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Inspection carried out on 24 January 2018

During a routine inspection

We inspected Beechville on the 24 January 2018. The inspection was unannounced. Beechville is owned by Methodist Homes (MHA) which is a charity providing care, accommodation and support.

Beechville is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Beechville is registered to provide accommodation for up to 63 older people who require personal care. Some of the people were living with dementia. There were 61 people using the service at the time of the inspection. The home is a two storey purpose built home situated in its own grounds in a residential area of Lostock, Bolton. The home is on the main road that connects the towns of Horwich and Bolton. There is adequate car parking at the front of the home.

We last inspected Beechville on 21 August 2015 and the service was rated as good.

The registered manager had left the home in January 2018. A new manager from another of the Methodist Homes had been appointed. In the interim period the home was being managed by the Area Support Manager (ASM) who was available to facilitate the inspection. The ASM had been at the home for two weeks. The ASM had experience of managing a care home.

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 and associated Regulations about how the service is run.

On arrival at the home there are two sets of doors before people enter the large, comfortable reception area. The reception area has a coffee bar and is used for activities.

The service used the local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow.

The home was clean, tidy and fresh. The environment was maintained at an excellent level and homely in character.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities. However the infection control nurse who was at the home at the time of the inspection found areas of concern with regard to some poor practice. Most of these were addressed by the end of the inspection.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP). A PEEP informs the fire service what room people live in and what assistance they require to evacuate them safely.

People were offered a well balanced and nutritional diet and encouraged to eat and drink to ensure they were hydrated and well fed.

Staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The ASM was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

We observed there were good interactions between staff and people who used the service. People told us st

Inspection carried out on 21 August 2015

During a routine inspection

Beechville is a two storey purpose built home set in mature well maintained grounds and gardens. The home is in a residential area and is on the outskirts of Bolton. The home is registered to provide care and support for 63 older people. The home is separated into four areas known suites. Oak and Maple suites are located on the ground floor and provide care for people living with dementia. On the first floor which is accessible by a passenger lift Cedar and Sycamore suites are located. Cedar suite cares for people with early onset of dementia and Sycamore suite is a residential suite.

This inspection was unannounced and took place on the 21 August 2015 commencing at 06.30 am. There were 61 people using the service at the time of the inspection.

We last inspected the home on 17 December 2013. At that inspection we found the service was meeting all the regulations we reviewed.

The home had a manager who was registered with the Care Quality Commission (CQC) who was present on the day of the 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 and associated Regulations about how the service is run.

Beechville had a large reception area with comfortable seating and a coffee bar which operated two afternoons a week and alternate Friday and Saturday afternoons. There was also a piano which was played by a person who used the service. There was a range of books for people to bring in and exchange.

We arrived early at the home as we had received information that people who used the service were being got up out of bed. We found this was not the case and people on all the suites were still in bed.

We found people were being cared for by sufficient numbers of staff who were suitably skilled and experienced and who were safely recruited. We saw that staff had received training and support to enable them to do their job effectively and care for people safely.

Staff were able to demonstrate their understanding of the whistle-blowing procedures and they knew what to do if any allegations of poor practice or abuse was suspected.

People who used the service told us they felt safe and spoke positively about the care and support they received. People told us about the kindness, caring and compassionate attitude of the staff.

We found the system for managing medicines was safe and we saw how staff worked in cooperation with other healthcare professionals to ensure people received appropriate care and treatment.

We saw all areas of the home to be clean and well-maintained. Procedures were in place to prevent and control the spread of infection.

People’s care records contained sufficient information to guide staff on the care and support required. The care records showed that risks to people’s health had been identified and what actions had been taken to eliminate and reduce the risk. People and their relatives (where appropriate) were involved and consulted about the care plans to help ensure people’s wishes and preferences were considered.

We found the provider was meeting the requirements of the Mental Capacity Act 2005(MCA) and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

We saw that people looked well cared for and there was sufficient equipment available to promote people’s safety and independence.

People who used the service were provided with a varied and nutritious diet to ensure their health needs were met.

The registered manager had systems in place to monitor and assess the quality of the service. Opportunities were place for people to comment on the service by the use of questionnaires and meetings.

Inspection carried out on 17 December 2013

During a routine inspection

We visited Beechville on 17 December 2013; and we saw the home was prepared for the Christmas festivities.

Beechville was a purpose built home set in extensive mature grounds. Accommodation was provided on four suites, with Maple and Oak on the ground floor offering care to people with a dementia related illness. Sycamore and Cedar are on the first floor and provided residential care.

On arrival we found the home to be warm, clean and tidy. We were told most people were up and had been served breakfast. We observed there was a flexible time for breakfast being served. This gave people the opportunity to have a lie in if they wished.

We observed sufficient numbers of staff were on duty, these included volunteer staff and students who were on college placements. The staff were supported by a team of ancillary staff.

We sampled a selection of care records and found they contained clear and concise documentation to inform staff how each person wished to be cared for.

We spoke with several people who used the service. One told us, �It�s marvellous here; it�s like a five star hotel�. Another told us, �I have not been here very long, but what I have experienced so far has been very good. The staff appear to be very kind and caring�.

We saw information displayed in the foyer, including a service user guide and the complaints procedure. We also saw number of compliment cards which had been received from relatives. Some comments included, �Thank you for the wonderful care that was given to X by all the staff. X was treated with dignity and respect at all times. Another read, �Many thanks for the love, care, kindness and respect you all showed to X in their last days, you were wonderful�.

A new manager had recently been appointed. The manager was in the process of registering with the Care Quality Commission. Staff we spoke with complimentary about the new manager, one member of staff told us, �I like her (the manager) approach, she is very supportive and has some good ideas�.

We spoke with the students on placement, one said, �This is my first placement but I have really enjoyed working here, it�s been a good experience.�

Inspection carried out on 13 September 2012

During a routine inspection

When we visited Beechville the home was fully occupied. We noted that the home was light airy and well maintained and in pleasant grounds with car parking facilities.

We observed that there were sufficient numbers of staff on duty. We saw that care staff interacted well with people who use the service. They treated people respectfully, offering privacy, dignity and choice.

Whilst on the visit we saw equipment being used. This was done efficiently and competently. Equipment was appropriate and appeared to be well maintained. People were transferred from wheelchairs to easy chairs safely. All equipment was stored correctly after use.

We checked a number of care files and found that people�s personal preferences were recorded within their care plans these records were kept within the persons bedroom and available for relatives at all times.

People told us;

"My X is really settled here and well looked after, she has been here since it opened, it is far better than where she was before".

"Mother is happy here they see to all her needs efficiently and nothing is too much trouble". "I sign all the paperwork monthly but the girls always go through it with me before I do, they keep me fully informed which puts my mind at rest".

Reports under our old system of regulation (including those from before CQC was created)