Bedhampton Nursing Home and Specialist Care Unit

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were protected from abuse and avoidable harm. Staff had a good understanding of safeguarding and were confident to raise concerns if needed. Incidents were investigated and lessons learned if care had not gone to plan. Risks associated with people’s health conditions and support needs were assessed, monitored and mitigated effectively. People received their medicines as prescribed. There was mixed feedback about staffing levels. The manager told us they were currently reviewing this. Some improvement was needed with recruitment practices and the manager told us of their plans to make the necessary improvements. Infection prevention and control was safely managed, and people lived in a clean home.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most people told us they could raise concerns with staff, and these would be dealt with appropriately. One person said, “If I have any concern, I tell them [care worker] and if they can’t put it right, they get a nurse.” A relative told us improvements had been made to processes when they made concerns. They felt effective learning was taken to reduce the likelihood of events reoccurring. Despite this, people were not usually aware of the complaint’s procedure. The manager told us they would share the complaints procedure with people.

The provider had systems in place to report accidents and incidents, record the actions taken and any lessons learnt. Staff understood these processes and used them effectively.

Staff felt encouraged to raise safety concerns and told us these were investigated openly and with a focus on learning lessons. For example, a staff member said, “There is a culture of safety in the home. I haven’t ever experienced a blame culture, everyone gets on well. We all help each other out.” Staff told us the management team supported them and provided feedback if they had reported an incident or raised a concern.

Staff confirmed they understood how people needed to be supported when they were admitted to the home. When people needed to leave the service, staff told us how they ensured the person had everything they needed so the new service could safely and effectively support them.

Policies and procedures contained details of the robust processes to enable people to move safely between services. These were understood and followed by staff.

Professionals external to the service were positive about how people were supported if they needed to transition to and from another service. For example, a professional said, “We work together for the benefit of the people living here.”

People told us they had an assessment of their needs prior to moving in to the service. This meant staff had a good understanding of how to support them when they were admitted into the home. Relatives were pleased that people changed their GP to the GP surgery linked to the home. This provided a good continuity of care for people.

The provider had an effective safeguarding policy in place which staff followed. Staff completed incident forms if they were concerned people were at risk of harm or abuse. These were fully investigated by the management team. The provider ensured relevant agencies were notified of safeguarding concerns appropriately. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). DoLS applications had been made as required. Mental capacity assessments were in place where required.

Most people told us they felt safe, well cared for and listened to. For example, 1 person said, “I feel safe here because of the whole picture and how it operates. I do feel listened to.” Another person told us, “The staff make me feel safe.”

Staff had a good understanding about safeguarding people from the risk of abuse. They knew how to identify, and report concerns internally and externally. They were confident the manager would act appropriately to ensure people were safe if they raised a concern. Staff additionally provided examples of how they had supported people to prevent abuse occurring.

People appeared relaxed and comfortable with staff during our site visits. We saw staff treating people with care and respect.

Staff knew people well and understood the risks to people. Staff knew how to monitor and mitigate the risks to people and raise issues if people’s needs changed.

People were supported in line with their risk assessments. Staff supported people in a way that reduced risks for them. For example, drinks were regularly replenished and left within arms reach of people to reduce the risk of dehydration. For other people, they had their meals prepared to the correct consistency to reduce the risk of choking.

The provider had effective processes in place to ensure people’s risks were managed safely. People’s risk assessments were detailed and updated if their needs changed, and staff were made aware of this. Records to monitor risks such as pressure injury were complete.

People and their relatives felt involved in managing their risks. A relative told us, “The inevitable challenges arising from complex needs have been worked on with good results every time, in turn leading to established improvements in care ongoing.”

Staff told us there were effective arrangements to monitor the safety and upkeep of the premises. For example, a member of staff told us how they undertook checks of the environment and equipment to ensure it was safe. Other staff members showed good understanding of how to reduce the likelihood of a fire breaking out and what action they would take if this were to occur.

The home was secure, and we observed checks taking place to ensure only authorised people could enter the premises. Equipment to support people’s care such as call bells and motion sensor aids were well maintained and in good working order.

Health and safety policies and procedures were in place which staff understood and followed. Health and safety audits took place regularly and any areas for action were addressed. Regular checks of the environment and equipment were undertaken to ensure they were safe. These were either undertaken by a staff member employed by the service or an external specialist. Records demonstrated this.

People and their relatives mostly told us the environment and equipment in the home were safe. For example, 1 relative said, “There is good security when entering the home.” However, 1 person told us, “We have concerns about the security of equipment in our rooms, things are ongoing at the moment. We can’t lock our doors.” The manager told us they were aware of the concern and would be discussing how to make improvements with staff and individual people.

Staff supported people in a timely way, and we observed call bells were answered promptly during our site visit. Support was provided to people in a relaxed and unhurried manner, and we saw staff spending time talking to people.

People and relatives provided mixed feedback about staffing levels. Comments included: “Of course [there are enough staff]”, “They are so short staffed here, it is ridiculous.”, “My buzzer works, it depends how busy they are on how long it takes to be answered. They are very busy in the mornings.” and “There are not enough staff at night.” People and relatives felt staff were well trained and had the skills to support them appropriately.

Staff told us there were usually enough staff to support people in line with their needs and preferences during the day. Agency staff were sometimes used to cover vacancies and staff told us this could put pressure on the team because agency staff did not know people’s as well as permanent staff. The deputy manager explained how they planned the rota to ensure there was an appropriate skill mix of staff on duty. Some night staff were not assured with the number of staff at night. The operations manager told us they were in the process of reviewing people’s dependency levels and staffing arrangements to ensure people always received safe and high-quality care. They had also recently increased the number of housekeeping staff. All staff told us they were well supported by the training and supervision they received and said they worked well as a team.

The provider used a tool to determine staffing levels. Staffing levels were being reviewed at the time of our assessment. The provider had effective processes in place to ensure staff had the necessary skills and competence to carry out their roles. Staff received an induction, a wide range of training relevant to their roles and regular supervision. Recruitment processes were not always safe. There were gaps in recruitment records. For example, records did not always demonstrate potential staff had gaps in their employment explored. Although the manager told us their recruitment practices were safe, records did not evidence this.

People and their relatives were positive about the cleanliness of the home. For example, 1 relative said, “Genuinely dynamic, responsive care is given in a clean, bright and peaceful setting.”

There was a robust infection prevention and control policy in place. Cleaning schedules were available, and staff had a good understanding of these. Health records showed people had been supported to have vaccinations to protect them from infectious illnesses.

We saw that all areas of the home were clean. Housekeeping staff used appropriate cleaning materials to prevent cross contamination. Soap and paper towels were available to ensure good hand hygiene. Staff mostly wore personal protective equipment (PPE) appropriately. When we saw an incident where PPE was not used effectively, we were assured the manager would address this.

Staff told us how they contributed to keeping the home clean. They were positive about how the this was managed.

People were positive about the support they received with their medicines. For example, people said they received their medicines at the right time and another person said they knew how to request medicines if they needed them for a particular reason. One person said, “I used to self-medicate but I’m happy they [staff] do this for me now.”

Medicines were dealt with by registered nurses. All had a good understanding of how to order, administer, store and dispose of medicines safely. 1 staff member told us how the management of medicines had improved since the new manager had started. They felt they had the right training to support people with different needs effectively with their medicines.

There was a robust medicines policy in place. This was accessible to staff who demonstrated a good understanding of it. Regular medicine audits were undertaken to ensure safety and the service had recently had an audit carried out by a community pharmacist. This showed medicines were safely managed. Risk assessments were detailed and provided effective guidance about how to manage people’s medicines safely.