All inspections: The Beeches - Care Quality Commission

Date of assessment: 14 - 22 October 2025.

The Beeches is a care home without nursing for up to 54 older people, some of whom may be living with dementia, or have needs related to a learning disability or autism.

As the home is registered to provide care to people with a learning disability and/or autistic people, we assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The last inspection of the service was on 30 April 2019 when we rated the service Requires Improvement. The provider was in breach of legal regulations in relation to safe care and treatment and person-centred care. Improvements were found at this assessment, and the provider was no longer in breach of these regulations.

People lived in a safe, clean environment. People’s medicines were managed safely. Staff carried out regular checks on facilities and the equipment used in the delivery of people’s care. Some people’s pressure-relieving mattresses had not been set correctly. The provider took immediate action to address this and created a reminder for staff to check pressure-relieving mattress settings daily.

Staff were recruited safely and had access to the induction, training and support they needed to carry out their roles. Staff attended safeguarding training and knew how to recognise and report abuse.

People’s needs were assessed before they moved into the home and their care plans developed in line with their individual needs and preferences. Staff encouraged people to make choices about their care and how they lived their lives.

Staff shared information effectively to ensure people’s needs were met. Staff teams met regularly to discuss any changes to people’s needs and any concerns or suggestions they had. Feedback from residents and their families was listened to and acted upon.

Staff received good support from their line managers and the management team and had opportunities to discuss their performance and professional development. Managers understood the importance of demonstrating the provider’s values in their attitudes and behaviours.

The provider’s quality monitoring and governance systems helped ensure effective management oversight of the service. Where areas for improvement were identified, these were included on the home’s action plan, which was reviewed regularly by the management team.

About the service: The Beeches is a residential care home that provides personal and nursing care for up to 54 older people, some of whom are living with dementia. At the time of the inspection, 47 people were living at the home. The Beeches is divided into four separate units in one building: Squirrels, Foxes, Dormouse and Woodpecker.

People’s experience of using this service:

People were not protected from the risk of infection. Paper containing faecal matter had been left on top of the cistern in one toilet and a bedsheet was stained with faecal matter. Continence pads were not stored safely.

People’s care needs were recorded, as were their preferences, likes and dislikes in most cases. However, activities were not planned based on people’s interests, although there was a programme of activities every day. Information was not presented in an accessible format in line with people’s communication needs. Care plans lacked detail in some cases on how staff should support people’s specific needs.

People did not always feel there were enough staff to support them promptly when they needed help. One person said, “There are not enough staff and it puts me off calling them. I don’t want to overwork them, they do so much”. We have made a recommendation in relation to the deployment of staff.

On the day of inspection it was not clear who had overall management of the home. People had mixed views about the management. One person said, “We have two or three [managers], but they are mostly in their offices. You can go and see them, but they should be out here seeing us”.

People were positive about the care they received and staff were friendly, kind and caring. People were treated with dignity and respect and encouraged to make decisions about their care. A relative said, “We are always made welcome. They know we travel a distance and there’s always a drink and we can eat if we want to. We couldn’t be happier”.

People told us they felt safe living at the home. Their risks had been identified and assessed appropriately with guidance for staff on how to mitigate risk. Medicines were managed safely.

People were happy with the food on offer and said they had a choice of menu. Special diets were catered for. People had access to a range of healthcare professionals and support. 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 support this practice.

People and their relatives were asked for their feedback through questionnaires and results were overall positive. Residents’ meetings took place and suggestions were listened to and acted upon. Staff felt supported in their roles and completed a range of training to carry out their responsibilities. They had the skills, knowledge and experience to deliver effective care.

Rating at last inspection: At the last inspection, this service was rated as Good (published in April 2018).

Why we inspected: We were required to inspect this service within 12 months of the last inspection because of a breach of regulation. The provider sent us a plan after the last inspection which outlined the actions they proposed to take to address the issues of concern. This inspection took place to check on the improvements made and in line with CQC scheduling guidelines for adult social care services.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will review the service in line with our methodology for ‘Requires Improvement’ services.

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

The Beeches is a care home that provides accommodation and support for up to 54 people with a variety of physical conditions, disabilities and long term conditions. Some people living at the service were living with dementia. 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 home is set over two floors and divided into four separate living areas. Each living area has its own lounge and dining facilities. At the time of our inspection 45 people were living in the home.

This inspection took place on 5 March 2018 and was unannounced.

There was a registered manager however they had been on maternity leave since August 2017 and were not due back at the service until later in 2018. 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 and associated Regulations about how the service is run. The acting manager, who was overseeing the service in the absence of the registered manager, assisted us with our inspection. We have referred to the deputy manager as the acting manager in our report.

Safeguarding concerns had not always been notified to CQC which is a requirement of registration. We also found that records in relation to people were not always up to date. The Beeches was clean and people received the medicines they required, however we found some poor medicines management processes. We have made a recommendation to the registered provider. People told us they felt safe living at The Beeches and staff were able to give us examples of what might constitute signs of abuse.

Although quality assurance audits were carried out to check the quality of the service, we found these did not always identify shortfalls. However, there were other audits undertaken which were robust and we found actions raised were addressed.

People could take part in activities if they wished and staff actively encouraged this. The acting manager had developed new activities within the service to help people feel included. However, people told us they would like to go out of the service more.

People and staff told us there were sufficient staff to care for people and we did not see people having to wait for their care on the day. Recruitment processes were in place to help ensure that there were only suitable staff working at the service. Accidents and incidents relating to people were recorded and action taken to help mitigate reoccurrence and staff discussed events for lessons learnt.

Regular fire checks and fire drills were carried out to help ensure staff would know what to do in the event of an emergency. Individual fire information was available should the emergency services require it.

People who were unable to make their own decisions had the necessary processes carried out to help ensure that any decisions made for them were made in their best interests. Before people moved into the service their needs were assessed to ensure staff could provide the care they required. People were supported to eat a good range of nutritious foods and staff recognised people’s dietary needs.

People were cared for by staff who had access to relevant training and the opportunity to meet with their line manager on a regular basis. People were also cared for by staff who took time to involve health care professionals to help ensure people remained healthy and received effective care.

People were supported to make their own decisions and remain as independent as possible. Staff showed people respect and recognised that people may wish privacy at times. People were supported and enabled to spend time with those close to them and staff showed people empathy and attention when they needed it. There was a close, friendly atmosphere within the home. Relatives were greeted warmly by staff and they only had good feedback for us in relation to the care their family members were receiving. People’s rooms were personalised to their individual tastes.

People’s care records contained information about their needs and guidance for staff to help support them to provide responsive care. In the event that a person required end of life support the acting manager told us they worked closely with the relevant agencies. If people felt the need to make a complaint there was a procedure in place for them to follow.

There was a good working relationship between the acting manager and staff and staff felt supported. People were involved in the running of the service and invited to give their feedback on the care they received.

The acting manager was proactive in relation to any shortfalls we identified and they had a clear vision of how they would like to improve the service. The culture within the staff team was good and staff worked well together and were aware of their responsibilities to demonstrate team work. The service worked in conjunction with other agencies to help provide good care to people.

During our inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made two recommendations to the registered provider. You can see what action we told the provider to take at the back of the full version of the report.

The Beeches is a care home that provides accommodation and support for up to 54 people. Some of whom are living with dementia. Accommodation is arranged over 4 units each with its own dining and lounge facilities. A lift provides access to the first floor. The home is owned and oTperated by Anchor Trust.

The home had a registered manager in post on the day of our 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 and associated Regulations about how the service is run.

People told us they were treated well by staff who were kind and caring. People’s privacy and dignity was respected. We saw staff knocked on people’s doors before they entered, and personal care was undertaken in private.

People told us they felt safe. Staff had undertaken training regarding safeguarding adults and were aware of what procedures to follow if they suspected abuse was taking place. There was a copy of Surrey County Council’s multi-agency safeguarding procedures available in the home for information and staff told us this was located in the office for reference.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. The manager and staff explained their understanding of their responsibilities of the Mental Capacity Act (MCA) 2005 and DoLS and what they needed to do should someone lack capacity or needed to be kept safe. However we noted that not everyone who required a DoLS authorisation had an application in progress.

Staff had a good understanding of the Mental Capacity Act 2005 and had undertaken training in this. We observed that some mental capacity assessments had not been completed correctly and were not signed or dated.

Risk assessments were in place where people had an identified risk. For example a person was required to have a soft diet because they were at risk of choking, and people who were at risk of falling had manual handling risk assessments in place to protect them from being hurt due to excessive falls.

Care plans were well maintained, easy to follow and information was reviewed monthly or more frequently if needs changed. For example someone was having ongoing speech and language intervention for swallowing difficulties which was clearly documented.

People’s health care needs were being met. People were registered with a local GP who visited the home weekly. Visits from other health care professionals for example care managers, and district nurses also took place.

People had sufficient food and drink to keep them healthy. We saw lunch was well organised and people had the choice of four dining areas. There was sufficient staff support available for people who required help to eat. Where people had an identified risk in relation to nutrition this was managed well by staff.

We looked at the medicine policy and found all staff gave medicine to people in accordance with this policy. Medicines were managed safely, stored securely and people received their medicines in a safe and timely way. Staff were trained appropriately in the administration of medicine.

There were enough staff working in the home to meet people’s needs. People said the staff were very good and they did not have to wait too long when they required assistance. We saw several examples of staff responding to call bells in a timely way throughout the day.

Staff recruitment procedures were safe and the employment files contained all the relevant documentation and safety checks to help ensure only the appropriate people were employed to work in the home.

The activity coordinator showed us the activity arrangements in place. People were engaged in activities during the day and these were organised on individual units. People had been provided with a complaints procedure and knew how to make a complaint should they need to. They told us they knew who to talk to if they had issues or concerns.

People had been provided with a complaints procedure and knew how to make a complaint. They told us they knew who to talk to if they had any issues or concerns.

There were effective quality assurance systems in place to monitor the service being provided, for example reviews of care plans, risk assessments, and health and safety audits.

The home was being well managed. People relatives and staff said they found the registered manager approachable and available. Staff told us they felt valued and feedback from people about the quality of the service was positive.

Records relating to the care and treatment of people were stored securely and maintained accurately.

This was a follow up inspection because at our last inspection on 19 November 2013 we found the registered person was not fully meeting the regulations set out in the Health and Social Care Act 2008. The registered person sent us an action plan telling us what actions they would take and gave us 31 March 2104 as the date they would become compliant with the regulations.

At this inspection we found the provider had taken appropriate steps to ensure that people who used the service now had records including medical records in place that were accurate and fit for purpose.

We also looked at the staffing arrangements in the home to ensure that there were sufficient staff employed in the home to meet the assessed needs of the people living there.

During the inspection we spoke with twelve people who used the service, four relatives, the business manager, care manager, chef manager and six members of care staff.

People told us that they received good care from staff who knew their needs well. They said that they enjoyed the food provided by the home and that there was a good choice of meals available. We saw evidence that where dietary needs had been identified, they had been communicated to the catering staff and referrals to appropriate professionals had been made.

Since our last inspection, concerns about the management of medication at the home had resulted in a multi-agency safeguarding investigation. At this inspection we found that the provider had taken action to improve the management of medication

At our last inspection we found that staff did not have adequate opportunities to receive feedback about how they were performing or to discuss their training needs or professional development. At this inspection we found that the systems in place to support staff had improved but would benefit from further development.

We checked a sample of care records and found that some contained inaccuracies that could have affected people’s safety or welfare. For example the information recorded on some falls risk assessments was incorrect and, as a result, the assessments did not identify any measures to manage the risks to people.

During the inspection we spoke with 12 people who used the service, five relatives, nine care staff and the registered manager. We found that people were happy with the care they received. Residents told us that staff were available when they needed them and that they knew the staff who provided their care, which was important to them. They said that staff were polite and treated them with respect.

Relatives confirmed that their family members received good care and support. Relatives said they were consulted about their family member’s care and involved in any important decisions that were made. We found that, whilst staff knew the needs and preferences of the people they cared for, the sharing of information about any changes to the delivery of care needed to improve.

We found that the provider had an effective complaints procedure and that complaints were investigated and responded to appropriately. The staff we spoke with during the inspection were aware of their responsibilities in relation to recognising and reporting abuse. Staff told us that they had received a comprehensive induction when they started work and that they had access to the training they needed. However we found that staff did not have regular opportunities to receive feedback about their performance or to discuss their professional development.

People told us that they liked living at The Beeches. They liked the idea of individual units because it provided a small and friendly atmosphere. They told us that they liked their rooms and that it was important to them to be able to bring personal possessions with them. They said it made the decision of living in a care home easier having a little bit of home with them.

Service users told us that the staff were kind and considerate and were always available when required. They said some were better than others.

They told us that they are consulted about their care and how this is delivered. They are aware of care plans and are involved in reviews of care.

Relatives were satisfied with care outcomes They said they are kept informed of changing needs, and invited to participate in events in the home. Generally there was good feedback about the food provided and people said that the meals were tasty, appetising, with plenty of choice.

Some people told us that they enjoyed the activities. They said they liked to visit other units and join in the planned activities. Music, bingo and visiting the caf' were some of their popular choices.

The Beeches

All Inspections

During an assessment under our new approach

30 April 2019

During a routine inspection

5 March 2018

During a routine inspection

20 August 2015

During a routine inspection

4 September 2014

During a routine inspection

19 November 2013

During a routine inspection

19 March 2013

During a routine inspection

13 May 2011

During a routine inspection