Central Bedfordshire Council Sandy Depot

This service had not been inspected before. We rated it as requires improvement because:

• The service did not keep cleaning records or carry out any audits of cleanliness, therefore we were unassured that infection risk was controlled.
• The vehicle keys were not always stored securely in line with recommended practice.
• The service did not have a process for the safe disposal of clinical waste.
• The service did not have a formal exclusion and inclusion criteria for patient suitability, which meant we could not be assured there was a set criteria for staff to follow during the assessment process, or that the assessment process was carried out consistently between service users.
• The service did not have access to mental health support for patients with mental health conditions.
• The service did not currently have access to extra trained staff if permanent staff were absent.
• Records were not stored securely, which meant that patient confidential information could be viewed by persons not authorised to see this.
• The service did not have service specific policies that were dated, referenced, version controlled or authorised.
• The service did not minute staff meetings, which meant there was no record of the discussions held during these meetings.
• Staff had not received training in the Mental Capacity Act and consent.
• The service did not collect feedback from patients and relatives.
• Staff did not have clear career development and progression routes.
• The service did not have a vision and strategy.
• Managers did not monitor the effectiveness or performance of the service and did not always identify and manage service level risk robustly.

However:

• The service generally had enough staff to care for service users and keep them safe. Permanent staff had training in key skills and understood how to protect service users from abuse. Staff assessed risks to service users and acted on them.
• Staff provided good care and treatment. Managers generally made sure staff were competent. Staff worked with other agencies in the council for the benefit of service users and supported them to make decisions about their care.
• Staff understood and respected the individual needs of service users and understood the emotional and social impact a service user’s care and condition may have.
• The service planned care to meet the needs of a subgroup of the local population and took account of service users’ individual needs. People could access the service when they needed it.
• Staff felt respected, supported and valued. They were focused on the needs of service users receiving care. Staff were clear about their roles.