15 June 2022
During a routine inspection
People’s experience of using this service and what we found
People’s quality of life, quality outcomes and their preferences were affected by the environment in which they lived. People struggled to have baths or showers as bathing facilities did not meet people’s mobility needs, and there were issues with the reliability of water temperatures for the accessible shower facility. Areas of the home were not in use due to repairs being needed.
Central heating and hot water systems were not fit for purpose. The central heating had to be on at all times, irrespective of the weather and the external temperature. This was to ensure there was hot water at the home. The hot water heating system did not operate independently of the heating system. The provider informed us following our site visit that remedial work had been undertaken to address this.
The provider was aware of the environmental challenges and the actions required. A report commissioned by the provider for potential development plans for the service was in place. However, no decisions had been made based on the report findings.
Opportunities were available for people and family members to share their views. However, feedback had not brought about changes to concerns expressed by people with regards to the environment and the premises, and its impact on their quality of life.
People's privacy and dignity was not always maintained and not all staff demonstrated kindness or compassion. A contributory factor was a majority of staff were agency staff, who were unfamiliar with people's needs. Staff supporting people did not always recognise or understand people's needs and the support they required, or respond to people when they became distressed or anxious.
Opportunities for staff to access training to enable them to promote people’s safety and quality care was limited. Reasons for this included; staff shortages, the Covid-19 pandemic, and poor internet connections to access online e-learning.
People’s assessed needs required improved support from staff for the management of oral health, as people were not being routinely supported. People’s care records could be used to better reflect person centred care by including greater detail as to people’s individual needs and preferences, and the role of staff in supporting them.
Systems and processes were in place to promote people’s safety through ongoing assessment and monitoring. Staff followed good practice guidance for infection prevention and control. Systems and processes for the recruitment of staff were in place and followed.
People’s needs were assessed and kept under review. People had access to support from a range of health care professionals, which included regular reviews of their prescribed medicines. People’s dietary needs were met.
People were supported to have maximum choice and control of their lives, within the limits created by the improvements required to improve the equipment and premises. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People and family members spoke positively of the kindness and care demonstrated by staff.
People and family members were involved in decisions about their care, which included the reviewing of care plans and decision related to the going monitoring and treatment of their health, and decisions related to end of life care.
Opportunities were available for people to take part in activities within the home.
Quality monitoring systems and processes were in place, which included a range of audits to identify where improvements were needed. People’s views were sought, and we found examples where people’s comments had been acted upon and listened to. Family members spoke positively of effective communication between the registered manager and staff in relation to general issues and specific issues related to their relative’s care.
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 the service under the previous provider, Shaw Healthcare (de Montford) Limited was Requires Improvement, published on 1 February 2019. Beech Close was registered with us under the new provider, North Northamptonshire Council on 1 April 2021 and this is the first inspection.
Why we inspected
This was a planned inspection based on the provider's registration date.
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.
Enforcement
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 breaches in relation to staff training, unsuitability and maintenance of the premises to meet people’s needs, and the treating of people with dignity and respect.
Please see the action we have told the provider to take at the end of this report.
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 to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.