Our Enter & View function in action: two positive examples of change from HBB

Increasing confidence in digital transformation and record-keeping

“During a routine visit to a care home, the management team initially expressed reservations about transitioning from paper-based systems to digital records, citing concerns around usability and reliability for staff who weren't digitally minded. Our Authorised Rep was able to use their experience and knowledge of IT systems to provide a clear and comprehensive explanation of digital system benefits over paper record keeping, including safeguards, accessibility and benefits in relation to governance and oversight.

Having taken the time to explain how the transition would work, the management team demonstrated an improved understanding of the system and were left feeling reassured about its proven effectiveness. In our post visit report recommendations, we suggested that the home in question should:

‘Consider re-investigating the move to electronic care plans in the near future, in line with Bedfordshire, Luton and Milton Keynes (BLMK) digital transformation plans.

Whilst we fully recognise that pen and paper are the preferred option for most of the workforce, we are mindful that as everything these days is moving online, you will be left behind and that this would eradicate a proportion of time chasing results and updates as they would be available at the click of a button. We are also mindful of the fire risk of having everything in paper files as opposed to being backed up in the cloud.’

In the provider feedback on receipt of the report, the manager stated that:

"We are considering digitalisation now that you have talked us through the benefits and risks and I am going on a course shortly.' (Registered manager)

Positive outcome. The care home in question embraced the transfer to digitalised records shortly after the visit."

2. Strengthening culturally inclusive meal provision

“During a care home visit HBB identified that the service was not meeting residents' cultural culinary needs. Menus did not adequately reflect the cultural or religious dietary requirements of some of the residents and there was no evidence on receipt of complaints from residents during the visits that their individual preferences were being routinely offered or incorporated into meal planning. This meant that some residents were not supported to receive appropriate food choices that respected their backgrounds and beliefs.

One elderly resident advised, ‘They occasionally offer us rice, but it’s no good. She can do 300 things with a potato. I hate potato! I have to eat it because there isn’t anything else to have!’

Such comments highlighted the need for the provider to have a radical re-think of their catering provision and menu choices to ensure they met the individual needs of residents.

Given the additional communication needs of the residents in respect of cognitive impairment, HBB reported that they were disappointed not to have seen picture-based menus. HBB felt this warranted immediate attention in regard to choice and consent and this was queried with management at the time of visit.

Residents reported that whilst they were free to ask for something different to what was on the weekly menu, they were doubtful that other options would be provided.

In a meeting with the manager, the Authorised Rep explained local restaurant and takeaway options to meet residents' needs for meals of specific cultural heritage that could not be made by the cook. We suggested getting an account with a food provider and offering a meal choice twice a week on trial to start, whilst undertaking an overhaul of catering provision. The owner was accepting of our suggestion as he'd received multiple complaints about the cook and felt he needed to look at alternative options.

In our post visit report recommendations, HBB advised the provider that, 'More attention is needed on the cultural dietary needs of residents,'' explaining consent, choice and dignity when looking at the nutritional needs and experiences of residents born overseas.

Following our visit a new cook was appointed externally who was experienced in writing menus and preparing meals to reflect residents' cultural and religious preferences, supporting a more person-centred approach to meal provision and nutrition.

Positive Outcome. This provider went from an overall CQC rating of inadequate to receiving five 'Good' ratings.”

Why these case studies matter

These examples show how Enter & View can lead directly to improvements in care. In both cases, practical conversations with residents, relatives, staff and managers helped identify issues that were affecting people’s daily lives.

The recommendations made by Healthwatch Bedford Borough were acted on, resulting in better record‑keeping, more inclusive meal provision and a more person‑centred approach to care. They demonstrate why Enter & View remains one of Healthwatch’s most important statutory powers and how it continues to make a difference for local people.