Harpenden Bethesda Home

Harpenden Bethesda Home is a residential care home providing personal care to up to 25 people. The service provides support to older people, some of whom are living with dementia, in a purpose-built building. At the time of our inspection there were 11 people using the service.

People’s experience of using this service and what we found

There were monitoring processes in place to help ensure a good standard of service. Quality assurance systems were used to identify any areas that needed further development and to help ensure remedial actions were implemented. However, the overview and use of these systems needed to be more robust and carried out in accordance with the quality assurance policy so that gaps in records or themes and trends were identified.

People felt they were safe and well supported by the service. Individual risks were assessed, although these needed to be reflected throughout some care plans, but staff were aware of these and supported people safely. Reviews of events and accidents were carried out and any actions needed were carried out. Medicines practice, audits and checks needed to be more robust as we identified an error. Staff had received training and competency checks. Staff knew how to report any concerns about a person’s safety or welfare. People told us there was enough staff to meet their needs. Infection control systems were in place.

Staff received training for their role, although some updates were due, and people felt they had good knowledge and skills. Staff felt supported by the provider and management team. People told us staff their preferences and choices.

People and relatives told us staff were kind and caring, and they were happy living at Harpenden Bethesda Home. Interactions observed were very positive, staff responded to people in a way that anticipated their needs and demonstrated they knew people well. All observations found staff to be attentive and caring about the people they supported.

Staff enjoyed working at the home and wanted to ensure people were happy and well cared for. Care plans included all information needed to support people safely and in accordance with their wishes and preferences. These were reviewed regularly. However, work was needed to ensure that key information was carried across all areas of the plans.

The registered manager was well known in the home, people, their relatives and staff spoke positively about them and the management team. They worked closely with the nominated individual to help ensure a good service for people.

People, their relatives and staff felt their views about the service were sought and listened to. People and staff told us that the registered manager was often around the home and the service was well run.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service under the previous provider was good (published 14 May 2019).

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We received concerns in relation to the management of risks and governance, staff training and records. As a result, we undertook a focused inspection to review the key questions of safe and well led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harpenden Bethesda Home on our website at www.cqc.org.uk.

Recommendations

We recommend that the management team ensure records accurately reflect people’s risks and ensure governance systems are consistently followed to identify any shortfalls and allow themselves to implement actions that may be needed. Also, that action plans have a clear completion date to help ensure work is completed.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.