Archived: Bedford Charter House

Updated 19 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was carried out on 4 December 2014 by three inspectors 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. The inspection was unannounced.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the content to identify good practice and to help focus our planning in order to determine what areas we needed to look at during our inspection.

We also checked the information we held about the service and the provider, such as notifications. A notification is information about important events which the provider is required to send us by law. In addition, we asked for feedback from the local authority, who have a quality monitoring and commissioning role with the home.

During the inspection we used a number of different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not able to talk to us about their experiences. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at care records for six people who used the service, as well as other records relating to the running of the service such as staff records, audits and meeting minutes.

We spoke with the registered manager, deputy manager, eight care staff, the chef manager, the home’s administrator and four visitors. We also spoke with or observed the care being provided to over 30 people living in the home, so that we could corroborate our findings and ensure the care being provided was appropriate for them.

Updated 19 March 2015

Bedford Charter House is a care home for up to 64 people who have a range of care needs including dementia and physical disabilities. Short term (respite care) and some rehabilitation (home from home) support packages are also provided.

Plans to redevelop the service in stages; to include a new build care home and extra care housing on the same site, were well underway. Because the provider was making plans to move people from the old building to the new building in the New Year, the service had temporarily stopped admitting new people to the service, with the exception of people requiring short term care packages. To this end there were 58 people using the service on the day of our inspection, 4 December 2014.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We found that staff had been trained to recognise signs of potential abuse and demonstrated a good understanding of the potential risks faced by people living in the home. People we spoke with confirmed they felt safe living in the home.

There were sufficient numbers of staff who had the right skills and knowledge to meet people’s needs. And we saw that the provider carried out proper recruitment checks on new staff to make sure they were suitable to work at the home.

Systems were in place to ensure people’s medicines were being managed in a safe way.

All the staff we spoke with confirmed that they had received training to carry out their roles, including support to achieve national health and social care qualifications.

We found that improvements were required to ensure the home consistently acted in line with legislation and guidance in terms of seeking people’s consent and assessing their capacity to make decisions about their care and support. The registered manager told us that further training was planned for staff to make sure they had the right skills to assess people’s capacity properly.

People were supported to have sufficient quantities of food and drink and there was an emphasis on maintaining a balanced diet. The majority of people we spoke with told us they had a choice of food each meal and that the food provided was of a good standard. We observed that people ate well and seemed to enjoy their meals. Assistance was provided in a discreet and helpful manner to people who required help with eating and drinking. We saw that people’s dignity was respected at all times and they were encouraged to maintain their independence as far as possible.

Arrangements were in place to meet people’s healthcare needs. People we spoke with had a good understanding of the support being provided to them to manage their healthcare needs, and we saw that clear information was provided to staff to enable them to understand people’s healthcare needs and how best to manage these.

Staff were observed providing care and support in a caring and meaningful way and people were treated with kindness and compassion. We spoke with people who confirmed the staff treated them well and that they discussed their care, or their relative’s care, with them. They told us they felt involved and listened to.

We learnt that people’s privacy was respected at all times and that their social needs were provided for. We observed too that people were encouraged to make their own choices and decisions, as far as possible.

A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to. We saw that complaints that had been received had been responded to in a prompt and appropriate way.

Systems were in place to monitor the quality of the service provided including satisfaction surveys, meetings and internal audits. People told us there were regularly asked for feedback about the service and had opportunities to be involved in contributing to the running of the service. People thought the home was well managed and felt able to approach staff, including the registered manager, if they needed to discuss anything. We saw that action had been taken to address improvements that had been identified as a result of internal audits and feedback from people using the service.