Beeches Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

At the last inspection the service was in breach of regulations relating to safe care and treatment, premises and equipment, staffing and good governance. At this inspection, enough improvements had been made, and the provider was no longer in breach of these regulations.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff confidently explained how they would respond to an incident or accident, confirming information and lessons learnt were shared amongst the team. A staff member told us, “Incidents are recorded, and we talk about the outcome and any required changes and discuss them in monthly governance meetings. We will hand over information about any falls or incidents over a few days, to ensure all staff are captured.”

Systems were in place to log accidents and incident, and actions taken in response to these had been signed off by the registered manager. For example, informing people’s next of kin, updating care plans and making the appropriate referrals.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider ensured pre-assessment paperwork was completed prior to, or as people moved into the home, and staff confirmed information about new referrals was shared in daily handover meetings.

People had access to a service user guide which helped them understand what they should expect, helping prepare people for their move into the home.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider ensured staff had up to date training in safeguarding. Information about safeguarding, including the local authority contact details was available in the staff room, for ease of access.

People and relatives confirmed people generally felt safe. One relative said, “[Person] is ok. They were very anxious at the beginning. They feel safe now.” A person added, “I know staff are here to look after me and wouldn’t hurt me.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff did not always ensure information about risks to people was robust, so we could not be assured care always met their needs safely. Several people at risk of falls, diabetes or pressure sores did not have the associated care plans, to guide staff.

However, staff received had a good level of training and were generally knowledgeable about risks to people. One staff member told us about changes implemented within the service to help mitigate risk. For example, staffing levels had been reviewed, and staff were now monitoring communal areas to reduce the risk of falls.

The provider detected potential risks in the care environment but did not always control them or make sure equipment, facilities and technology supported the delivery of safe care.

The provider had not ensured all staff had been shown how to use the fire evacuation equipment, and work was still ongoing to ensure fire doors were compliant with safety standards.

However, a full-time maintenance person was available to resolve maintenance issues quickly, and ensured the appropriate safety checks were carried out. A staff member told us, “The new maintenance person is quite good.” Staff confirmed they received training in fire safety and attended fire drills.

Following feedback, the nominated individual assured us a contractor had been scheduled to carry out the work to fire doors and gave a time frame for remedial actions. A nominated individual is responsible for supervising the management of the service on behalf of the provider.

The provider did not always make sure there were enough qualified, skilled and experienced staff. Staff received effective support, supervision and development and worked together to provide safe care that met people’s individual needs.

The provider’s dependency tool was used to calculate the required staffing levels, but we received some negative feedback about staff numbers. One relative said, “I visited the other week, they were short staffed, and it took ages for them to open the door. There was only 1 carer downstairs.” A staff member added, “I would like more staff. Mornings can be difficult to manage.”

However, the provider ensured staff were recruited safely and the appropriate checks had been completed. Staff received a thorough induction, and there was a good level of training and ongoing support.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Housekeepers were available daily and we observed the home to be clean and tidy. Kitchen staff maintained a good level of cleanliness in the kitchen, and systems were in place to ensure compliance with food hygiene standards.

The registered manager appropriately managed an outbreak which occurred during inspection; isolating those affected, implementing additional cleaning, ensuring personal protective equipment was available and securing treatment. No further cases were identified which indicated actions had been effective.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

The deputy manager ensured appropriate systems and processes were in place to order, store and dispose of medication safely, including controlled drugs. Records were completed clearly.

People’s medicines were regularly reviewed; and when people needed to receive their medication covertly, a multi-disciplinary approach was taken to decision making and the appropriate records were kept.

Staff had a good understanding of Stopping the Over Medication of People (STOMP). The deputy manager was promoting a culture of investigating potential triggers or utilising non-clinical methods of managing people’s behaviour, reducing the need for medication.