Random inspection report
Care homes for older people
Name: Address: Highfield Avon Drive Bedford Bedfordshire MK41 7AH three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sally Snelson Date: 1 2 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Highfield Avon Drive Bedford Bedfordshire MK41 7AH 01234267196 01234353046 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) BUPA Care Homes (Bedfordshire) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 34 Number of places (if applicable): Under 65 Over 65 34 34 34 dementia old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 0 0 Highfield is a purpose built residential home operated and managed by BUPA Partnership Homes (Care First Bedfordshire Limited), part of BUPA Care Services. The home provided permanent and some respite care for service users over the age of 65 years. The accommodation consists of 34 single bedrooms over two floors with a
Care Homes for Older People Page 2 of 8 Brief description of the care home passenger lift. There was a secure courtyard garden, and various communal areas. The home was located in Brickhill, a residential suburb of Bedford with a small shopping centre nearby and Bedford towns amenities accessible via a local bus route. The has ample parking available to the side of the home. The home offers accommodation in 34 single bedrooms, divided into 3 units for operational purposes. Care Homes for Older People Page 3 of 8 What we found:
This Random Inspection was carried out as a result of information we had received via our contact centre. On three separate occasions we received anonymous calls that provided us with information that suggested people using the service might be at risk because staff were leaving the home. None of the callers identified specific examples and only told us that a number of staff were leaving and that other staff were having to work additional hours to provide the necessary cover. One caller suggested that staff were put under pressure to do these additional hours. We were also made aware that a visitor had contacted social services because their relative appeared to have lost a considerable amount of weight. As a result of these concerns we spoke to the social worker who had investigated the alleged weight loss. We were told that additional support had been identified to help the resident who had lost her appetite and consequently weight, and that no further action was being taken. We decided to undertake a random inspection to look at other residents who had difficulty with eating and to talk to the staff team about their concerns for the management of this home. We also spoke to the Responsible Individual (RI) for this service who told us that she was aware that some staff were unhappy about the management changes, but she believed when we contacted her that those staff had now left. During this Random Inspection we spoke to the manager, staff on duty and a number of residents and looked at care plans for three residents. The residents chosen either had nutritional needs or required the assistance of more than one carer with moving. We established that when the previous manager, who had been at the home for a number of years left, some of the staff had also left. Staff told us it had been a difficult time because as new, less experienced, staff were employed there was a training issue. Staff told us that currently there were no vacancies on day duty and that they had not not been expected to do any shifts that they were not happy to cover. The duty rota and the manager confirmed that five care staff worked with a team leader to provide care during the day. The deputy and the manager were supernumerary but often worked on the floor as extras. During the day there were also additional staff to clean, do the laundry and cook. However during the night there were only two staff on duty to care for a maximum of 34 residents accommodated over two floors. One staff member told us that she had covered some night shifts, but this had been within her normal working hours and she had been happy to help out. We were told that currently there were vacancies on night duty which had been recruited to, but the staff had not commenced duties because they were waiting for completed recruitment checks. Staff we spoke to, who had experience of working night shifts, told us that it was more difficult at night and that sometimes people had to wait for attention because the staff were providing the care on a different floor. We were also told that staff were expected to do any washing up left from supper time, any laundry not completed by the laundry staff who worked Monday to Friday, vacuuming and cleaning in the communal areas and the cleaning of the communal toilets. Staff did tell us that they were told that care was to be given preference to any cleaning roles. We sampled the file of a person who required two staff at night and we believed that appropriate care was delivered. The home had three people using the
Care Homes for Older People Page 4 of 8 service who had pressure sores and we could see that two of the sores had developed as a result of a hospital admission or before admission to Highfields. Community nurses had worked with the home to provide the necessary treatment for any sores and care records showed that sores were responding to treatment. There was evidence that people who needed moving at night were receiving this care. The file of one resident who had difficulty eating documented that the manager had sat and had a meal this person as he/she had complained the meal didnt have enough taste. As a result the GP, dietitian and the cook had been consulted and some changes made as it was established that the persons condition, pain relief and smoking habit could be affecting taste-buds. This person was deemed to have capacity and staff, including the chef, were taking personal wishes into account when providing meals. Another resident told us about a five year history of swallowing problems. She said that the new manager Natalie, had been vigilant about finding a cause for her weight loss and that her weight was now increasing. She said when talking about the manager, she was interested in me and found out what I liked. During the visit we spoke to five care staff, two who had been at the home for a number of years and they all told us that they respected the new manager and believed that the standard of care she expected was high. When discussing the staff team the manager told us that she believed she had a good skill mix of staff and that although it had taken her a while to be accepted she had persevered and now felt that that the staff team were working with her. On the whole the documentation that we viewed had been completed correctly although there was one particular staff member who when completing food diaries failed to record accurately what had been consumed. We bought this to the managers attention who told us that she had already identified this as a training need for the next team meeting. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 37 17 Records must be accurate and kept up-to-date. This ensures that the documentation about a service user is current and that any problems can be identified as soon as possible. 10/02/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 27 The service must be able to show that two staff are duty during the night are sufficient to meet the needs of the people using the service. Care Homes for Older People Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
