CQC report explained · a residential care home
What the CQC found at Puttenhoe
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2020
Inspected but not rated; inspectors found good infection-control arrangements but were not assured that all necessary work was complete.
This was a targeted inspection on 12 November 2020. Inspectors looked only at infection prevention and control in the six-bed reablement unit, which might have been used for people discharged from hospital with COVID-19.
Inspectors found several positive measures. Staff and people using the service had access to regular COVID-19 testing, staff had personal protective equipment, and bedrooms had their own bathrooms to help with distancing and isolation.
However, repairs and improvements to cleaning procedures were still under way. Inspectors were therefore not assured that the unit met good infection prevention and control guidelines at the time of the visit.
The service was inspected but not rated. This means the inspection did not give an overall quality rating or a rated score for the five areas of care.
Clear entry procedures
The manager gave inspectors clear instructions to reduce the risk of infection when entering the home.
“The registered manager provided clear instructions about the procedures we would be expected to follow, to avoid spreading infection on entering the premises.” from the report
Testing and protective equipment
Staff and people using the service had access to COVID-19 testing, and staff had personal protective equipment.
“Staff had access to Personal Protective Equipment (PPE), and regular Covid-19 testing took place of people and staff as required - to minimise the risk of infection spreading.” from the report
Bedrooms supported distancing
Bedrooms were large and had their own bathrooms, supporting distancing and isolation arrangements.
“Bedrooms were a good size with their own bathrooms, to support social distancing and isolation arrangements.” from the report
Travel support for staff
The provider paid for staff taxis where needed, to reduce their use of public transport.
“The registered manager told us the provider paid for staff to use taxis to and from the service where needed, to minimise the risk of them catching Covid-19 on public transportation.” from the report
Repairs and cleaning work incomplete
seriousRepairs to the building and improvements to cleaning procedures had not been completed. As a result, inspectors were not assured that infection prevention and control was good enough for a designated setting.
“However, as this work was not yet complete, we were not assured that this service met good infection prevention and control guidelines as a designated care setting, at the time of this inspection.” from the report
- 01Have all the building repairs and cleaning improvements identified during the inspection now been completed?
- 02How do you check that infection prevention and cleaning standards remain safe and effective?
- 03How often are people using the service and staff tested for COVID-19?
- 04What personal protective equipment is available, and how do you make sure staff use it correctly?
- 05How would you isolate someone who tested positive or was at risk of spreading infection?
This was a targeted inspection of infection prevention and control in the six-bed reablement unit only; the wider service and the other four questions were not assessed. This explanation was written from the published report of 11 December 2020 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, March 2019
Rated Good; inspectors found safe, kind and personalised care, with some daily notes and end-of-life training needing improvement.
This was an unannounced planned inspection on 3 January 2019. One inspector spoke with people, a relative, staff and managers, and checked care files, medicine records, staff files, complaints, audits and safety records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and staff were kind. Inspectors found high-quality, person-centred care and good support from managers.
The home had improved since its previous inspection in December 2017, when it was rated Requires Improvement and had breaches about medicines and documentation. Those concerns had been addressed, although some daily notes still did not fully reflect the person-centred care seen in practice.
Safe medicines
Inspectors found that medicines were safely managed, stored and checked. The previous medicines concerns had been addressed.
“There were robust systems in place for daily auditing of medicines and medicine records.” from the report
Kind and respectful care
Staff were patient and respectful. They involved people in decisions and encouraged them to do as much as they could for themselves.
“Staff were extremely caring and patient in their approach and people responded with warmth and smiles.” from the report
Personalised activities
Activities reflected people's interests and abilities. One person was supported to use their gardening skills, gain confidence and become more independent.
“The service was responsive to people's needs and utilised people's talents and interests to improve their health and well-being.” from the report
Good management support
People, relatives and staff gave very positive feedback about the management team. Meetings and feedback were used to make changes to menus and activities.
“People and staff gave extremely positive feedback about the registered manager and deputy manager and said they felt very supported by them.” from the report
Choice at mealtimes
People were offered choices and meals were adapted for religious beliefs, dietary needs and personal preferences. Food and drinks were available throughout the day.
“People gave very positive feedback about the meals and the choices offered and we saw a lot of choice being given during the inspection.” from the report
Daily care notes
needs fixingSome daily notes did not reflect the person-centred care inspectors saw in practice. The manager said this was being monitored and staff were receiving support to improve their report writing.
“Some of the daily notes were not written in-line with the person-centred approach that was evident in practice.” from the report
End-of-life training
needs fixingStaff understood different approaches to end-of-life care, but several staff said they had not received formal training in this area.
“Staff were aware of the different approaches that can be used to support people receiving end of life care, however a number said that they had not yet had formal training in this area.” from the report
- 01What changes have been made to ensure daily notes consistently reflect each person's care and preferences?
- 02Have all staff now received formal training in end-of-life care?
- 03How are medicines audited each day, and how are any errors or concerns followed up?
- 04How will you support my relative's specific interests, independence and preferred activities?
- 05How will my relative and our family be involved in care planning and reviews?
This was a planned, unannounced inspection covering the overall quality of care and all five CQC questions across the home's three units. This explanation was written from the published report of 8 March 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.
Every inspection of Puttenhoe
3 rated inspections over 3 years: the service has held its Good rating throughout.
- December 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- March 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- April 2014
Registered with the Care Quality Commission on 7 April 2014.
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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88 live-in carers within about an hour of Bedford
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 76 can care for a couple. 12 years' experience on average.
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Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.