We carried out a review of the data available to us about Beechwood Gardens on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Beechwood Gardens, you can give feedback on this service.
Beechwood Gardens is a residential care home providing accommodation and personal care to 20 people living with dementia. At the time of the inspection 16 people were living in the home and two people were in hospital.
People’s experience of using this service and what we found
People’s risk and needs were assessed and managed although records would benefit from having more detail in them to support staff in managing people’s risks. Infection prevention and control concerns had been raised during the first day of inspection, but these had been addressed and improvements made before the second day of inspection.
The registered manager had oversight of the home, but quality assurance systems were not always robust enough to identify shortfalls or areas for improvement as identified in the areas relating to IPC during the first inspection.
Medicines were well managed. Staff had received training and support to ensure medicines were managed safely.
People and relatives were happy with the care provided. Staff knew people extremely well and this was evident in the care provided so people felt safe in the home.
Staff had confidence in the registered manager. They were supported and happy and felt able to contribute in all aspects of the care provided.
Rating at last inspection and update
The last rating for this service was good (published 16 December 2017).
Why we inspected
We inspected and found there was a concern with infection, prevention and control, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
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 COVID-19 and other infection outbreaks effectively.
The provider had taken action to mitigate the risks identified during the first day of inspection and had an action plan in place to continue to make the improvements needed.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beechwood Gardens on our website at www.cqc.org.uk.
Follow up
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.
We inspected Beechwood Gardens on 31 May 2017. The inspection was unannounced. At our previous inspection in February 2016 the service was in breach of Regulation 9, Personal Care, of the Health and Social Care Act 2008 because people were not receiving choice about their food or activities. Following our inspection the provider sent us a plan of how they would improve the choices people receive. At this inspection we found that improvements had been made and the provider was meeting the legal requirements.
There was a registered manager in post at the service. 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.
People, their relatives and staff said Beechwood Gardens was a safe place to live. Staff understood their role in keeping people safe and for reporting concerns about abuse or poor practice within the home. There were systems and processes to protect people from risk of harm. These included a risk management process, a thorough staff recruitment procedure and an effective procedure for managing people's medicines.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards DoLS). Staff had completed training in the MCA and understood how to support people to make decisions about their daily lives. Where people lacked capacity to make decisions about their care, decisions had been made in the person's best interests.
People told us staff were friendly and caring. Throughout our visit staff showed people kindness and treated people with respect. People were treated as individuals and were encouraged to make choices about their care. Staff protected people's privacy and dignity when providing care.
Staff had up to date information about people's care and a good understanding of people's needs and preferences. People's care records contained individualised information about how people liked to receive their care.
There were enough suitably trained staff to keep people safe and to meet people's needs. Staff received the training and support they needed to meet people's needs effectively. All staff had been trained to understand dementia so they could interact effectively with people living in the home.
People's health needs were monitored and people were referred to healthcare professionals when a need was identified. There were processes to ensure people's nutritional needs were met and people had enough to eat and drink during the day.
Visitors were welcomed and relatives and friends could visit at any time. There were processes in place for people and relatives to express their views and opinions about the home. People and relatives told us they were listened to and were confident they could raise any concerns with staff and the managers.
People told us they were happy with their care and had no complaints about the service they received. People who lived at the home, relatives and staff said the home was well managed. There were systems in place to monitor the quality of the service. This was through feedback from people and their relatives, staff meetings and a programme of checks and audits.
Beechwood Gardens is a care home which provides residential care for up to 20 people who live with dementia. During our inspection there were 17 people who lived at the home. Bedrooms were on the ground and first floor and there was a combined lounge and dining area on the ground floor which was split into two areas for people with differing stages of dementia.
The home had a registered manager in place. 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.
Most staff ensured they maintained people’s privacy and dignity and treated people with compassion and respect. However, we observed two occasions where this was not the case.
Weekly menus were planned that met people's nutritional needs however people did not always have a choice of meals.
The service was not consistently responsive to people's needs. Although people's choices were respected and listened to, people who had difficulties communicating had limited stimulation and opportunities for their social care needs to be met.
Background information about people’s interests and preferences was recorded but was not always included in people’s daily care. This meant there were people who did not experience person centred care.
People we spoke with told us they liked living at the home and felt safe. There were sufficient numbers of staff to meet people's needs on the day of our visit. New staff went through recruitment checks to ensure their suitability prior to working with people in the home.
People received their medicines as prescribed and checks were undertaken to ensure they received them in a safe way.
Mental capacity assessments were completed when needed and specified the nature of the decision the person was being asked to make. This demonstrated that the provider was following the principles of the Mental Capacity Act (2005). When people had a DoLS authorisation in place for continuous monitoring, it was reviewed within the specified time frame to ensure that people were not being deprived of their liberty unlawfully.
Individual risk assessments were completed and reviewed regularly to help prevent avoidable harm to people who lived in the home.
People were supported to maintain relationships with people important to them.
There was a system to record complaints and people told us they felt able to approach the manager if they had any concerns.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
We saw staff being attentive to people's needs throughout our visit. There was much personal attention and reassurance being given to people. Staff showed a good knowledge of individual needs and how to best meet them.
We spoke with two relatives and a visiting health professional. They were very positive about the service. One person told us they were 'More than happy with the care.' Another person said 'They manage the care very well.'
The report from the provider gave details of the complaints notice they had put in place. It confirmed that this had been displayed prominently in the home to make people aware of how to complain if they were not happy with any element of the service.
We spoke with a member of staff by telephone on March 1st 2013 and they confirmed that the notice was in place so that people were clear on what to do if they were unhappy about any aspect of the service.
We spoke with the manager and three of the staff on duty. Staff demonstrated a good awareness of people's needs and how to meet them.
The owner also visited while we were at the home and we spoke with them. We spoke with the relative of one person at the home, who told us they were happy with the care, but was not so happy about laundry items being lost.
We also spoke with a visiting health professional, who was impressed by the home's 'Responsible' attitude and the 'Extra effort' that staff and management put in to ensure people were well looked after. The home was clean and free from unpleasant odours. People were well-groomed and interacted positively with each other and staff.