Beechcroft

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were generally safe and protected from avoidable harm. However, the service remained in breach of legal regulation in relation to safe care and treatment as improvements were still required in some aspects of medicines management.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Theproviderhad developed a proactive and positive culture of safety, based on openness and honesty.Stafflistened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had introduced systems that ensured accidents, incidents or adverse events were subject to monitoring and oversight by management and the provider. Records showed that events reported by staff were reviewed and where appropriate, learning was shared with staff within the service and other services operated by the provider. Staff understood reporting systems and were able to identify what events would need reporting and escalating to management. A healthcare professional told us, “Falls are consistently reported to the GP practice, allowing appropriate assessment and follow-up where required.”

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People’s risks were assessed, and care plans had been improved to include detail about how staff should support them to manage identified risks safely. People’s care records were regularly reviewed and updated to reflect people’s changing needs, where appropriate.Where people had specific health needs which placed them at risk of harm, risk assessments had been completed and the risks relating to the condition had been considered.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider deployed staffing levels based on the needs of the people living at the service and were planned in advance to identify shortfalls. The electronic care planning system was used to calculate a dependency score for people. Systems were in place to respond flexibly to shortfalls and maintain safe staffing. The service had a very limited staff turnover to support continuity in care.No concerns were raised by people, their relatives or staff in relation to staffing levels.

The provider had a continuous training programme in place for staff to meet the needs of people using the service. This included a blend of online and in-person training. There were systems in place to ensure staff received appropriate supervision and appraisal. Staff spoke positively of the training provided and confirmed they received supervision and appraisal.

New staff were recruited safely with appropriate pre-employment checks completed to ensure they were suitable for the role. There was an appropriate induction in place for new staff.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean and well maintained. Housekeeping staff were on duty 7 days a week and worked effectively to maintain a high standard of cleanliness. Records showed cleaning schedules were in place and consistently followed to ensure all areas of the service were clean and well maintained. There were management level audits in place to ensure good cleanliness and infection control practice was followed.

Staff understood their responsibilities in reducing the risk of the spread of infection and had received appropriate training. We observed there was Personal Protective Equipment (PPE) such as gloves and aprons available for staff to access throughout the service and staff used the PPE appropriately where required.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. However, improvements were still required in the oversight of medicines storage and ensuring all relevant documentation was completed.

Improvements had been made in relation to the management of topical preparations. The provider had changed their previous systems and application of creams was now clearly recorded and guidance for staff on where to apply creams had been put in place. However, we identified one person had been discharged from hospital with a cream which had not been accurately recorded by staff. The service management were unaware the person had this cream. As a result, no clear guidance was in place in relation to directions of use of the topical preparation, and risk assessments had not been completed where required due to the cream being a flammable product.

If medicines were prescribed to be taken ‘when required’ there were protocols and care plans in place to guide staff when these might be needed. However, we identified 1 instance where this was not the case. A person had been prescribed a controlled drug for anxiety 6 days prior to our visit. There was no protocol in place to guide staff on key information such when to use the medicine, the medication dose, route, minimum time between doses, the maximum 24-hour limit or expected outcomes. Whilst there was no impact to the person as they had not required the medicine, this placed them at risk. Immediate steps were taken by the provider to rectify this.

People’s records showed they received their medicines as prescribed for them. There were generally suitable arrangements for ordering, storage and disposal, including for medicines needing cold storage and those requiring extra security. Temperature monitoring was carried out to check that medicines would be safe and effective. However, we identified opening dates on liquid medicines were not recorded. Whilst we did not identify any impact on people, there was a risk medicines could be used outside of the manufacturer’s recommended storage guidelines as it was not always clear when some medicines had been opened.

This contributed to the continued breach of regulation in relation to safe care and treatment.