Beech Hill Grange

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question Good.

At this assessment the rating has changed to Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider was previously in breach of the legal regulation in relation to safe care and treatment. Insufficient improvements were found at this inspection, and the provider remained in breach of this regulation.
 

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always ensure that people were supported in ways which respected their privacy and dignity.

During our assessment most interactions we observed between staff and people were positive, with kindness and empathy being shown by staff.
However, we observed 1 staff member not interacting with, or explaining to someone what they were doing, when supporting them to eat their lunch. They sat in silence putting the spoon to the person’s mouth.

Some people’s support plans contained details of how they wished to be supported and make choices about how their support was delivered.

However, this was not consistent in all care plans we looked at. For example, where people were sharing a room and they were unwell, there was no guidance for staff on how to continue to provide support in a way which ensured both the person and the person they were sharing with, had their privacy and dignity protected.

Most relatives told us staff adopted a caring approach to their work. For example, 1 relative told us, “Staff are lovely” and another said, “Staff are kind and [person’s name] is looked after.”

A relative explained how supportive staff had been when their loved one had passed away, adding, “They not only supported [person’s name], they also supported us as a family.”
 

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Support plans gave basic information about people’s cultural and religious needs, but they did not demonstrate how these had been considered or addressed as part of each person’s care. This included a lack of information about who was important to each person, such as friends and people from wider communities such as faith or external interest groups.

We saw evidence that the service planned some activities around the Christian calendar and preparations for Christmas were underway during our assessment. A folder containing photographic evidence of other festivities being attended by people at the service was seen. However, activities undertaken while retaining the finding that personalised cultural involvement was not consistently evidenced.

We did not see evidence of how the service had explored and celebrated other festivals and important dates for people living and working at the service from other cultural or religious backgrounds.

We observed that most people who required support to eat their meals, and who were not cared for in bed, were sat in the conservatory for mealtimes. This area was separate from the dining room Seating arrangements were not always varied or people’s preferences and choice documented. We had observed people in the same places across all of the days we were on site and was also observed at the previous inspection.

The providers documentation did not always ensure staff knew how to promote people’s independence, including their rights and have choice and control over their own care, treatment and wellbeing.

During our assessment we saw most staff encouraged people to be as independent as possible and make decisions about their daily life. However, care records did not always clearly show how independence would be supported.

Although most care plans, we looked at detailed the tasks staff needed to complete, there was a lack of personalisation and specific detail on what staff should help with and what the person could do themselves to maintain their independence.

We saw where people lacked capacity to make some decisions about daily life staff still offered choice wherever possible.

People and their relative spoke positively about the overall support people had to make choices and remain independent. Comments included, “[Staff] do their best to make me feel settled since I have been here and I still do what I can for myself” and “They [Staff] look after [name] and try and encourage them to do things for themselves and help more on bad days.”

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

People did not always receive timely care and support. For example, we identified a number of people supported in bed whose records showed us they had gone several hours without being repositioned, despite their care plan stating they required pressure relief every 2 to 3 hours.

We reviewed the weekly clinical risk meeting records and saw a number of people were receiving treatment for a chest infection.

The records detailed themes and analysis including the rise in cases and actions to be taken. We were told by the registered manager that there was not an outbreak, and people were being encouraged to socially distance.

During our assessment, we saw the piano lounge was very busy and there was no enhanced measures in place to reduce the spread of infection.

A relative told us that a loved one was waiting a long time for assistance from staff when they pressed the call alarm during the morning.

There was insufficient oversight and monitoring to ensure people’s needs were being met promptly. Daily records were not routinely reviewed or audited, which meant the provider could not be confident that people’s immediate care needs were consistently addressed.
 

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Most staff working at the service had been there a number of years and told us they were happy to work at the service and it was a good place to work.

The registered manager told us how they employed staff based on their values.

Staff spoke positively about their colleagues and the people they supported. A staff member said, “I get on well with the carers [staff], they are very friendly.” Another said, “I like looking after the residents, they are all lovely like family.”

Staff told us they felt valued and supported by the management team. They told us the registered manager encouraged them to voice their opinions, ideas and suggestions.

Their comments included, “We can go to the office if we have any concerns, [registered manager name] and the team make time to make sure we are ok.”
We observed positive interactions between management and staff.
People commented positively on overall staff morale.

One person said, “The staff are all nice and very kind to you, they get along and work together.”