Archived: The Beeches

The Beeches is a residential care home providing personal care for 30 people at the time of the inspection. The service can accommodate up to 32 people. The Beeches is a purpose built establishment, situated to the rear of another residential care home. Accommodation is provided on two floors with stairs and a passenger lift between the floors and bedrooms are single occupancy with ensuite facilities.

People’s experience of using this service and what we found

The service completed various risk assessments and care records to mitigate risk to individuals where possible. Staff had completed a variety of training in relation to falls management and there were clear policies and procedures which guided staff on what action they needed to take. Hospital passports were in use, in line with national initiatives to improve communication for those who needed to be admitted to hospital, and improve outcomes in these circumstances.

The home was clean and staff were following current guidance in relation to infection prevention and control practice. Staff completed a variety of training in the use of PPE and good infection control practice and signage regarding good hand hygiene, social distancing and PPE was displayed throughout the home. The home was proactive in supporting people to maintain contact with their families, following current guidance, which included window visits and a visiting pod as well as video calls and phone calls.

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

Rating at last inspection

The last rating for this service was good (published 01 March 2018).

Why we inspected

We undertook this targeted inspection to check on a specific issue that had been raised following an Inquest into the death of a person living at The Beeches following a fall. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

Follow up

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

The Beeches 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. The service could accommodate up to 32 people. At the time of the inspection 27 people were using the service.

The Beeches is a purpose built establishment, situated to the rear of Yew Trees Residential Home. Both homes are owned and managed by Meridian Healthcare Limited, part of HC-One Limited. Accommodation is provided on two floors with stairs and a passenger lift between the floors.

We inspected the service in January 2015 and rated the service as 'Good'. At this inspection we found the service remained 'Good'.

The service had a registered manager. 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.

Relatives felt the service was safe. Policies and procedures were in place to keep people safe such as safeguarding, accident and incident policies. Staff had received training in safeguarding and knew how to report concerns.

We found that medicines were safely managed and only appropriately trained staff had the responsibility for administering medicines to people.

Staff recruitment procedures were robust and included Disclosure and Barring Service checks and references. Staffing levels were appropriate to the needs of the people using the service.

Risk assessments were detailed, person-centred, and gave staff clear guidance about how to help keep people safe. People had personal emergency evacuation plans in place in case of an emergency.

Records were available to demonstrate that where appropriate mental capacity assessments and deprivation of liberty safeguards authorisations were in place. We saw records that indicated people and / or their representative had given their consent to their care and treatment. However, the provider needed to ensure they evidenced people’s Lasting Power of Attorneys (LPA) to provide assurances people’s relatives / representatives had the correct legal authorisation to be involved in the persons care.

Staff were trained in a range of subjects such as infection control, health and safety and fire safety. Staff had also received training to support them to meet the needs of people who used the service, such as dementia awareness.

Staff received regular supervisions and an annual appraisal which covered their personal development. Staff felt they were well supported by the registered manager and assistant manager.

We found that people's nutritional needs were being met. People's views on the quality of the food were however mixed. We looked around the home and found the environment to be conducive to the needs of the people who lived there. The environment was generally well maintained. However, we found some areas of the home would benefit with redecoration. Rooms were bright and people had been encouraged to bring in personal items from home and many rooms were personalised.

We saw that the interactions of the staff with people were kind and they treated people in a respectful and dignified way and we saw that people were well dressed and cared for.

Staff were carrying out activities whenever they had the opportunity and time to do so and we observed people enjoying participating in a game of bowels and bingo during the inspection.

We looked at the complaints file and the complaints being dealt with at the time of our inspection. We saw that appropriate details of each complaint had been recorded along with details of actions taken to date.

The premises were well suited to people's needs, with ample individual living space. Communal areas were available for people to spend time together. Bathrooms were designed to meet the needs of the people living at the home.

Person-centred care plans were in place and contained good levels of detailed information. Care plans contained people's likes, dislikes and preferences. Regular reviews took place to ensure staff had up to date information.

The provider had a quality assurance process to monitor the quality of the service. Staff were extremely positive about the registered manager and assistant manager. We found people who used the service, family members and staff attended regular meetings where the quality of the service was discussed.

Everyone who commented spoke positively about the home and the staff members working there. Comments included; 'very nice'; 'can't fault the staff'; 'it's a pleasure to get up in the morning' and 'it's the best'. However, both some residents and relatives stated that there were not enough activities for residents to take part in.

The home had a safeguarding procedure in place. This was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.

Information about the safety and quality of service provided was gathered on a continuous and on-going basis via feedback from the people who used the service and their representatives, including their relatives and friends, where appropriate.

“The staff work hard and look after us well.”

“I need hoisting and two people always do that, they know what they are doing.”

“They (care workers) do talk to me about my care plan each month and I sign.”

We looked at the care records of four people using the service. Each contained appropriate documentation and information regarding the person’s initial admission into the home. Care plans and associated risk assessments were in place and all had been regularly reviewed.

Two people we spoke with told us that they were supported to take their medicines when they should. One person said, “They bring our tablets to the table in little pots, they never miss.” Another person said, “If I need my painkillers then I only have to ask.”

The registered manager of The Beeches had recently moved to manage another home within the organisation. The deputy manager was in charge on the day of our visit and will become the new manager of the service. It was confirmed that an application will be made to register with the Care Quality Commission.

On completion of this compliance review we found that people were well cared for and that the provider was meeting the regulations we looked at.