We carried out a review of the data available to us about Beth Ezra on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Beth Ezra, you can give feedback on this service.
Beth Ezra is a residential care home providing personal care to up to 20 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 18 people using the service.
People’s experience of using this service and what we found
People were safe at Beth Ezra. Staff had been trained to safeguard people from abuse and understood when and how to report safeguarding concerns to the relevant person/agency.
Staff were provided with current information about risks to people’s safety and wellbeing. They understood these risks well and what action they should take to help keep people safe.
There were enough staff to support people and meet their needs. People did not wait long for staff’s support and assistance when this was required.
Recruitment and criminal records checks were undertaken on staff to make sure they were suitable to support people. The registered manager was taking action after this inspection to make sure decisions to employ staff before all the relevant checks had been completed, were suitably risk assessed and documented.
Health and safety checks were carried out of the premises and equipment to make sure they were safe. The service was clean and hygienic because staff followed current infection control and hygiene practice, to reduce the risk of infection.
People’s relatives and friends were free to visit without any unnecessary restrictions
Medicines were managed safely and people took their medicines as prescribed.
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.
People were satisfied with the care and support they received from staff. People’s views were sought about how the service could improve and the service acted on these.
The registered manager was suitably experienced and understood how people’s needs should be met. People knew who they were but said they would like more interaction with them. The registered manager already had a plan in place to increase their visibility and accessibility at the service. Staff felt valued and well supported by the registered manager.
The registered manager had oversight of the service. They undertook audits and checks to monitor and review the safety and quality of the service. They investigated all accidents and incidents and shared the learning from these with staff to help them improve the quality and safety of the support provided.
The service worked with healthcare professionals involved in people’s care and acted on their recommendations to deliver care and support that met people’s needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 14 September 2017).
Why we inspected
We received concerns in relation to staffing, medicines administration, cleanliness and hygiene of the environment, the quality and safety of care provided to people and management and leadership of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained good, based on the findings of this inspection. We found no evidence during this inspection that people were at risk of harm from the concerns we received.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
• The service used a booking system for visits from families and friends and staggered the times of visits to reduce the risk of spreading infection between people. Visits took place in the garden, with a transparent screen between people and their visitors. Visitors coming from far away could book two visiting time slots in a row. The service screened visitors for Covid-19 symptoms and could take visitors’ temperature before they entered the building. The service gave visitors Personal Protective Equipment (PPE), including face masks and hand sanitiser and provided detailed guidance to staff and visitors on how to put on and take off PPE.
• The service had an infection prevention and control lead and people were admitted into the home in accordance with national guidance. The provider made sure people being discharged from hospital had tested negative for Covid-19 before being admitted into the home and new admissions had to isolate for 14 days. The provider was regularly testing people and staff for Covid-19, in accordance with government guidance.
• The provider had a flat next door to the service that could be used to support people to isolate or socially distance. People that had to isolate had their own dedicated staff who provided a support bubble to support all their needs. The service used video calls to make sure people had regular contact with their families and friends and the provider delivered activities for people in creative ways. For example, staff set up a café in the service every Friday to recreate people’s experience of going to the café across the road.
• The provider supported people and staff to stay safe. Staff had been trained and were confident in the management and prevention of infection. People had been given information about Covid-19 and had received hand washing training. The provider had offered each member of staff a payment towards buying a bicycle, so staff could use public transport less and had liaised closely with the GP to support people with anxiety during Covid-19.
• The provider had an up-to-date infection prevention and control policy and business contingency plan and used a Covid-19 pandemic checklist and a daily PPE monitoring system to make sure the service was well prepared and had a large stock of PPE.
Further information is in the detailed findings below.
Beth Ezra is a residential care home that provides accommodation and personal care support for up to 18 older adults. People living at the home had a range of needs and some people were living with dementia. There were 18 people using the service at the time of our inspection.
At the last inspection in 2015, the service was rated Good. At this inspection we found the service remained Good. The service demonstrated they continued to meet the regulations and fundamental standards.
People continued to feel safe and well cared for at Beth Ezra. Relatives shared similar confidence in the service. Assessments were undertaken to identify risks that may be involved when meeting people's needs. Staff were aware of people's individual risks and knew what to do to keep people safe. They understood their responsibilities to report any concerns they had about people’s care and welfare and how to protect people from abuse.
The environment remained well maintained and comfortably furnished. People had the equipment they needed to meet their assessed needs. Health and safety checks were carried out to make sure the premises and equipment was safe.
Medicines were managed safely and people had their medicines at the times they needed them. People were supported to maintain good health and attend routine health care appointments. The service involved other professionals when this met an identified need. For example, when people became unwell or required additional services.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and staff took prompt action when people were at risk of poor nutrition or dehydration.
The service remained responsive to people's individual needs. People were involved in their care planning, and staff respected their choices and promoted their independence. Care plans were updated to reflect any changes and ensure continuity of their care and support.
Activities were varied and arranged according to people’s needs and interests. The home employed an activity coordinator who supported people to take part in activities either individually or in groups.
People experienced positive, caring relationships with the staff and this extended to relatives and other visitors. Staff treated people with respect and kindness and maintained people’s privacy and dignity.
The provider continued to follow safe recruitment practices and people felt there were enough staff to support their needs. Staff received an induction and ongoing training to support people with their care needs and develop their knowledge and skills.
People's care records recognised their rights and were person centred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the home supported this practice.
The registered manager continued to provide effective leadership. People and their relatives were comfortable to raise any issues and felt they were listened to. Staff felt supported and had regular opportunities to discuss and review their development and performance.
The provider had good oversight of the quality of the service. People were involved in reviewing and providing feedback on the care and support they received. Where improvements were needed or lessons learnt, action was taken.
This inspection took place on 10 February 2015 and was unannounced. At our last inspection in October 2013 the provider met the regulations we inspected.
Beth Ezra is a residential care home that provides accommodation and personal care support for up to 18 older adults. People living at the home have a range of needs and some people are living with dementia. 18 people were using the service at the time of our inspection.
A new manager was in post at the time of our inspection and was in the process of completing their registration. They successfully registered with us shortly after our inspection. 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 2008 and associated Regulations about how the service is run.
People using the service and their representatives told us they felt safe and well cared for at Beth Ezra. Staff were trained in safeguarding adults and the service had policies and procedures in place to ensure that the service responded appropriately to allegations or suspicions of abuse. The manager and staff team understood their role and responsibilities to protect people from harm. Risks were assessed and appropriate action was taken to reduce or eliminate the risk.
People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff understood people’s rights to make choices about their care and support and their responsibilities where people lacked capacity to consent or make decisions.
The provider’s recruitment procedures helped ensure that people were protected from unsafe care. There were enough staff on duty day and night to make sure people’s needs were met in a safe and timely way. Most of the staff had worked at the home for several years which meant that people experienced consistent care.
People lived in a safely maintained service and the quality of the environment was regularly checked. Medicines were managed safely and people had their medicines at the times they needed them.
People were able to take part in activities of their choice and were supported to maintain relationships with family and friends who were important to them. People spoke positively about the quality of the food and choices available and were provided with homemade, freshly cooked meals each day.
There were positive and caring relationships between staff and people who lived in the home and this extended to relatives and other visitors. Staff treated people who used the service and their guests with respect and courtesy. Staff maintained people’s privacy and dignity at all times and interacted with individuals in a caring and professional manner.
Care plans contained information about the health and social care support people needed and they were involved in making decisions about their care. Arrangements were made for them to see their GP and other healthcare professionals as and when they needed to do so. Where people's needs changed, the provider responded and reviewed the care provided.
Staff told us that they had the training and information they needed to care for people and that the manager was always available to offer guidance and support.
People who lived in the home and their relatives said they felt involved in the way the home was run and were encouraged to express their views and opinions about the services provided.
The provider carried out regular audits to monitor the quality and health and safety of the service and to plan improvements. Where improvements were needed, action was taken.
There was an open and inclusive atmosphere in the service and the manager led by example. Staff had a good understanding of the ethos of the home and told us they were clear about their roles and responsibilities.
During our visit we saw staff treating people who use the service with dignity and respect. We observed staff always knocked on the door to occupied rooms. We also observed that when people using the service were not available to ask consent staff did not enter their rooms.
People using the service said that they felt able to raise any concerns or anxieties should they have any. One person we spoke to said, "I have been invited to complain if necessary, you don't feel intimidated.'
The provider had effective systems in place to ensure that people who used the service had their medicines at the times they needed them, and in a safe way. There were clear processes in place for the appropriate safe management of medicines.
We saw people who use the service eating lunch in the dining area, one person using the service told us, "food is very good; inclined to be rich, but good food.'
During our visit we saw staff treated people who used the service and their guests with respect and courtesy. People received effective and safe care from suitably skilled staff who understood their individual needs, abilities and preferences.
The provider also had effective systems in place to routinely assess and monitor the quality of the care and support people received.
It was evident from all the comments we received from the people who live at Beth Ezra that they felt staff listened to them and that they could influence how their home was run. People told us: 'We are given lots of information about the homes rules and how we can help run it', 'Staff listen to us here and always take us seriously', and 'I can have my meals in my bedroom if I want, but I prefer to eat with everyone else in the dinning room'. Another person we spoke with told us they believed the service was good at: 'Letting people get on with their lives'.
There are good arrangements for ensuring that people who use the service live a
fulfilling lifestyle, in accordance with their wishes. Structured activities are provided
daily (including the daily Bible Reading at 4.00pm) and there are opportunities
and space for people to relax and spend time with their family and/or
friends.
The feedback we received from people who use the service was very complimentary about the quality and choice of the meals provided at Beth Ezra. Typical comments made, included: 'The food is generally very good here', 'You always get a choice at mealtimes'the staff did ask me today what I wanted for my lunch, although I cannot recall what it was', and 'I do not like the cabbage here, but most meals are fine'no real complaints about the food'.
Arrangements for handling complaints and allegations of abuse are good. People are also protected by the safe handling of medication. People told us they felt safe living at Beth Ezra and able to talk to staff if they were unhappy or dissatisfied with anything. Typical feedback we received from people, included: 'I feel completely safe living here', 'I never lock my bedroom door'no need', 'I would tell my key-worker or the manager if I was unhappy'They listen to me', and 'I would definitely tell the staff if I was not happy about something, and I am pretty sure they would take me seriously'.
The home is comfortable, very clean, and well maintained. The grounds of the
home offer an expansive and pleasant space to enjoy and relax.
Typical comments made by the people who live at Beth Ezra, included: 'I have got everything I need in my bedroom', 'They let me bring some of my own furniture and hang up some of my paintings', and 'My room is fine'plenty of space and a good view of the garden'.
Staff members are supplied in adequate numbers, and there is good staff
training provided. Furthermore, all the people we met told us staff always treated them well and respected their privacy and dignity. Typical comments we received, included: 'Staff are all very kind, cheerful and friendly here', 'The staff treat us well'most of them are Christadelphians, which I think helps', 'Staff always knock on my bedroom door before coming in'they are all very careful to do that', 'There's always enough staff about', and 'Best thing about the place is the staff'.
Beth Ezra is extremely well run by a very competent and experienced registered manager. The care home also has excellent quality assurance systems in place, some of which are independently run by a 'Quality Assurance Group' that takes into account the views of all those using the service. Regular visits by members of the Board of Trustees is also a further mechanism to ensure best practice.