Beech House

Beech House is a residential care home providing accommodation and personal care to up to 27 people. The service provides support to older people. At the time of our inspection there were 27 people using the service.

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

People told us they felt safe. Risks to them were identified and well managed. Where required, people were supported safely with their medicines. Infection control measures were in place to prevent cross infection and staff wore appropriate PPE. The home was clean throughout although parts of the décor required some improvement. This was part of the provider's ongoing improvement plan for the service.

The provider had robust recruitment systems to ensure staff were safely recruited. Staff spoke knowledgably about the systems in place to safeguard people from abuse.

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

The management of the home promoted a person-centred service. There was an open and transparent culture and good partnership working with others. The quality and safety of the service was monitored through regular checks. Audits were in place and the provider had oversight of the service and the ongoing improvements.

Necessary referrals were being made and the provider spoke about being open and honest when things go wrong. Staff worked in partnership with other agencies to support people and enhance their quality of life. Staff spoke highly of the registered manager and people using the service and their relatives spoke positively of the care they received.

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

Rating at last inspection

The last rating for this service was good (published 10 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Beech House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

There were measures in place to reduce the risks associated with COVID-19 related staff pressures.

Staff had received training in the use of Personal Protective Equipment (PPE), and we observed staff wearing PPE as required. There were ample stocks of PPE.

People living in the home and staff were tested regularly for COVID-19. The service was meeting the requirement to ensure non-exempt staff and visiting professionals were vaccinated against COVID-19.

The registered manager was supporting visits for people living in the home in accordance with the current guidance. Visitors were required to undertake COVID-19 testing and wear PPE in line with current government guidance.

The home was very clean and uncluttered. Cleaning schedules were in place and frequently touched areas were cleaned regularly throughout the day to reduce the risk of infection. There was a range of auditing and monitoring in place to ensure infection control procedures were being followed properly. There were staff who acted as ‘champions’ for infection control, handwashing and PPE.

The system in place ensured any infection outbreaks could be effectively managed. The registered manager and staff demonstrated a commitment to providing people with continuity of care and caring support.

The registered manager had been in regular contact with the local authority and public health teams. The service had detailed risk assessments and policies and procedures in place to manage the risks of COVID-19.

Beech House is a residential care home providing personal care for up to 26 people aged 65 and over in one adapted building. There were 17 people accommodated at the home at the time of the inspection.

We found the following examples of good practice.

• Visitors risk assessments and temperatures were undertaken prior to entry.

• National guidance around coronavirus had been implemented. Personal protective equipment (PPE) was used effectively to safeguard staff and people using the service. Residents confirmed that staff wore PPE. We observed clear signage reminding people about the need to wash their hands and information on donning and doffing PPE effectively. Staff received specific training on infection control and how to keep people safe from the risk of infection.

• Although local restrictions were in place at the time of the inspection, alternative measures such as video calls and phone calls were utilised to update and maintain contact with family and friends. Communication was good at the home and families were sent updates and pictures of their relatives.

• The provider complied with shielding and social distancing rules. We observed some people at high risk were shielding and appropriate risk assessments were in place.

• We observed the home looked clean and hygienic. We viewed cleaning schedules and infection control audits.

• Infection control policies and procedures were in place and staff had received specific training.

Further information is in the detailed findings below

Beech House is a care home providing personal care and accommodation for up to 27 older people in one adapted building. On the day of the inspection the home was full, having 27 people using the service. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Beech House is a traditional Victorian style building, which has been converted and extended to provide all single bedrooms, one of which has en-suite facilities. The home is situated approximately one mile from Heywood town centre and is on bus routes to and from Rochdale, Middleton and Bury.

There was a registered manager 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.

Care files included a dependency tool, which outlined the level of assistance each person who used the service required. There were sufficient staff to meet the needs of the people who used the service.

The service had a robust recruitment procedure and disciplinary procedures were followed appropriately. There was an appropriate safeguarding policy, staff had regular training and demonstrated good knowledge of procedures and confidence to report any issues.

Health and safety policies and procedures were followed appropriately. Infection control procedures were in place and staff had undertaken relevant training. Medicines systems for ordering, storage, administering and disposal were appropriate and safe.

There was relevant information within the care plans, relating to health and support needs. We saw evidence of appropriate referrals to other agencies and partnership working.

The induction programme was thorough and included all mandatory training, introduction to the service and reading of all policies and procedures. Training was on-going and mandatory courses were refreshed on a regular basis. Staff were given opportunities for extra courses and National Vocational Training (NVQ).

Nutritional and hydration needs were documented and there were complete and up to date food and fluid charts for people who required extra support.

The service was working within the legal requirements of The Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People who used the service told us staff were kind and caring. We observed care throughout the home during the day and saw interactions were friendly and respectful.

Staff promoted people’s choices and encouraged as much independence as possible, whilst offering support to everyone. We saw examples throughout the day where staff members ensured people’s dignity was preserved.

The service had an up to date policy and procedure around equality and diversity. It was clear from observations that people were treated as individuals and their diversity respected.

There were regular residents’ meetings. There was evidence within care plans of involvement of people who used the service and their relatives in care planning and reviews.

There was a service user guide and a statement of purpose with relevant information included.

Care files we looked at included personal information and were person-centred. Appropriate equipment and technology, such as sensor mats, were used to help keep people safe.

There was a monthly magazine for people who used the service and all the information was in easy read format, with pictorial representations, to make it as accessible as possible to all.

There was a dedicated activities coordinator and there were a number of activities on offer at the home. Care plans and risk assessments were reviewed and updated on a monthly basis or when anything changed.

People’s wishes for when they were nearing the end of their lives, were recorded within the care files. Six members of staff were currently undertaking training in end of life care.

There was an appropriate, up to date complaints policy and procedure in place, which was outlined within the statement of purpose and the service user guide.

Management were approachable and supportive. We saw evidence of regular staff meetings and staff supervision sessions were undertaken regularly and handovers were thorough.

Spot checks were undertaken by the registered manager on a regular basis. Any issues were followed up appropriately. There were a number of regular audits undertaken and results were analysed and actions followed up.

Systems to monitor that records were kept up to date had been developed to help make sure people's health and well-being was maintained.

During our inspection we spent some time observing the care provided for people. We also spoke with people and their visitors. Comments received were positive. People told us; 'It would be hard to find something wrong', 'We're quite happy' and 'I would feel able to raise anything if I needed too'.

From our observations we saw that staff were gentle in their approach and offered people reassurance and encouragement with activities, such as using the hoist.

Some of the care records directing staff in the safe delivery of care were not as accurate as they should have been. This potentially left people at risk of not receiving the care and support they needed.

Suitable arrangements were in place with regards to meeting the nutritional needs of people.

Ongoing refurbishment was taking place within the home to enhance the standard of accommodation provided for people.

Suitable arrangements were in place for the safe recruitment of staff and their on-going training and development.

Systems to monitor and review the quality of service provided had been developed. Where improvements had been identified, action was planned for.

As our visit was early in the morning, most people were not awake to speak with us.

During this visit we spoke with the two night staff on duty. It was acknowledged that earlier in the year this had been the practice followed by staff however this had now ceased. One staff member said 'we don't feel under pressure to do this now'. Staff did tell us that four people were woken so that their medication could be administered at a specific time and prior to eating.

Looking round the home we saw that two people were up and sat in the lounge. We were told that one person liked to sleep in the chair and that this was detailed in their care records. The second person was able to wash and dress themselves. This person told us that they had wanted to get up. They appeared to have a good rapport with the night staff and told us that they, "like those two girls, they look after me' and 'they are the best two'.

During our discussions with staff it was clear that they had a good understanding of people's individual needs and how they liked to be cared for.