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Inspection Summary


Overall summary & rating

Good

Updated 16 December 2017

This inspection took place on 14 November 2017 and was unannounced. This meant the registered provider did not know we would be visiting.

The Beeches was last inspected by CQC on 3 May 2016 and was rated Requires Improvement overall and in four areas; Safe, Effective, Responsive and Well-led. We informed the provider they were in breach of regulation 12 regarding the safe management of medicines and the management of risk assessments.

Whilst completing this visit we reviewed the action the provider had taken to address the above breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that the provider had ensured improvements were made in these areas and this had led the home to meeting the above regulation.

The Beeches is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Beeches provides personal care for up to 64 people. At the time of our inspection there were 59 people living at the home, some of whom were living with dementia.

There was 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.

At the last inspection we found that the service didn’t have appropriate arrangements in place for the safe handling of medicines. Stock checks of controlled drugs were not always recorded accurately and room and medicine temperatures were not always recorded. People’s medicines records were not always person centred and lacked detail and audits of medicines did not identify issues. Records for people who took medicines ‘as and when required’ were not detailed enough to give staff enough guidance. At this inspection we observed actions had been taken and sustained improvements were achieved in this area including improved records.

At the last inspection risk assessments for people were not updated regularly and some lacked detail. At this inspection we found people were supported to take risks in everyday living and individualised risk assessments were in place and updated regularly.

Accidents and incidents were monitored by the registered manager to monitor any trends and to ensure appropriate referrals to other healthcare professionals were made if needed.

The premises were clean and tidy. However we observed a malodour on the first floor of the building and this was addressed by the registered manager.

Throughout the inspection we saw staff cleaning communal areas, and we noted that people’s rooms were also tidy. Staff had access to personal protective equipment.

People who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes.

Staff understood safeguarding issues and procedures were in place to minimise the risk of abuse occurring. Where concerns had been raised we saw they had been referred to the relevant safeguarding department for investigation. Robust recruitment processes were in place.

People’s health was monitored and referrals were made to other health care professionals where necessary, for example, their GP, community nurse or dentist.

Staff were supported to maintain and develop their skills through training and development opportunities..

Staff had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their care practice and identify further training needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Inspection areas

Safe

Good

Updated 16 December 2017

The service was safe.

Improvements had been made to ensure people’s medicines were managed safely.

Risks to people were assessed and individualised plans put in place to minimise them.

Safe recruitment systems were in place.

Staff had an understanding of safeguarding issues and the action they would take to ensure people were safe.

Effective

Good

Updated 16 December 2017

The service was effective.

People were supported to maintain a healthy diet; improvements to records to support this had been made.

People were supported to access other healthcare professionals as required.

Staff training was appropriate and up to date.

Staff were supported by regular supervisions and appraisals.

The service was worked within the principles of the Mental Capacity Act 2005 to protect people’s rights while providing care and support.

Caring

Good

Updated 16 December 2017

The service was caring.

People and their relatives spoke positively about the care they received at the service.

People were treated with equality, dignity and respect.

People could access advocacy support when required.

People were supported to make choices.

Responsive

Good

Updated 16 December 2017

The service was responsive.

Peoples care plans were person centred and had been recently improved to contain more details on preferences.

People were supported to access meaningful activities

People know how to make a complaint if needed.

People were supported with end of life care.

Well-led

Good

Updated 16 December 2017

This service was well led.

A registered manager was in place. A registered manager is a person who has registered with CQC to manage the service.

There were effective systems in place to monitor and improve the quality of the service provided. Staff were complimentary about the management and the provider.

Staff were supported by the management arrangements and felt able to have open and transparent discussions with them through one-to-one meetings and staff meetings.