Archived: Beechcroft Care Centre

This summary is based on our observations during the inspection, discussions with two people, eight relatives, the manager, three nurses, seven carers and the two chefs on duty. We also spoke with a Dietician and Speech and Language Therapist (SALT) who was visiting the service. We reviewed records relating to the management of the service and four people's care and health records. As most people could not talk with us about their experiences of living at the service we spent time observing how they were cared for and treated by staff. We observed interactions between staff and people who lived at the service for three hours during the morning and lunchtime period.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

There were enough suitably qualified and experienced staff on duty to meet people's needs. We noted that during the month of June 2014 staffing levels had not always been maintained. The manager was able to explain the reasons behind this and described the actions taken to maintain the staff numbers on shift. We found that the staffing numbers had improved in the month of July and that the staffing level and mix had generally been achieved. Staff told us that they were able to meet people's needs safely. We observed that staff responded quickly to meet people's needs and to ensure their safety.

People's care records were up to date and had been reviewed on a monthly basis. In general records were accurate and fit for purpose. This meant that the service monitored and identified changes in people's needs and could plan appropriate care.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Since our last visit one application had been made. The manager demonstrated knowledge of their responsibilities in respect of this.

Is the service effective?

We found that people's care plans were detailed and that they had been reviewed on at least a monthly basis. This ensured that the care provided was in line with their individual needs and preferences. One relative told us, 'You can't fault the carers'. Another said, 'X (their relative living at the service) is more chilled out and more relaxed, the best they've been. X is happy there'.

As most of the people living at the service were unable to speak directly of their experience, we spent time observing the care and support that they received. Staff demonstrated skill and experience when supporting people. People that we spoke with confirmed that they were happy with the support they received and with the activities on offer. One said, 'I'm good, I'm fine'.

People were supported to eat and drink enough to meet their needs. There was a varied menu and the service had clear information on people's dietary preferences and needs. We observed that people were given time to enjoy their food. Where people were at risk of malnutrition, the service monitored their intake and took action where required. This included referrals to other healthcare professionals such as the dietician, SALT or GP.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. People or their representatives were involved in decisions relating to their care. We spoke with two people. They were both satisfied with the care that they received. One relative told us, 'I've been very happy with the staff'. A member of staff said, 'There's a lot of love in this place'.

Is the service responsive?

The service monitored people's needs and took appropriate action to address any changes. This included working with multidisciplinary teams to ensure that people's needs were met. Most relatives told us that they were kept informed and updated if there were any issues or concerns regarding the health of their family member. They told us that the manager and staff were approachable. We found that the service listened and responded to questions and feedback received from people, their representatives and from staff.

Is the service well-led?

We saw that there were systems for monitoring the quality of services provided. The manager demonstrated a commitment to making improvements to the quality of service provided to people.

Systems were in place to make sure that the manager and staff learnt from events such as accidents and incidents. This reduced the risks to people and helped the service to continually improve.

At our previous inspection of 24 January 2013 we found that the provider had failed to tell CQC of notifiable incidents related to safeguarding. We looked at this area again to check whether the provider had made improvements. We saw that CQC and other relevant stakeholders had been informed when injuries or safeguarding matters arose.

We found that people received appropriate care and support to meet their needs. People's care was delivered in line with their individual care plans. Staff took into account the way in which people communicated to ensure that they were understood and their wishes met.

The home had measures in place to ensure people received appropriate medicines. Medicines were administered, stored and recorded appropriately to ensure people's safety.

The service was divided into three separate units, Beechcroft House, Chestnut Lodge and Hazel Lodge. All of the three units we saw were safe and suitable. Measures had been taken to ensure all units were appropriately maintained. The environments of all three units were pleasant, clean and safe for people.

The provider had appropriate methods to assess and monitor the quality of the service. There were effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

During the inspection we observed the care provided and people's interaction with staff. We saw that people were alert and the majority appeared interested in activities and their surroundings. Staff were kind, caring and energetic and communicated well with people. We saw that staff were aware of people's body language and the individual ways in which each person was able to communicate to express their needs.

Care plans were very detailed and provided information for staff so that they knew how each person communicated. For example they explained "When I do this......it means.....you should do this'.." We found that most care plans contained good information and detail about how to care for people.

We found that one person had fractured their arm and this had not been investigated or reported as a safeguarding concern. There were several other instances where the CQC had also not been notified appropriately of safeguarding alerts or

incidents. This meant that the provider had failed to follow appropriate procedures to safeguard people from harm.