Beech Hill Grange

Updated 16 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by three inspectors. An Expert by Experience made calls to relatives on 12 May 2022. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Beech Hill Grange is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with three people who used the service and nine relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, clinical lead, nursing staff, lead care workers and care workers. 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 reviewed a range of records. This included six people's care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management and quality assurance of the service, including policies, procedures, safeguarding, accidents and incident were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Updated 16 June 2022

About the service

Beech Hill Grange is a residential care home providing accommodation, nursing and personal care to 71 people at the time of the inspection. The service can support up to 74 people. The accommodation is provided in one adapted building with bedrooms on the ground, first, second and third floors.

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

Whilst we found quality checks of medication records had not always been completed in a consistent way by senior staff and managers, we found people were supported by trained staff to take their medicines when needed. Medication records were accurately completed and there were no missing entries.

Staff were recruited safely and there were enough staff to meet people's needs. Staff received on-going support, training and supervision to be effective in their roles.

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.

Staff understood who to report concerns to as well as any new risks to people’s health. People's support needs were risk assessed and care plans provided staff with the information they needed to manage the identified risk. Staff followed the infection control procedures the provider had in place. People were comfortable, relaxed and happy around care staff and staff understood how to keep people safe.

The environment was clean and staff observed and followed infection control procedures in line with national guidance for reducing the spread of COVID-19.

People's individual communication needs were considered to support them to be involved in their care. Staff had the necessary skills to carry out their role. Staff had regular training opportunities and training specific to people's individual needs was provided. Staff had very good knowledge and understood people's health conditions and the support they required.

Staff spoke positively about working for the provider. Systems and processes in place promoted a positive culture in the home. Staff worked with a wide range of stakeholders involved in people's care. These included occupational therapists, health professionals and safeguarding authorities. Staff understood their responsibility to be open and honest when things had gone wrong. The registered manager operated an ‘open door’ policy which enabled people, their relatives and staff to approach management to discuss any concerns they had.

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 this service was Good (published 21 December 2018)

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service died. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident. 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.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.