Background to this inspection
Updated
13 February 2020
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.
Inspection team
The inspection team consisted of one inspector, one assistant inspector and a specialist advisor who was a registered nurse.
Service and service type
Beechdale House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 manager registered with the Care Quality Commission. 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
The inspection was unannounced.
What we did before the inspection
We reviewed any notifications we had received from the service (events which happened in the service that the provider is required to tell us about). We reviewed the last inspection report. We asked Healthwatch Nottingham for any information they had about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also asked commissioners for their feedback about the service. Before the inspection we asked the provider to send us their Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. This information was used to plan the inspection.
During the inspection
As part of this inspection, we spent time with people who used the service talking with them and observing support; this helped us understand their experience of using the service. We observed how staff interacted and engaged with people. We spoke with eight people who used the service and three visiting relatives or friends of people living at the service. We also spoke with five visiting health care professionals. We spoke with the registered manager, the nominated individual who is responsible for supervising the management of the service on behalf of the provider, a nurse, a senior care worker, three care staff, the cook and housekeeper. We reviewed a range of records. This included six people's care records. We looked at three staff files. We reviewed a variety of records relating to the management of the service, including accidents and incidents, numerous medicine records, audits, staff training and checks on health and safety.
After the inspection
We continued to seek clarification from the provider to validate evidence found in relation to resident and staff meetings, the current action plan and confirmation of action taken immediately in response to some feedback from this inspection relating to records. This information was included in the inspection.
Updated
13 February 2020
About the service
Beechdale House is situated in Nottingham City. The service is registered to provide accommodation and nursing for a maximum of 40 older people and people living with dementia in one adapted building. There were 31 people living at the service on the day of our inspection visit.
People’s experience of using this service and what we found
People received safe care and treatment from staff who knew and understood their needs, including how to manage and reduce known risks. Whilst some care records needed updating, this had not impacted on the safe care and treatment provided and immediate action was taken where required, to make improvements. Staff had received training in safeguarding and health and safety. Staff were deployed effectively and safe recruitment practice was used when new staff were appointed. Medicines were managed safely and people received their proscribed medicines when they needed. Infection prevention and control measures were used, to reduce the risk of cross contamination. Incidents were reviewed and analysed to consider what lessons could be learnt to reduce further risks.
People received effective care and treatment. Recognised assessment tools, best practice guidance and current legislation, were used to assess and monitor people’s health care and well-being needs. Staff received an induction and ongoing training and support. People received a choice of meals and their hydration and nutritional needs were met. Staff worked with, and shared information across agencies to support people with their ongoing care needs. People’s health conditions were assessed and monitored, and they received support to access health services. Improvements had been made to the environment and plans were in place for further improvement.
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 cared for by staff who knew them well. Dignity, respect and independence was encouraged. People and their relative or representative, were included as fully as possible in their care and treatment. Advocacy information was available, should people have required this support.
People received a responsive service that met their individual needs. People's diverse needs, preferences and social history was assessed and care plans provided staff with guidance. People received opportunities of social activities and community involvement. Action was being taken to appoint a new activity coordinator, to further develop people’s opportunities. Complaints and concerns were acted upon and investigated in a timely manner and resolutions found. End of life care was discussed and planned with people and their relative or representative.
The service was well-led by a management team who understood their role and responsibilities in meeting the fundamental care standards and legislative requirements. The culture of the service was open and transparent. The registered manager actively engaged and had developed a positive relationship with the community and external professionals. This had a positive impact on people. The management team were visible and involved in providing care and clearly knew people well. The registered manager used research and best practice effectively, they had been successful in achieving recognition awards for their practice and for improvements made at the service.
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 4 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.