Archived: The Beeches

Updated 11 April 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was carried out by one inspector.

Service and service type: The Beeches is a care home. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: The inspection was unannounced so the provider, registered manager and staff team did not know we would be visiting. We visited the service on 12 and 13 February 2019.

What we did: Before the inspection, we had asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make. We reviewed the information included in the PIR and used it to assist in our planning of the inspection. We also looked at information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events, which the service is required to send us by law.

During our visit we spent a period observing how people were spending their time and the interactions between them and the staff team. We spoke individually with eight people to ask about their experience of the care provided. We spent time with the provider, registered manager and administration manager. We spoke individually with eight staff. We looked at four people's care records, together with other records relating to their care and the running of the service. This included four staff employment records, policies and procedures, audits and quality assurance reports.

Updated 11 April 2019

About the service: The Beeches is a residential care home providing personal care and accommodation for up to 23 people. At the time of the inspection there were 17 people living at the service.

People’s experience of using this service:

Since the last inspection the registered manager had failed to assess and monitor staff training, to equip staff with essential skills and knowledge. They had not considered that training was out of date and not assessed whether the training staff had received was effective. This had a potential impact on people’s safety, for example, around infection control and medicines management.

Staff were not supported through the home’s formal supervision process and those supervisions that had taken place were not always effective. Improved quality monitoring and record keeping would have highlighted the above improvements.

Despite the above improvements required, there was no doubt that people were very happy living at The Beeches. They spoke fondly of the provider, registered manager and all staff. Likewise, although staff wanted to be better supported by the registered manager, they enjoyed caring for ‘their residents’ and felt proud when they went home.

Satisfaction and views around feeling safe were positive. One person told us, “We all feel very safe, it’s one of the main reasons we decide to live in a care home. Staff are kind and support us 24 hours a day, we have good food, we are warm and safe and have a nice home to live in”.

Staff understood their responsibility to keep people safe from harm. People were supported to take risks and promote their independence. Risks were assessed, and plans put in place to keep people safe. There was enough staff to safely provide care and support. Checks were carried out on staff before they started work to assess their suitability to support people in a care setting.

Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. 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. People were provided a healthy, nutritious, balanced diet whilst promoting and respecting choice and they confirmed this when we spoke with them.

Everyone we spoke with agreed that staff were caring and kind. Comments included, “Oh they are a super bunch”, “I like them all. I feel they genuinely care about us and enjoy their job”, “I have no concerns they are very respectful and always have a smile on their faces”.

Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. The service was responsive to people’s health and social needs. People received person-centred care and support. Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals. Where necessary care and support had been changed to accurately reflect people's needs and improve their health and wellbeing.

People were encouraged and supported to make their views known and the service responded by making changes. Although improvements had been identified the provider and registered manager had good intentions and people and staff said positive things about them. The registered manager was genuinely disappointed that training and supervision had lapsed, and they had missed this. They agreed that quality assurance needed to improve to ensure the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.

We identified three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection: Good (published September 2016)

Why we inspected: This was a planned, comprehensive inspection based on the services previous rating of Good. At this inspection we found that in some areas the service required improvement.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk