Bedford Care Home

Updated 14 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by three inspectors, a bank inspector, a medicines inspector, a medicine team support officer and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Bedford Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave a short period of notice of the inspection due to the COVID-19 pandemic to ensure we had prior information to promote safety. We announced the inspection on the afternoon of the 27 July 2021 and completed the first day of inspection on the 28 July 2021. Additional site visits were completed on the 29 July 2021, 4 and 5 August 2021 to complete the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and six visiting relatives and friends about their experience of the care provided. We spoke with 22 staff members, which included the registered manager, unit managers, nursing and care staff. We also spoke with a visiting professional.

We reviewed a range of records. This included 15 people’s care records and multiple medication records. We looked at six staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures, audits and training data were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 14 September 2021

Bedford Care Home provides personal and nursing care for up to 180 people. The home is divided into six different units, each with 30 beds. Astley and Lilford units are predominately for people who require personal care and support, Croft and Kenyon for people with mainly physical nursing needs and Pennington and Beech for people with dementia care nursing needs. The home also has designated beds on two of the units for intermediate care. At the time of the inspection only five units were in use, Kenyon unit was closed and had been repurposed to support safe visiting during the pandemic. On the first day of inspection there were 119 people living at Bedford Care Home.

People’s experience of using this service and what we found

People told us they felt safe living at Bedford Care Home. Enough staff were deployed to meet people’s needs, albeit people commented on staff being very busy and not having much time to chat with them. Staff knew how to identify and report any safeguarding concerns. Accidents and incidents had been logged consistently on the provider’s electronic system, with analysis completed to look for patterns and trends to help prevent a reoccurrence. Medicines were being managed safely, by staff who had been trained and their competency assessed. The home was clean with effective infection control processes in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff received sufficient training and support to complete their roles. People’s healthcare needs were being met. Timely referrals to the necessary professionals had been made when any issues or concerns had been noted. People told us they had enough to eat and drink each day, although comments on the quality of the food provided varied. People’s food and fluid intake was documented, as was the provision of personal and oral care, however, this process required strengthening. Some consideration had been made to ensure the environment was suitable for people who lived at the home.

We have made a recommendation about the completion of research into personalisation and dementia friendly décor.

Care files provided information about people’s needs and how they wished to be cared for. The provider had switched to an electronic care planning system and was in the process of finalising the transfer of information from the previous paper based files. People provided mixed views about the social and recreational activities available within the home, which had been affected by the loss of two activity co-ordinators and the COVID-19 pandemic. A weekly schedule was in place, with each unit having one planned activity per day throughout the week. Recruitment for additional activity staff was ongoing, to enable the frequency of activities to increase across the home. People said they knew how to complain but had not needed to.

The home used a range of systems and processes to monitor the quality and effectiveness of the service provided. Actions had been identified and added to the home’s improvement plan, which was regularly reviewed, both by the registered manager and at provider level. People and staff’s views were sought through regular meetings and questionnaires.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 18 April 2020) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 11 March 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and staff support.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-Led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bedford Care Home on our website at www.cqc.org.uk.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.