Enter and view: Baxendale Care Home (safeguarding)

Healthwatch Barnet carried out a safeguarding-focused Enter and View visit to Baxendale Care Home in Whetstone on 23 May 2019. The home accommodated 48 residents at the time of the visit, including people living with dementia, Alzheimer's disease, Parkinson's disease and other long-term conditions. Healthwatch spoke with management, staff, residents and relatives to assess safeguarding practices and residents' experiences. 

Overall, the report found Baxendale Care Home to be a caring service in an attractive setting, with an experienced manager and staff who were committed to residents' wellbeing. Residents and relatives were generally very positive about the quality of care, activities, food and cleanliness of the home. Many described staff as kind, patient and dedicated, and all residents and relatives interviewed said they would recommend the home. 

The home operated safeguarding procedures that staff appeared to understand well. All staff had received safeguarding training, knew how to raise concerns and demonstrated awareness of their responsibilities. The manager reported that safeguarding concerns would be investigated promptly and appropriate action taken where necessary. Residents and relatives were informed about safeguarding through admission processes, information leaflets and access to complaints procedures.

Staff recruitment processes included references, Disclosure and Barring Service (DBS) checks, probation periods and induction programmes. Safeguarding training was delivered face to face and refreshed annually. Staff generally spoke positively about the home and described good teamwork and supportive management.

However, concerns were raised about staffing levels. Although the home maintained a staff-to-resident ratio of around 1:5 during the day, several staff, residents and relatives felt there were not always enough staff available to meet residents' needs promptly. Staff reported having limited time to socialise with residents and occasionally feeling rushed when providing care. Concerns were also expressed about the quality and consistency of some agency and bank staff compared with permanent employees. 

Residents had access to a varied programme of activities, including films, sensory activities, religious services, creative projects and life-story work. Activities were widely praised, and residents described them as stimulating and enjoyable. Healthwatch noted that more use could potentially be made of volunteers and suggested greater efforts to support residents to spend time outdoors in the home's attractive gardens and patio areas. 

The report highlighted some concerns regarding care delivery. Residents reported occasional delays in receiving assistance, particularly with showers, bathing and responses to requests. Some residents also expressed frustration about long waits for meals, especially breakfast, while staff acknowledged that pressures on staffing could contribute to these delays. 

Healthwatch found that residents generally felt safe and well cared for. Staff described respectful approaches to managing challenging behaviour and emphasised the importance of treating residents with dignity. Nevertheless, some comments suggested that agency staff were sometimes less familiar with residents' needs and could be less confident with moving and handling techniques. 

The home had recently introduced a digital care planning system, although not all care staff had direct access to it. Healthwatch considered that extending access could improve communication and consistency of care. The report also recommended making policies more readily available to staff, either electronically or through easier access arrangements. 

A significant concern related to external safeguarding processes rather than the home itself. Management reported frustrations with delays in responses from Barnet Council regarding safeguarding investigations and Deprivation of Liberty Safeguards (DoLS) applications. The home reported waiting up to 12 months for some DoLS decisions and highlighted poor communication during safeguarding investigations. 

Healthwatch concluded that Baxendale was a caring home providing a good quality environment and positive resident experience despite resource pressures. Recommendations included recruiting additional permanent staff, improving support at mealtimes and with personal care, ensuring agency staff are fully briefed on residents' needs, expanding access to digital care plans, making policies more accessible to staff, increasing opportunities for residents to go outdoors, promoting the home's weekly shop service, and considering the introduction of volunteers. 

The report also made recommendations to Barnet Council, including improving communication about safeguarding investigations, providing named contacts for care homes, establishing clearer processes and timescales, and ensuring concerns are formally closed with written confirmation. Healthwatch noted that no formal response had been received from Baxendale Care Home by the time the report was published in August 2019.