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Inspection carried out on 26 June 2017

During a routine inspection

Beyer Lodge Nursing Home is registered to provide accommodation with nursing care for a maximum of 16 older people aged 65 years and above assessed as requiring nursing care for mental health needs.

At our last inspection in October 2014, the service was rated Good. At this inspection we found the service remained Good.

Due to the nature of the service provided at Beyer Lodge, we were unable to speak with the majority of people who used the service to ascertain their views about the care and support provided. However, we spoke with relatives and visiting professionals and completed a Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

People told us they felt safe living at Beyer Lodge. Staff received safeguarding training and knew how to keep people safe and raise concerns if they suspected someone was at risk of harm or abuse.

People who used the service had risk assessments which were reviewed and updated timely to meet people’s changing needs. This ensured staff had access to the relevant information and guidance to mitigate risks.

Staff we spoke with and visiting relatives told us there were sufficient numbers of staff on duty to meet people’s needs.

The management of medicines was safe. There were appropriate arrangements in place to ensure that medicines had been ordered, stored, received and administered appropriately.

People were supported in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were encouraged to make decisions and choices about their care and had their choices respected.

People's consent to care and treatment was sought prior to care being delivered.

People were encouraged to maintain a nutritionally balanced diet and had access to sufficient amounts to eat and drink, at times that suited them.

People's health care needs were monitored and maintained; people had access to health care services as and when needed.

People continued to receive care and support from staff that were kind, caring and compassionate.

People were treated with dignity and respect and had their independence promoted by staff that openly expressed their fondness for the people they cared for and supported.

The provider had a complaints procedure in place and people felt confident in raising concerns or complaints to staff and the registered manager.

People, relatives and staff spoke favourably of the management and felt the home was well-led.

The registered manager carried out regular audits of the home. We saw areas of improvement were identified and disseminated throughout the staff team to demonstrate action had been taken in a timely manner. Feedback of the home was sought and used to drive continued improvements.

Inspection carried out on 21 October 2014

During a routine inspection

This inspection took place on 21 October 2014 and was unannounced. The home was last inspected in December 2013 and there were no breaches of legal requirements at that time.

Beyer Lodge Nursing Home is registered to provide accommodation with nursing care for a maximum of 16 older people aged 65 years and above assessed as requiring nursing care for mental health needs.

The home had recently been taken over by Making Space.  

There was a registered manager in place at the service. 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.

People who lived at Beyer Lodge were encouraged to make their own decisions about their lives and it was clear from speaking with people and our observations that the staff had developed good relationships with people. We saw people had their dignity and privacy respected. People did not always want to speak with us and staff respected their choices. 

The care plans were detailed and contained a good amount of information to help staff support people well. There were capacity assessments in place and the correct procedures had been followed to ensure people were not unlawfully deprived of their liberty or have any restrictions put upon them which had not been agreed.

We found the service to be well led, relaxed and friendly and people were supported by appropriately trained staff who were caring and knowledgeable about them. We found the skill mix and staffing levels were sufficient to support people safely and effectively.

The community mental health team (CMHT) had made us aware of a concern in relation to the recording and administration of medication. We found medication records were in good order and where the error had occurred the correct reporting procedures had been followed.

People had the opportunity to be involved in a range of activities and were encouraged to maintain relationships with their friends and family, to participate in their local community and enabled to take risks. 

The home had experienced some difficulties providing support to some people who used the service in relation to their assessed dietary requirements. This was because the speech and language team (SALT) had made recommendations for some people to be provided with soft food or thickener to reduce the risk of choking. Sometimes people who used the service did not always want to follow these recommendations. We found the home had responded appropriately to try and manage the situation whilst respecting the choices of the people they supported.

From discussions we had with people who used the service, staff and other professionals we found there was a mixed response in the feedback we received from healthcare professionals about the service. From further information and meeting with stakeholders after the inspection we were able to ascertain the home was providing a good service, which took account of people’s views and embraced continual improvement and development.