CQC report explained · a residential care home
What the CQC found at Bedford House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable safeguarding procedures, detailed risk assessments, safe medicines systems, enough staff and clean, well-maintained premises. Some staff mentioned occasions when staffing was tight because of sickness or appointments, but the inspector found enough staff on the inspection day.
- Effective?
- Good
- Staff had relevant training, supervision and appraisals. People's nutritional needs, communication, capacity and healthcare needs were assessed and included in their care plans.
- Caring?
- Good
- Inspectors saw staff treating people with patience, kindness, respect and compassion. Staff encouraged independence and understood people's individual preferences.
- Responsive?
- Good
- Care plans were detailed, personalised and reviewed monthly. People were supported to keep family relationships, access healthcare, take part in activities and communicate in ways that suited them.
- Well-led?
- Good
- The home had an approachable management team, regular staff communication and audits covering care, medicines, safety, training and other areas. Inspectors found records up to date and an improvement plan in place.
What inspectors found, January 2019
Rated Good; inspectors found safe, kind and personalised care, with one record-keeping issue about staff references.
This was an unannounced inspection on 4 December 2018. One inspector observed care, spoke with staff, the manager, the activities coordinator and chef, and spoke with 10 relatives. The inspector reviewed five care plans, seven staff files, training records and service records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, detailed care plans, suitable activities and kind relationships between staff and residents.
The home had changed one unit from respite care to care for people with autism after renovation work. Relatives told inspectors that the changes had gone well. The previous inspection in May 2016 also rated the home Good.
Safe medicines
Inspectors checked medicines policies, storage, records, training and administration in both units. They found no gaps in the sample of medication records reviewed.
“We found the service was managing medicines safely.” from the report
Personalised care
Care plans covered people's routines, preferences, communication, health, nutrition, interests and cultural needs. They were reviewed monthly and updated when needs changed.
“Care plans were person-centred, detailed and specific to each person and their needs.” from the report
Kind relationships
Inspectors observed patient and respectful support. People appeared relaxed and comfortable with staff, and relatives spoke positively about the care.
“Positive caring relationships had developed between people who used the service and care support staff and people appeared at ease in the presence of care support staff.” from the report
Communication and choice
The home used communication passports, pictures, gestures and objects to help people express their choices. Activities were planned around people's interests and routines.
“All people had a communication passport which clearly detailed how the person wished to communicate” from the report
Open management
Staff and relatives said the manager was approachable. Regular audits, meetings and an improvement plan were used to monitor and develop the service.
“They told us there was an open and transparent culture within the service.” from the report
Staff reference records
minorTwo written references were not held on the staff files inspected. Management later provided evidence that the local authority's human resources department retained them.
“We did not see evidence of two written references on staff files we looked at” from the report
- 01How do you make sure staff numbers remain sufficient when staff are sick or people need support with appointments?
- 02How do you use each person's communication passport to understand choices, discomfort or changes in health?
- 03How are care plans reviewed with residents and relatives, and how quickly are changes made when needs alter?
- 04What activities are available for someone with my relative's interests, abilities and routine?
- 05Where are staff references held, and how can you confirm that all required recruitment checks have been completed?
This was an unannounced inspection covering all five quality areas; most residents could not communicate verbally, so the inspector relied on observation, records and discussions with relatives and staff. This explanation was written from the published report of 4 January 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2017
Harrow Council - Bedford House is rated Good; medicines were being managed safely after a previous legal breach.
This was an announced focused inspection on 23 March 2017. One inspector spoke with the registered manager and shift leader, and checked three care plans, 19 medicines records, training records, audits, policies and procedures.
The inspection looked only at whether the home was safe, because the previous inspection had found problems with medicines. Inspectors found that medicines were stored securely, records were complete, and staff had received training and competency checks.
The home had daily, weekly and monthly medicines checks. The previous legal requirements had been met, and the safe rating improved from Requires Improvement to Good. The overall rating stayed Good, while the other four ratings carried over from the previous comprehensive inspection.
Complete medicines records
Inspectors reviewed 19 Medicines Administration Records and found no gaps. The records clearly showed the medicines, doses and times.
“We reviewed nineteen Medicines Administration Record (MAR) sheets and saw that there were no gaps which indicated people received their medicines as prescribed.” from the report
Secure storage
Medicines were stored in two locked metal cabinets. The previous unsuitable storage arrangements had been changed.
“During this inspection we found medicines were now stored in two metal cabinets which were kept locked and secure.” from the report
Staff training and checks
Care workers had medicines training and were assessed for their knowledge and competence. The home also used regular checks and audits to identify and address problems.
“Records showed care workers had received medicines training and comprehensive medicines policies were in place.” from the report
Previous medicines breach
seriousAt the previous inspection, medicines were not managed effectively and this was a breach of Regulation 12. Inspectors said this had been corrected by the March 2017 inspection.
“At our comprehensive inspection on the 16 May 2016 we found the service did not have effective arrangements for the management of medicines which may place people at risk.” from the report
- 01How are the daily, weekly and monthly medicines checks recorded and followed up?
- 02How do you assess staff competence before they administer medicines?
- 03What happens if a medicines record is incomplete or a dose is missed?
- 04How are instructions for medicines given when needed, creams and other special medicines kept up to date?
- 05When was the most recent pharmacy medicines audit, and what action followed from it?
This was a focused inspection of Safe only; the Effective, Caring, Responsive and Well-led ratings carried over as Good from the comprehensive inspection in May 2016. This explanation was written from the published report of 14 April 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Bedford House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- January 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodstayed GoodSafe: Good
- June 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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