The Care Quality Commission
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Archived: Beeches Care Home

Overall: Inadequate read more about inspection ratings

Darnhall Crescent, Bilborough, Nottingham, Nottinghamshire, NG8 4QA (0115) 929 4483

Provided and run by:
Beeches Care Homes Limited

All Inspections

22 and 24 February and 2 March 2015

During an inspection looking at part of the service

We inspected the service on 22, 24 February and 2 March 2015. The inspection was unannounced. Beeches Care Home provides accommodation for 43 people who require personal care. On the day of our inspection 33 people were using the service.

We carried out an unannounced comprehensive inspection of this service on 7 October 2014. Breaches of legal requirements were found in relation to the quality of the care and support people were receiving and how they were protected from harm. We took action against the provider and told them they must make improvements. After our unannounced comprehensive inspection we received concerns in relation to the care and support being given to people who used the service, including people being not being supported to change their clothing when they had been incontinent and a high number of falls occurring in the service.

We undertook this focused inspection to confirm that the provider now met legal requirements and to look at the concerns we had received. This report only covers our findings in relation to those requirements and what we found in relation to the concerns raised. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Beeches Care Home on our website at www.cqc.org.uk

The service did not have a registered manager in place at the time of our inspection. 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 were not protected from abuse or the risk of harm and the acting manager did not share information with the local authority when needed. People were not protected from the risk of falling and there were not enough staff to meet the needs of people.

People were not protected by The Deprivation of Liberty Safeguards and had restrictions placed upon them without staff having the authorisation to do so.

People were not supported to eat and drink enough to keep them healthy and they were not cared for appropriately.

People were not given care and support that was responsive to their needs and this placed them at risk. Complaints were not listened to or acted on and this led to a failure to use this information to improve the quality of care received.

We alerted the local authorities to our concerns and we shared information about seven people we had observed had suffered neglect.

7 October 2014

During a routine inspection

This inspection took place on 7 October 2014. Beeches Care Home provides accommodation and personal care for up to 43 people. On the day of our inspection 32 people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager was not present during this inspection.

At our inspection in January 2014 we found that the care provider was not meeting the legal requirements in respect of  people’s care planning, safeguarding people who use services from abuse, management of medicines and supporting staff. We took enforcement action against the provider regarding care and welfare. We followed this up during an inspection in April 2014 and found some improvements had been made.   

During this inspection we found that sufficient improvements had not been made in respect of safeguarding people from abuse and the care and welfare of people who use services. Sufficient improvements had been made in respect of management of medicines and supporting staff.

People were not kept safe because there was not always an appropriate response to incidents when they occurred.

People received their medication when they needed it and medication was stored and recorded appropriately. There were sufficient numbers of staff to meet people’s needs.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The DoLS is part of the MCA, which is in place to protect people who lack capacity to make certain decisions because of illness or disability.  DOLS protects the rights of such people by ensuring that if there are restrictions on their freedom these are assessed by professionals who are trained to decide if the restriction is needed.

People’s rights to make decisions had not always respected because assessments of people’s capacity to make decisions had not always been carried out. Although there was no one living at the service who was currently subject to a DoLS, the manager was aware of their responsibility in relation to this and had systems in place ready to follow the requirements of the DoLS.

Staff had the knowledge and skills to care for people. People’s health care needs were met and appropriate referrals were made to health care professionals for additional support when needed. 

People had access to sufficient quantities of food and drink which they enjoyed.

People were not always involved in planning their care and making decisions. People told the staff treated them with dignity and respect and were supported to maintain any hobbies and interests they had.

People did not always receive support in line with their care plan. People found the acting manager and deputy manager approachable and they would have no hesitation in making a complaint.

People were aware of different ways they could provide feedback about the service. However, the systems in place to monitor the quality of the service were inconsistent and did not always result in improvements.

We had not received the required notifications in a timely way. Providers are required by law to notify us of certain events in the service. 

You can see what action we told the provider to take at the back of the full version of the report.

11 April 2014

During a routine inspection

We had issued a warning notice to the provider following our last inspection on 14 January 2014. We did this inspection to check that improvements had been made and to check the provider had complied with the warning notice. We found that improvements had been made to people's care plans, however further improvements were still required to become fully compliant, as care plans did not always contain all of the required information about people's needs..

We spoke with three people who were using the service during this inspection. The people we spoke with told us they were happy living at the home. One person said, 'Yes I'm very happy, I can't think of anything that could be done better.' Another person said, 'I feel very settled at the moment.'

14 January 2014

During an inspection in response to concerns

We observed the interaction between staff and people using the service during our inspection. We saw that staff spoke with people in a polite and respectful manner. Care was not always planned and delivered in a way that was intended to ensure people's safety and welfare because people's care plans did not always contain information that was accurate and up to date.

People were not fully safeguarded against the risk of abuse because allegations of abuse had not been responded to appropriately. We found gaps in the completion of medication administration records and so could not be sure people had received their medication as prescribed. People had access to equipment in the home that was regularly serviced.

There were enough staff employed to meet people's needs. Staff had not received all of the training that was relevant to their role and staff had not received recent supervision meetings with their manager.

19 September 2013

During an inspection looking at part of the service

We spoke with four people who were using the service and asked if they were happy with the care and support they received. We were told by one person, 'Yes I am quite happy here.' Another person said, 'Yes it's alright, the staff take good care of me.' We saw that staff were not always present in the main lounge area to ensure the safety of people who may be at risk of falling.

We spoke with four people who were using the service and asked if they felt safe. We were told by one person, 'Yes I feel safe here it's quite alright.' Another person indicated that they felt safe living at the service. People were cared for in an environment that appeared to be clean and hygienic. We observed staff carrying out cleaning duties throughout our inspection.

There were sufficient staff available to meet people's needs. We did not observe anybody having to wait for assistance because of insufficient staff. Staff received appropriate professional development in the form of on-going training and supervision.

Systems were in place to assess and monitor the quality of the service provided and bring about improvements where required.

16 April 2013

During a routine inspection

We spoke with four people who were using the service who told us, 'It's very nice here, the staff are all very nice'. We spent periods of time in the communal areas of the home observing staff interactions with people. We saw that staff interacted with people in a polite and respectful manner. Some staff appeared to have a good rapport with people using the service.

We spoke with two relatives of people who were using the service and asked if they were satisfied with the care provided. We were told, 'I think my relative gets their needs met about 80%.' All of the people we spoke with indicated they felt there was a lack of activity for people using the service.

We spoke with four people who were using the service who felt that the home was kept to an acceptable standard of cleanliness. People were cared for in an environment that was not always clean and hygienic.

We spoke with four people who were using the service who told us, 'I don't know if they have enough staff or not, but they always look busy.' A relative told us, 'Staff are very busy, they're always in a bit of a hurry.'

27 June 2012

During a routine inspection

We spoke with three people who were using the service who all confirmed they were asked for their consent before care was delivered. One person told us, 'I am always involved with my care plan, I have agreed to everything and am happy things are only done that I want.' Another person said, 'Yes I have given consent and was involved as much as I wanted to be.'

Our observations confirmed there was always at least one member of staff monitoring people in the lounge and dining room area. Staff told us they also used their time in the lounge and dining room area to interact with people.

A relative of a person using the service told us they had received a survey and indicated they were happy with all aspects of the service. This person also told us, 'Whenever I raise anything it is dealt with. There are also monthly meetings I can attend as can residents.'

8 November 2011

During a routine inspection

The majority of people who used the service were unable to comment about their care or make decisions about their lives. However, we observed that care workers enabled people to make decisions about their lives whenever possible. People were able to walk around the building as they wished, and care workers asked people if they were ready to move from the dining room through to the lounge area. We saw that when care workers spoke with people they were respectful, and this was confirmed by comments from relatives.

People and their relatives told us they were happy with the care provided. A number of relatives commented that staff were very good. Relatives told us that they were kept informed about any changes in people's condition, and felt that staff recognised changing needs and contacted the doctor quickly.

Relatives also told us they thought people were safe, and they had not seen care practices that gave them cause for concern. Relatives told us that care workers and the manager were approachable, and they were happy to raise any issues.

People and their relatives told us that there were usually enough care workers on duty to meet people's needs and spend time with them.

16 March 2011

During an inspection in response to concerns

People told us that they felt well cared by staff and that generally their privacy and dignity was respected. However, they also told us that staff did not always knock on their bedroom doors before entering. We observed that the routine at the service was flexible and people were able to walk around the home as they wished, and remain in their rooms if they did not wish to sit in the communal areas. People using the service were offered a range of activities and were supported by staff to join in with these if they wished to.

We observed that at times the communal area was very noisy, with both the television and music on at either end of the room. We were told by a visitor that this can have an impact their relative due to their disability and they often remove themselves from this area. We observed that people using the service were offered choices at meal times and supported by staff where appropriate. We also observed that people were offered hot and cold drinks at regular intervals throughout the day.

We observed that the needs of people using the service sometimes mean that individuals can become distressed or angry. We observed that staff did not always have the skills to deal with these situations. As a consequence, people's distress for example, may be made worse despite the well meaning efforts of staff.