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We are carrying out a review of quality at The Beeches. We will publish a report when our review is complete. Find out more about our inspection reports.
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Inspection report

Date of Inspection: 7 May 2014
Date of Publication: 10 June 2014
Inspection Report published 10 June 2014 PDF | 84.6 KB

Overview

Inspection carried out on 7 May 2014

During a routine inspection

This was an unannounced inspection. This meant the provider did not know we were coming. At this inspection we also followed up on concerns we identified at the last inspection visit in December 2013 in relation to the management of medicines and the quality of records.

We spoke with four people who used the service and looked at their records. We also spoke with four relatives of people, five members of staff, a visiting professional and the provider to help us to understand the outcomes and experiences of people who used the service.

Is the service safe?

People who used the service told us they felt safe and had no concerns regarding the staff that supported them. People told us that the manager was approachable and they would speak with her if they had any concerns.

Staff spoken with had a good understanding regarding the level of support each person required to maintain their safety and well-being. Information within care plans and risk assessments demonstrated that people were supported to maintain their safety and welfare.

We saw that all care staff carried a radio whilst on duty and we observed these being used regularly. One member of staff we spoke with told us, “We all carry radios to contact one another in the building especially when we are assisting someone”.

Appropriate policies were in place regarding safeguarding vulnerable adults and staff demonstrated a good knowledge of what procedures to follow if they identified any safeguarding concerns or if any information of concern was disclosed to them.

Is the service effective?

Discussions with people using the service and information in care records showed that people’s needs and preferences were met. We saw a log that ensured that people’s preferences were respected with regards to their bedtime, waking and personal hygiene routines. The provider said, “It also makes staff accountable in case a service user doesn’t look well dressed; then we know who dressed them up that day”.

Relatives of people who used the service were generally complimentary of the care their relatives received. One relative said, “X receives very good care here. This place is ideal for her needs”.

During the visit, we saw that other healthcare professionals were involved in the care and treatment of people who used the service. One visiting professional told us that they came regularly to carry out health reviews of people who used the service. They said, “If they’ve [the staff] got any concerns or queries about medications, they’ll ring the clinic for advice. I’ve never gone back and felt concerned about anybody I have seen”.

People who used the service and their relatives told us that structured activities took place regularly and external providers were often invited to engage in activities with people. On the day of the visit, we observed a volunteer activities person engaging people in a sing-along group and exercises. People we spoke with told us that they enjoyed the activities that took place at the home.

Although the provider had made improvements to ensure that people were protected from the risks of unsafe medicine administration, they needed to ensure that their system for recording medication stored at the premises was effective.

Is the service caring?

We observed a positive working relationship between the staff and the people they supported. We observed that staff were caring and sensitive when they supported people with their personal care needs.

People using the service said that they liked the staff and confirmed they were helpful. A person who used the service told us, “The staff are polite and nice”. One relative said, “Staff are pleasant and friendly. I’m perfectly happy he’s [relative] here. I wouldn’t mind being in care here myself”. Another relative told us, “The staff are very caring. They’ve just thought of things that are very good for people”.

We observed that people were treated with dignity and respect by staff. Some people required support during meals and we observed that staff were professional and demonstrated care when they supported these people.

Is the service responsive?

People we spoke with told us that if they had any concerns or worries they would tell a member of staff or a family member. One person said, “You’ve only got to talk to X [the manager] and you’ll be alright”.

From our observations we saw that people using the service appeared relaxed and comfortable with the staff on duty and were able to openly express their opinions and preferences.

We saw that staff responded promptly to ensure people’s needs were met, for example when people requested support to use the toilet staff responded in a timely manner. We observed staff treating people respectfully, ensuring their dignity was maintained.

We saw that staff responded to the changing needs of people. A visiting professional said, “I’ve seen a gentleman who was quite breathless and they told me he was waiting to be seen by the GP”.

At the previous inspection, we told the provider that they needed to make improvements because they did not have appropriate arrangements in place to manage medicines safely and accurate and appropriate records were not being maintained to protect people from the risks of unsafe or appropriate care. We saw that the provider had made improvements to ensure that medicines were managed, stored and audited appropriately. People’s personal records were stored securely and care plans had been updated to reflect the care people received.

Is the service well-led?

People told us that the provider was always around to respond to any concerns. One relative said, “The provider is very good and the staff are very good. I go to X [the Registered Manager] or X [the provider] if I have any problems”.

The provider was present on the day of the visit and we saw that relatives approached him to obtain information about their relatives. We spoke with the provider and he demonstrated a good knowledge of the people who used the service. He said, “We have an open door policy and I love to meet and greet the relatives and get feedback from them”.

People who used the service told us that the registered manger was always available, approachable and friendly. The registered manager told us, “I go round and ask them [people who use the service] how they are. It’s something I’ve always done. Families just come to us if they’ve got a problem and we solve it there and then if possible”.

We saw that the provider carried out audits of the service to ensure that people received safe and appropriate care. We saw that the views of people who used the service, their relatives, staff and other professionals were obtained, recorded, analysed and actions taken to address any concerns raised.

Staff were clear about their roles and responsibilities and spoke positively about the management support they received. Staff told us that they were being provided with regular team meetings. A member of staff told us, “X [the provider] is constantly drilling into all of us about the paper work, that if it’s not written up, then it hasn’t been done”.