Archived: Beech Court Care Home

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 felt safe and staff knew what actions to take to keep people safe. Risks to people’s health and safety were appropriately managed and staff also promoted people’s independence.

There were sufficient numbers of suitable staff to meet people’s needs in a timely manner. People received their medicines as prescribed and they were administered by competent staff.

People were asked to provide consent to their care where possible and relatives were involved in making decisions when this was appropriate, although completed capacity assessments were not always available where people lacked capacity to make their own decisions.

Staff told us that they felt well supported and we saw that they were provided with the training required to meet people’s needs. Support for people to access healthcare services was provided consistently. People enjoyed the food and told us they were provided with sufficient quantities of food and drink.

There were warm and friendly interactions between people and staff and we observed staff talking respectfully to people. People and their relatives were able to be involved in planning and reviewing their care and staff respected any choices people made. Staff treated people with dignity and respect.

People were happy with the support they received and staff provided person-centred care. Staff had access to up to date information about people’s needs and knew people well. There was a limited provision of activities for people within the home and some people and relatives felt that more activities would be beneficial. People felt able to make a complaint and were provided with information about the complaints process.

Feedback about the quality of the service was welcomed, however not everybody was aware of how they could give their opinions, for example by attending the ‘residents and relatives’ meetings. There was an open and transparent culture in the home, people and relatives felt the management team led by example. A range of audits was available and, where these had been carried out, they were effective in bringing about improvements.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, and the records we looked at. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

Risk assessments were in place for things such as moving and handling and falls. Control measures had been put in place. This meant that people's needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. One person said, 'Yes I feel safe, the staff are very kind, it is good.' Another person said, 'Yes, I feel safe the staff make my breakfast and help with my medicine.'

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Documented procedures were in place for the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made. Staff had also had training in the Mental Capacity Act 2005. Although systems were in place to safeguard people we found two incidents where best interest decisions had been made but capacity assessments were not available. This meant that people were not always safeguarded.

People were supported to understand their care and choices that were available to them. We saw systems were in place to gain consent from people. People or their relatives had signed care records. Staff told us they gained people's verbal consent for day to day decisions. One person said, 'We have choices for lunch, they always ask me.'

Procedures were in place for the management medicine. We found that insufficient information was available for staff when medicine was to be given on an 'as and when required' basis Where medicine was being administered covertly we found that there was insufficient information about how this should be done. This meant that people were not always protected from the risks associated with medicines. Staff who were involved in administering medicine had been trained.

Staff had received appropriate professional development and were able to obtain further relevant qualifications. The provider had a training schedule in place to ensure staff were up to date with their mandatory training. We noted that some staff were due to receive refresher training in infection control and first aid. This meant people's safety was maintained in respect of this area.

Is the service effective?

People experienced care and support that met their needs. People told us how they were supported. We saw that referrals had been made to professionals such as the district nurse and doctors. We saw records that showed specialist help was sought when a person was having difficulty eating and drinking. One person confirmed they received help with their medicine. A relative said, 'X is 100% better off here, X's needs are met.' They went on to say how the person's mobility had improved whilst being at the home. This meant that people received care that met their needs.

Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people's needs.

Is the service caring?

People were supported by friendly and considerate staff. We observed staff treat people with consideration and respect. One member of staff gently re-assured a person who was becoming anxious. One person said, 'Staff are marvellous.' This person confirmed that staff would listen to them if they had a concern, People and their relatives confirmed staff were caring, respectful and polite. One person said, 'Staff are very kind.' Another person said, 'I think staff are very nice, very helpful.'

People's preferences had been recorded and care and support had been provided in accordance with people's wishes. People were involved in their day to day care and were supported to maintain their independence. A staff member told us how they encouraged people to maintain their independence when eating. One person said, 'If I requested it someone would come from the church.' Staff told us that the vicar visited the home. We observed one person being encouraged to enjoy their hobby of knitting. This meant people's diversity and individuality were promoted and respected.

Is the service responsive?

People were treated with respect and dignity. This was confirmed by people we spoke with. One person said, 'They always knock my door.' Care plans had been developed and were reviewed regularly. One person said, 'I know about my care plan.' Records showed that relatives were invited to six monthly reviews. A relative said, 'I have been involved all along.' Staff demonstrated a good understanding of people's needs. We observed people being given choices and being supported to make decisions themselves. A relative said, 'They have looked after X's health needs, they listened to me.'

People told us they would speak to the staff in the office if they were unhappy about anything. People were issued a 'service user guide' that outlined the person's rights and how the service would support them. Details of the complaints procedure was contained in the 'service user guide'. People and a relative told us they had no complaints.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. This was confirmed by records we saw. One person said, 'Staff would listen if I had a concern.' A relative said, 'There is always staff available.' A staff member said, 'It is like a big family, I have no concerns.'

Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. Staff told us they enjoyed their jobs and working for the provider. One staff member said, 'Everything is fine, people are safe and well cared for.'

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents. This reduced the risks to people and helped the service to continually improve. No formal complaints had been received since 2010. However, informal comments and issues were not recorded which meant the provider was not able to monitor trends to make improvement's. People and a relative told us they had no complaints.

The service had a quality assurance system in place. Audits and checks were undertaken regularly. This meant the quality of the service was able to continually improve.

We found that people who used the service were not always protected from the risks associated with the administration of medicines. We found inconsistencies in the way unused medication was carried forward from one month to the next, and recorded prior to administration.

We found that appropriate checks were undertaken before new staff began work at the service. We saw that people were supported and enabled to make comments or complain about the care they received.

We observed staff were kind, caring and supportive of people, however this was not reflected in the records they kept for each individual. We found a number of shortfalls regarding the record keeping and there were gaps in the information to identify if the person's needs had been met.