Beech Lodge Nursing Home

Beech Lodge Nursing Home is a nursing and residential care home providing accommodation, nursing and personal care to older people, people living with dementia and people with physical disabilities. The service can support up to 40 people. At the time of the inspection 35 people were living at Beech Lodge Nursing Home. Beech Lodge Nursing Home is an adapted building with all accommodation on the ground floor.

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

People received safe support with their medicines from staff members who had been trained and assessed as competent. Staff members followed effective infection prevention and control procedures when supporting people.

People were supported by enough staff who were available to assist them in a timely way.

People were protected from the risks of ill-treatment and abuse as staff had been trained to recognise potential signs of abuse and understood what to do if they suspected harm or abuse.

The provider had assessed the risks associated with people’s care and support. Staff members were knowledgeable about these risks and knew what to do to minimise the potential for harm.

People were supported to have maximum choice and control of their lives and the provider supported them in the least restrictive way possible and in their best interests; the application of the policies and systems supported good practice.

The provider, and management team, had good links with the local communities within which people lived. The provider had effective systems in place to identify improvements and drive good care.

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 28 September 2019).

Why we inspected

This inspection was prompted by concerns raised with us in relation to the management of medicines and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence people were at risk from these concerns.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good, based on the findings of this inspection.

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 the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beech Lodge Nursing Home on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Beech Lodge Nursing Home is a nursing and residential care home providing accommodation, nursing and personal care to older people, people living with dementia and people with physical disabilities. The service can support up to 40 people. At the time of the inspection the service was providing support to 35 people. Beech Lodge Nursing Home is an adapted building which has been extended. It has three communal living areas, a dining area and an unsecured garden. All accommodation is on ground floor level.

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

Since the last inspection changes had been made to the ways in which meals were prepared. The registered provider said the changes had been made to ensure people received nutritious foods. We received mixed feedback from people and relatives about the quality of food provided. We have made a recommendation about this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, documentation did not always show the provider was working within the principles of the Mental Capacity Act (MCA). We have made a recommendation about following good practice guidance related to the MCA.

People and relatives told us safety was considered and promoted at Beech Lodge Nursing Home. The provider was aware of the need to monitor and address risk. Medicines were managed safely, in line with good practice. Staff were aware of the importance of keeping people safe and responding to the risk of abuse. We received mixed feedback about the deployment of staffing and have made a recommendation about this.

Relatives told us there was an emphasis on providing person centred care within the home. Staff had been trained to support people at the end of their lives. Relatives praised the responsiveness of the management team and their commitment to listening and responding to feedback.

Care and support was flexible and tailored to people’s needs. People were able to have some control over their preferred routines. Relatives told us they were always welcomed at the home. When people had no family members to assist them with decisions, advocates were encouraged. People and relatives told us staff were kind and caring. Observations made during the inspection confirmed this.

People, relatives and staff told us the service was well-led. They praised the skills and approachability of the registered manager. The registered manager was aware of their role and responsibilities and the importance of continuous improvement. We saw evidence of multi-disciplinary working to ensure care was delivered in line with good practice.

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 requires improvement (published 22 March 2017).

Why we inspected

This was a planned and scheduled inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beech Lodge Nursing Home on our website at www.cqc.org.uk.

Beech Lodge provides accommodation with personal care or nursing care for up to 40 people. There were 29 people living at the home when we visited.

There was a registered manager in post. 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.

Staff knew how to protect people from harm and abuse. They knew how to report any concerns if they suspected someone had suffered potential abuse. Risks to people's safety had been assessed, and staff knew how to support people to reduce any risk of harm. There were enough staff to meet people's needs and the provider had safe recruitment processes in place to ensure that staff were suitable to work with people. People were supported to take their medicines safely and risks of harm to people were assessed and action was taken to minimise the risks through the use of risk assessment.

People and their relatives told us they were happy with their care, and were cared for by staff who had been trained and had the required skills to support them. People were encouraged and supported to make their own decisions where possible and staff knew about the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). However, some people did not have formal assessments of their ability to make decisions for themselves.

People were supported to maintain a healthy diet and received access to health care professionals if their needs changed, or if they became unwell.

People were supported in a kind and caring manner by staff who knew them well, and their privacy and dignity was respected and promoted. Care was personalised and met people's individual needs and preferences.

People were able to participate in activities that they enjoyed. They knew how to raise any concerns or complaints and these were dealt with in a timely manner.

People were happy with the support they received from the service. Feedback was encouraged from people and their relatives. Staff were clear about their roles and responsibilities, and there were systems in place to monitor the quality of the service and drive continuous improvement.

Staff told us how they supported people to make decisions and people who used the service told us that they consented to their care and treatment. We spoke with staff who told us that they had not received training with regards to the Mental Capacity Act 2005.

We observed people who used the service being treated in a caring and respectful way. One person told us, 'The staff are wonderful'. Another person told us, 'I feel happy here. The staff treat me well'.

We viewed records that showed care was planned and delivered in line with people's preferences. Staff we spoke with knew the needs of people who used the service and how they preferred care to be carried out.

We saw that the provider had systems in place that prevented the risk of cross infection. We saw staff used protective equipment during our inspection and staff we spoke with understood the importance of infection control.

The provider had a recruitment system in place. We saw that staff had been checked to ensure that they were suitable to provide support to vulnerable people.

We saw that the provider had an effective complaints system in place. People we spoke with told us that they knew who to complain to if they needed to.

We saw that people who used the service and their relatives were involved in the planning of their care. People we spoke with told us, "I told the manager what I wanted" and "I was involved with all aspects of my wife's care plan".

We observed staff treating people who used the service with dignity and respect. Staff listened to people's wishes and acted upon them. People we spoke with told us that they chose what they wanted to do. One person told us, "I like to stay in my room and watch television".

We saw that people appeared comfortable when staff were providing support and staff we spoke with understood the procedures to follow if they felt that someone was at risk of harm.

We viewed training records, which showed that staff had received mandatory training, but not all staff had undertaken the annual refresher training provided.

The provider had a schedule in place to provide regular supervisions to staff and staff felt supported in their role.

The provider had systems in place to monitor the service provided and where improvements had been identified an action plan had been put in place.