Archived: Beech Tree Care Home Limited

Beech Tree Care Home is a residential care home providing personal care for people with mental health needs. The service is registered to support up to nine people. At the time of our inspection six people lived in the one adapted building.

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

People were protected from the risk and spread of infection by the hygiene practices of staff and the new ehanced cleaning programme they had implemented. The risks of people experiencing avoidable harm were reduced because known risks were assessed and plans were in place to mitigate them. The registered manager and staff were trained to identify and take action if they suspected people were at risk of abuse.

Staff supported people to take their mediciens safely. The registered manager ensured that medicnies records were in good order. Health professionals reviewed people’s medicines and worked in partnership with staff to support people’s mental and physical health needs.

Recruitment practices were robust. This meant the registered manager had assured themselves that all staff were safe and suitable to provide care and support.

The environment of thecare home was safe. Window restrictors were in place to provent people falling out of them. Potentially harmful cleaning products were secured and inaccessible to people and visitors. There were fire doors throughout the building along with smoke detectors and a fire alarm.

A new overarching auditing process was being implemented by the registered manager. This enabled an at-a-glance check of individual audits and the the completion of actions arising from them. The views of people, staff, relatives and healthcare professionals were sought and used to shape the service.

The registered manager and care staff worked collaboratively with health and social care professionals to meet people’s changing needs.

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 29 July 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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 that the service can respond to coronavirus and other infection outbreaks effectively.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

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

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.

Beech Tree Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Nursing care was not provided. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Beech Tree Care Home accommodates up to nine people with mental health needs in one adapted building. At the time of the inspection, there were six people using the service. Beech Tree Care Home is located on a residential road in West Purley close to local shops and good transport links.

People’s experience of using this service

Some areas of the home including people’s rooms and bathrooms were not clean. There was a strong, unpleasant odour in one area of the home. The lack of effective cleaning meant that people were at risk of infection.

People felt safe living at Beech Tree Care Home and with the way they were supported by staff. Appropriate arrangements were in place to make sure people received their medicines as prescribed.

People had enough to eat and drink, and were satisfied with the quality of food provided. People’s health was monitored and staff liaised well with external healthcare professionals which helped people to receive consistent care.

There were enough staff on duty to meet the needs of people. People were supported by staff employed following an effective recruitment and selection procedure which included relevant checks. This helped to make sure that only people suitable for the role were employed.

People were supported by staff who had received relevant training, regular supervisions and appraisals. Staff were kind, caring and approachable. Staff had built meaningful relationships with people and knew them well..

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. People went out when they wanted to and spent their time in the way they preferred.

People’s needs were assessed before they started using the service. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to be involved in their care.

The provider had a complaints procedure and people were aware of how to make a complaint. There were quality assurance processes in place but these were not always as effective as they needed to be. People and staff were regularly consulted about the quality of the service.

For more details, please see the full report.

Rating at last inspection:

At the last inspection the service was rated Good. The report was published in November 2016.

Why we inspected

This was a planned inspection. It was scheduled based on the previous rating.

Enforcement

Please see “the action we action we have told the provider to take” section towards the back of the report.

Follow up

We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

Beech Tree Care Home provides accommodation and support for up to nine people with mental health conditions. At the time of this inspection there were seven people using the service.

The home had 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.

The people living at the home were able to communicate clearly with us and provide feedback on the service. People were protected from the risk of harm and abuse by staff who knew how to recognise and respond appropriately to any concerns that they had.

Staff knew how to support people safely. Risks associated with people's care and support had been appropriately assessed and included ways to enable people to take risks, which respected their wishes to try new things. Staff were knowledgeable about the Mental Capacity Act and supported people to make decisions for themselves as far as possible.

Staff supported and encouraged people to keep healthy and well, they supported people to attend appointments with GP’s and external healthcare support when required. The staff team had developed excellent collaborative relationships with the external professionals. A senior member of staff from the mental health team reported positively on the service and the positive impact this had for people who used the service.

People were supported by a staff team who had the knowledge and the motivation required to support people achieve their goals to lead more independent lives. Reports were of a really caring service, relatives told of their overall impression of a manager and staff that really cared about people at Beech Tree and were not just ‘giving care’. People's independence was actively promoted, with people using the service and their families (with agreement) included in any decision making.

People had their nutritional needs assessed and people were supported develop practical skills and be more independent in shopping and involved in meal preparation. Mealtimes were friendly and sociable occasions with much interaction between people and staff. People were supported to take their medicines as prescribed by staff who knew what they were for. Medicines were ordered, stored and dispensed according to national guidelines.

The provider recognised the importance of regularly monitoring the quality of the service provided to people. They sought the views of people using the service and where people had made suggestions they had been listened to and acted upon. Staff enjoyed working at the home and they received good support from the registered manager. There was an out of hours on call system in operation that ensured management support and advice was always available when staff needed it.

We saw that peoples needs were met through assessments and agreed care pathways and support. Arrangements were in place to ensure peoples safety.

The service collected the views of people using the service and ensured that changes were implemented where needed.

There were seven people using the service and we met with four of them. People told us they could talk to staff if they had any worries or concerns. One person commented, 'I enjoy being here, it's a nicer atmosphere than my last place.'

People told us they received ongoing advice and treatment from heath and social care professionals to ensure that they stayed as well as possible.

Since our last inspection, the provider had registered a manager for the service. Staff told us that there had been improvements since the new manager took over. They had attended training which supported them in their role and felt that the record keeping had improved. One staff told us 'it's all running like clockwork now, things have gelled together.'

Quality monitoring systems had been strengthened. This meant that the manager knew what was working well and what needed improving in the home.