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Inspection Summary


Overall summary & rating

Good

Updated 7 May 2016

The inspection took place on the 30 March 2016 and was unannounced. The Beeches provides care and accommodation for up to 32 older people. There were 30 people living at the service on the day of our inspection.

The service has a registered manager. 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 told us that they liked living in the service and they and their relatives spoke highly of staff and the quality of care.

Risks to individuals were not always managed in a consistent way and it was agreed that further professional advice should be obtained regarding the safety of the environment and action taken to minimise risks. People were generally supported to take their medicines but practice did not always follow the recommended guidance.

Staff were attentive but were not always available in the communal areas to respond to individuals who may not be able to use the call bells to summon assistance. The manager told us that they had already identified issues regarding the availability of staff and their ability to meet people’s needs and had a plan in place to address this shortfall. Recruitment was underway and it was agreed that the deployment of staff would be explored as part of this process. The systems in place to recruit staff were thorough and the uptake of previous employment references and other checks were undertaken before staff started work at the service. Staff had a good understanding of abuse and the steps that they should take to protect people.

The majority of staff had worked at the service for some years were clear about their role and knowledgeable about the needs of older people. A training programme was in place and staff told us that they received regular updates to ensure that they were kept up to date with practice. Newer staff told us that they were well supported when they started working at the service and that they received regular supervision support from management.

People had access to health care support when they needed it and were provided with a balanced diet. People were enabled to make choices and were involved in making decisions about how they were supported.

Care plans documented people’s needs and were regularly reviewed. Staff knew the people they supported well and had a good understanding of people’s needs. We saw that people were supported to maintain relationships which were important to them. Group or personalised activities were regularly provided although there were plans to expand this provision further.

The manager was approachable and promoted an open culture. Staff knew what was expected of them. People’s views were sought in a variety of ways including resident meetings and questionnaires. Audits were undertaken and there were systems in place to drive improvement.

Inspection areas

Safe

Requires improvement

Updated 7 May 2016

The service was not consistently safe

Risks were not always identified and safely managed.

The provider operated a safe and effective recruitment system to ensure that the staff they employed were of good character.

There were sufficient numbers of staff but they were not always deployed in a way to ensure that they were available in communal areas when required which meant that steps had not been taken to mitigate the risk to people at high risk of falling.

Medication processes were generally safe but there were risks associated with the secondary dispensing of people’s medicines. We were also not confident that people were always receiving their creams as prescribed.

Effective

Good

Updated 7 May 2016

The service was effective.

Staff were trained and knowledgeable. Opportunities were provided to ensure that they were kept up to date.

People were supported to access a balanced diet. Mealtimes were flexible and people enjoyed the food.

People were supported to maintain their health. The service had good working relationships with professionals and referred people promptly when their needs changed.

Caring

Good

Updated 7 May 2016

The service was caring.

Staff were attentive to people’s needs. Staff were kind and thoughtful in their interactions with people.

People’s dignity was promoted.

Responsive

Good

Updated 7 May 2016

The service was responsive

People received care and support from staff who knew them. Care plans were informative and reflected people’s preferences.

People were supported to access activities and there were plans to expand the service further.

There were processes in place to consult with people and their relatives about the service provided. There was a complaints procedure in place although no complaints had been received.

Well-led

Good

Updated 7 May 2016

The service was well led

The service was managed by a manager who was visible and approachable.

Staff morale was good and staff told us that they were well supported.

There were systems in place to check on the quality of care provided and to drive improvement.