of their family members, commenting positively on the good standard of care provided. The home had detailed safeguarding policies and procedures in place, with clear instructions on how to report any safeguarding concerns to the local authority. Staff were all trained in safeguarding vulnerable adults and had a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.

We saw the home had systems in place for the safe storage, administration and recording of medicines. The completion of the medication administration record (MAR) was done consistently and the home had effective systems in place for the administering of topical medicines. Staff authorised to administer medicines had completed the necessary training and had their competency assessed. The home carried out a range of medicines audits and monitoring, including a post medicine round review, which involved checking all medicines had been administered and recorded, enough stock was in place, variable dose medicines had been recorded accurately and any handwritten entries followed protocol.

All staff demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We found the home was working within the principles of the MCA and had followed the correct procedures when making DoLS applications. We saw evidence of best interest meetings being facilitated and care plans had been drawn up to reflect any conditions stipulated by the local authority when granting DoLS applications. At the time of our inspection there had been 37 applications made to the local authority.

Staff were complimentary about the training provided by the home, regarding both induction and on-going refresher sessions. A new online system had recently been introduced which allowed staff to complete additional training in their own time. Staff told us they received reminders when refresher training was required to keep their skills and knowledge up to date. The home had links with external professionals and organisations that also provided training in the home, including Wigan and Leigh Hospice.

Staff confirmed they received supervision and team meetings were completed, however we saw there was some discrepancy in regards to the frequency and consistency of both across the six units.

Meal time observations showed these to be a positive experience, with people being supported to eat where they chose. Staff engaged in conversation where appropriate and encouraged people throughout the meal. Support was provided in a sensitive and caring way, with staff assisting people to eat at their own pace. People told us they received enough to eat and drink and were offered a good choice of meal options, with alternatives available. We saw nutritional assessments were in place and special dietary needs catered for. People’s weights had been tracked with referrals made to dieticians as required.

Throughout the inspection we found staff to be caring, attentive, professional and approachable and we saw people were treated with dignity and respect. This was supported by verbal feedback from both people living at the home and their relatives. Staff demonstrated a good knowledge of the people they supported and were mindful of the importance of promoting independence.

We looked at 17 care files which contained accurate and detailed information about the people who used the service and how they wished to be cared for. Each file contained detailed care plans and risk assessments, along with a range of personalised information which helped ensure their needs were being met and the care they received was person centred.

The home employed six activity coordinators, who planned and oversaw the activities completed within the home. We observed a range of different activities being completed during the inspection, although noted differences between the units, with more one to ones being completed on some, which left the rest of the people residing there with little to do during these periods of time. The home documented activities and displayed photographs of the different events that had taken place.

The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Audits were completed on a daily, weekly and monthly basis and covered a wide range of areas including medication, care files, infection control and the overall provision of care. We saw evidence of action plans being implemented to address any issues found. Additionally the provider completed six monthly inspections of the home, providing a detailed report, along with positive feedback and areas for improvement.