Archived: Beechey House

Updated 13 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14, 15 and 17 October 2014 and was unannounced. Two inspectors carried out the inspection over all three days. We met and spoke with everyone living at the home as well as the registered manager, one of the registered providers, five members of staff and three visiting relatives. Because people were diagnosed with dementia, they were not able tell us about their experience of life in the home. We therefore 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 looked at people’s care and support records, people’s care monitoring records, all 12 people’s medication administration records and documents about how the service was managed. These included staffing records, audits, meeting minutes, maintenance records, training records and quality assurance records.

Before our inspection, we reviewed the notifications we had been sent from the service since we carried out our last inspection. A notification is information about important events which the service is required to send us by law. We also liaised with the local social services department and received feedback from district nurses about the service provided to people at Beechey House.

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was used as part of our planning, and provided us with evidence of how they managed the service.

Updated 13 March 2015

Beechey House is registered to accommodate and provide personal care for up to 16 people and caters to the needs of people living with dementia. At the time of our inspection there were 12 people living at the home.

There was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

This was an unannounced inspection that was carried out over a three days by two inspectors.

At a previous inspection in November 2013 the provider was not meeting the requirements of the law in and we issued warning notices in respect of; people’s consent, the care and welfare of people, meeting people’s nutritional needs, safety and suitability of the premises and the monitoring of service quality. We met with the provider in January 2014 and discussed our concerns. At that time one of the providers was also the registered manager. They decided to focus on their role as a provider, and appoint a manager to run the service. A manager was registered with the Commission to run the home in June 2014.

We followed up on the service’s non-compliance with a further inspection of the home on April 2014. At that time we found improvements had been made and the service provided to people was compliant concerning meeting people’s nutritional needs, premises and monitoring the quality of service. We issued compliance actions in respect of consent to care and the care and welfare of people living at the home.

We received safeguarding concerns about the service in September 2014, which lead to us carrying out this inspection.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

At this inspection there were poor arrangements for the management and administration of medicines that put people at risk of harm. People did not always have medicines administered as prescribed by their GP.

People’s legal rights were not fully protected because legal requirements of the Deprivation of Liberty Safeguards (DoLS) had not been followed through. People were therefore detained of their liberty without proper legal protection. The provider had not complied with the requirements of the Mental Capacity Act 2005 at this or our two previous inspections.

Records did not fully detail ‘best interest’ decisions and who had been consulted in making these decisions for people who lacked capacity.

The service was not responsive to meeting people’s needs. Care plans were not up to date. For one person who was nearing the end of their life there was no plan setting out how to meet their end of life care needs. Staff therefore did not know how to consistently care for this person. Equipment was not always provided to meet people’s needs.

People’s nutritional needs were met. People who required support with eating and drinking were assisted appropriately by staff.

The staff team were trained in the protection of vulnerable adults and knew what constituted abuse and how to report concerns.

The home had a caring staff team who had worked at the home for many years. Staff received induction training and further training to ensure they were competent to care for the people living there. However staffing levels at the time of inspection were inadequate to meet people’s needs.

The systems in place and the culture at the home did not ensure the service was well-led. Staff did not feel supported and the systems to monitor the quality of service were inadequate. The provider had not taken action to address shortfalls identified at previous inspections to ensure that people received appropriate care.