Archived: The Beeches

Updated 18 March 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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. 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 two inspectors on the first day and one inspector on the second day. An Expert by Experience telephoned people’s friends and families to gather their experiences. 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

The Beeches is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. The Beeches is a care home without nursing care. 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 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 first day of inspection was unannounced. A second day was agreed for the lead inspector to return to check health and safety actions had been completed.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection-

We spoke with five people who used the service and nine relatives about their experience of the care provided. We spoke with ten members of staff including the registered manager, senior care workers, care workers, domestic staff and cook. We reviewed a range of care and support records. These included three people’s care records and multiple medication records. We looked at two staff files in relation to safe recruitment. The inspection team also looked at documents relating to daily care practices, risk assessments, audits and several policies and procedures.

After the inspection

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

Updated 18 March 2022

About the service

The Beeches is a care home which provides accommodation and personal care for people aged 65 and over. The home is registered to support up to 40 people in a single adapted building. On the day of inspection, 36 people lived at the home, some of whom were living with dementia. The accommodation consisted of a single building, arranged over two floors. There were two communal lounges, a conservatory and a large dining room. There were secure, partially covered outside areas and gardens.

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

Governance processes failed to monitor safety and risks effectively to keep people safe from potential risk of harm. The provider had not learnt lessons from the previous inspection and had not taken appropriate steps to improve the care being provided. Staff deployment and identified hazards, such as hot water were identified during the last inspection, these concerns were found again during this inspection.

Staff were not deployed adequately to meet people’s needs and people waited long periods of time to receive support from staff. The monitoring system for waiting times was insufficient and did not account for the amount of occurrences people needed to wait outside of the providers set maximum waiting time.

Risks to people were not always managed effectively to protect them from potential harm. Window restrictors did not comply with safety standards and several radiators were not safely covered in accordance with Health and Safety Executive requirements.

Staff told us how they could recognise unsafe care practices and the action they would take to report poor practice. People and relatives told us they felt the service was safe.

Staff were recruited safely, the provider sought out references and carried out criminal record checks prior to their employment.

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.

Medicines were administered safely. Staff followed systems and processes to prescribe, administer, record and store medicines safely. Medicines were regularly audited and action was taken to address any discrepancies.

The service used effective infection, prevention and control measures to keep people safe. People told us they felt the home was clean and hygienic.

The provider apologised to people, and those important to them, when things went wrong. Relatives told us they felt involved in the service and felt the management kept them updated on changes.

The service worked well in partnership with other health and social care organisations, to monitor people health and improve their wellbeing.

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 requires improvement (published 12 May 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

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 how the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

We received concerns in relation to infection prevention control practice and staffing levels. As a result, 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. The overall rating for the service has not changed following this focused inspection and remains requires improvement, based on the findings of this inspection.

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. The provider took effective action to mitigate some of the risks during the

inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Beeches on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified continued breaches in relation to Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 18 (Staffing) at this inspection.

We have issued the provider with a warning notice. We will check the provider is taking action to comply with the legal requirements set out in the warning notice.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk