Beverley Grange Nursing Home

Updated 5 November 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 6 September 2022 and was announced from the car park.

Updated 5 November 2022

This inspection took place on 4th, 13th and 15th June 2018 and was unannounced.

When we completed our previous inspection on 5th June 2017 we found concerns relating to record keeping processes which were ineffective in monitoring and improving the quality and safety of the service, assessing and mitigating risks and maintaining contemporaneous records of each person using the service. At this time these topic areas were included under the key questions of Responsive and Well-Led. We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework these topic areas are included under the key question of Effective and Well-Led. Therefore, for this inspection, we have inspected these key questions and also the previous key question of Responsive to make sure all areas are inspected to validate the ratings.

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

Beverley Grange provides accommodation and support to a maximum of 75 people some of whom may be younger or older adults that may have physical disabilities and/or living with dementia. At the time of our inspection there were 59 people using the service. The home is purpose built and split into two areas, the first floor is for those people requiring nursing care and the ground floor for people that are more mobile and independent. There are seven bungalows within the grounds of the home three of which were occupied at the time of this inspection. People could live as independently as they could with support available if needed. A large garden with a greenhouse and raised beds of flowers surrounded the home and parking is available on site. The home is located on the outskirts of Beverley in East Yorkshire.

There was a registered manager in post at the time of this 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.

Staff had exceptional skills and expertise to empower people and their families to be involved in the care planning process. Management supported staff by offering specialist training which supported them to achieve responsive and effective care outcomes.

Records showed staff were innovative and proactive in their approach. Staff worked above and beyond to support people, they arranged multi agency support frameworks, offered support for those transitioning back into the community and worked tirelessly to ensure nursing care was continuously improved to demonstrate high standards of achievement in areas such as pressure care.

Staff were highly skilled at enabling people to explore different innovative communication methods find those that best suited individuals and their capabilities. Relatives told us that staff were patient, friendly and very kind when facilitating people’s freedom to express themselves. This supported an inclusive environment with equal opportunities for all people living at the service.

Relatives feedback praised staff for their kindness and professional manner towards those people requiring palliative care. Staff spoke passionately about ensuring people were comfortable and meticulously cared for during end of life care. Relatives had thanked staff for their exceptional support, care and attention during difficult times.

Staff took time speaking with people about their life histories and captured this information to support people to achieve their future aspirations. People were encouraged to get involved with activities and event planning that incorporated parts of their life stories. People spoke proudly of their achievements and felt a sense of value and belonging within the home.

Detailed risk assessments had measures in place to mitigate risks such as, choking or falls. Records such as food and fluid intake had been accurately documented to reflect amounts taken each day. Guidance on best practice was readily available should staff need to refresh their knowledge.

The provider had various quality assurance processes in place to maintain good practice and improve quality standards within the home. The registered manager told us they were in the process of updating all their quality assurance systems to maintain good record keeping and monitoring to drive continuous improvements within the home.

People were protected from avoidable harm and abuse. Systems and processes were in place to minimise the risks and guide staff should they need to report a safeguarding incident. Staff were knowledgeable about the signs and types of potential abuse and how to report them.

Staff responsible for administration of medicines received regular training and competency checks. Medicines were administered safely and stored at correct temperatures. Medicines for pain relief were monitored to ensure they were effective.

The provider maintained safe staffing levels and robust recruitment checks were in place to ensure people were of suitable character to work in a care home environment.

Staff were encouraged to develop their skills and knowledge. The provider had employed an external trainer to support them in accessing the right courses to develop staff in their role. Regular supervisions and annual appraisals were in place to support staff. This meant that people received a higher standard of care as the staff team had developed their own knowledge and understanding in terms of caring and supporting people in the right way.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We observed staff promoting people’s dignity and privacy. Staff were knowledgeable about how they could ensure people maintained their independence. This included supporting people’s diverse needs and promoting equality in the home.

Systems and processes were in place to support people should they need to raise a complaint. Relatives told us that the registered manager was proactive in dealing with any concerns.

The provider sought feedback from people and their relatives to improve the service and lives of people living at the home. Staff and relatives told us the registered manager was approachable and supportive. We observed both people living at the service and their relatives speaking to staff without prior appointment throughout the day.

Management were always visible and the owner had a hands-on approach which made staff feel supported. The atmosphere was warm, jovial and welcoming.