Archived: Beechfields Nursing Home Limited

Updated 23 February 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014. The inspection was prompted as part of our enforcement procedures.

The service has been in special measures since June 2017, when we rated the service as ‘Inadequate’ in the areas of Safe and Well Led due to widespread breaches of regulations. Services in special measures are inspected again within a six-month timeframe, when they are expected to make the required improvements and no longer be rated Inadequate in any key questions.

We inspected the service again in November 2017 and found that insufficient improvements had been made. The service was again rated ‘Inadequate’ in Safe and Well Led and remained in special measures. In line with our enforcement procedures, we placed two conditions on the provider’s registration, telling them they must not accept any new service users without our written agreement and must send us an action plan each month of how they were meeting the regulations. We continued to monitor the service and inspected again in June 2018. We found the provider had failed to make the improvements they had told us about and therefore we took action to begin the process of cancelling the provider’s registration.

This inspection was carried out to check for improvements at the service and to provide a rating.

Inspection team:

The inspection was carried out by two inspectors, an assistant inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Beechfields Nursing Home Limited is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced.

What we did:

We reviewed information we had received about the service since the last inspection, which on this occasion did not include a Provider Information Return. This is information we request on at least an annual basis about what the service does well and improvements they plan to make. However, we checked to see that the provider had notified us about important incidents, such as accidents or incidents of abuse, and we sought feedback on the service from the local authority. We also reviewed the provider’s appeal documentation and any supporting evidence they had submitted. We used all this information to plan our inspection.

During the inspection, we spoke with five people who used the service and six relatives to ask about their experience of the care provided. Some of the people using the service were unable to tell us their views about their care because they were living with dementia. We completed the short observational framework tool (SOFI) to help us to assess if people’s needs were appropriately met and they experienced good standards of care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with eight members of staff: three members of care staff, two nurses, the activities co-ordinator, the cook and the registered manager.

We reviewed a range of records. This included nine people's care records and multiple medication records. We also looked at records relating to the management of the home, which included three staff recruitment

Updated 23 February 2019

About the service:

Beechfields is a care home providing accommodation and nursing care to up to 35 people aged 65 and over. At the time of the inspection, there were 18 people living at the home, some of who were living with dementia. The accommodation is provided in one building over two floors. There are three communal lounges, a dining area, a conservatory and a garden area that people can access.

People’s experience of using this service:

Improvements had been made and people received their medicines as prescribed. Risks associated with people’s care and the home environment were assessed and managed safely. Staff understood people’s needs and knew what actions to take to reduce any identified risks.

There were enough, suitably recruited staff who worked well as a team to ensure people received timely support. Staff received an induction and ongoing training and supervision to fulfil their role. Staff had a good understanding of how to recognise and report potential abuse. Any concerns raised were acted on by the registered manager in line with local safeguarding procedures.

Quality checks had been improved and there was greater oversight at the service. However, further work was needed to ensure systems were consistently effective and improvements sustained.

Staff had received training and supported people to have maximum choice and control over their lives. However, improvements were needed to ensure people’s consent to care was consistently recorded in line with the legal requirements.

Staff were kind and caring and had good relationships with people. They understood people’s needs and preferences and provided personalised care. People were involved in developing their care plans and work was ongoing to ensure they were kept up to date and reflected people’s needs and preferences accurately. There were opportunities for people to engage in activities that promoted their wellbeing.

People were supported to access other health professionals and have enough to eat and drink to maintain good health. Changes had been made to ensure people received the support and encouragement they needed with their meals. However, further improvements were needed to ensure people always received this in a timely way.

People and their relatives were positive about the improvements made at the service and were confident in the registered manager’s leadership of the staff. People knew how to raise any concerns and complaints and there was a procedure in place to manage this.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

Inadequate (report published 15/08/2018).

Why we inspected:

At our previous three inspections in in June 2017, February 2018 and June 2018, we rated the service as Inadequate and placed them in special measures. At each inspection we found repeated breaches of the regulations and insufficient improvements had been made by the provider. When services in special measures do not make the required improvements, we take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This inspection was carried out as part of our enforcement process to check for improvements and to review the ratings. We found the provider had made significant improvements although there remained a breach of the regulations in relation to governance at the service.

Enforcement :

You can see what action we have told the provider to take at the end of the full report.

Follow up:

We will continue to monitor the service closely to ensure the provider sustains the improvements made and improves the rating to at least Good.