Beech House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff appropriately responded to accidents and incidents, reported them accordingly and kept people’s relatives informed. The management team monitored and investigated accidents and incidents, sharing lessons learnt to embed good practice and reduced the risk of them happening again. A relative told us, “When [my relative] had a fall, they've made sure they've started putting the buzzer mat down so [staff] can come and sort [my relative] when they need them.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They worked with people and relevant health and social care professionals to gather and share information about people’s needs when they moved into or out of the service. This included assessing people’s needs and creating individualised care plans and risk assessments for staff to follow with referrals being made to relevant professionals as needed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff had the skills and knowledge to identify safeguarding concerns and reported them internally. Staff were confident concerns would be acted upon and knew who to contact outside of the provider if they continued to have concerns. Records showed safeguarding concerns had been appropriately reported.

People and their relatives consistently told us people were safe and they trusted the staff.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care services this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA and whether proper legal authorisations were in place when needed to deprive a person of their liberty. Applications were appropriately made to deprive people of their liberty, with people’s care plans updated following authorisations and to reflect any associated conditions. Systems were in place to ensure DoLS were monitored and to ensure new authorisations were applied for in a timely manner.

Risks to people’s safety and wellbeing were managed by experienced staff. Staff were knowledgeable about catheter care and associated risks. However, the provider had not ensured all risks had been assessed and recorded in people’s care plans. For example, some people used catheters, but risks associated with their use had not been assessed and care plans did not contain guidance for staff on how people should be supported with catheter care. We raised this with the provider who took immediate action to address shortfalls in care plans and risk assessments.

The provider and new management team had identified not all staff had taken part in fire drills and had started to address this to ensure all staff knew what to do in the event of a fire.

Staff promoted people’s safety. Staff were attentive and understood the equipment people used to mobilise, how it should be used safely and gave clear guidance to people when moving around the service.

The provider was making significant investment into the service to improve the safety and quality of the environment to better support people’s wellbeing. Regular safety checks of the building and equipment were completed, though some had not been completed within required time scales. The provider had identified this and had taken swift action to ensure outstanding checks were completed to maintain the ongoing safety of the service.

The management team ensured there were enough skilled and experienced staff. However, there had been shortfalls in the support and supervision they received. Staff told us recent changes to the management team had left them feeling unsettled and at times unsure of what was expected of them. We also found staff had not received annual appraisals. The provider and new management team were aware of this and were increasing support available to staff through supervision and staff meetings.

Staff had the skills and knowledge to support people. Staff completed mandatory training and the manager was arranging additional face to face training to further support staff when meeting people’s needs. We found some staff had not received formal training to meet people’s specific needs, for example catheter and stoma care. However, staff we spoke with were knowledgeable about how to meet these needs. We raised this with the manager who confirmed training would be arranged.

Staffing levels were safe and supported staff to meet people’s needs in a timely manner. Staff were visible throughout the home, were able to spend quality time with people and responded promptly when people needed support. Staff told us there were enough staff, but at times it could be busy. They spoke positively about the provider recently increasing staffing levels following their feedback.

Systems were in place to ensure the safe recruitment of staff. Appropriate checks had been made to ensure staff were safe to work with vulnerable people. The provider was reviewing staff recruitment records to ensure all required paperwork was in place and of an appropriate standard. Induction processes were in place to support staff development and could be extended or changed to support new staff as needed. The provider was reviewing induction processes to allow for a more supportive approach.

The service was clean and the provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading through ensuring staff were trained in infection prevention and control, sufficient stock of PPE and the replacement of old furniture with domestic staff on site daily to maintain the cleanliness of the service.

The provider did not always ensure effective oversight of people’s medicines. Staff told us they knew what time people had their medicines so they could ensure minimum time requirements between doses were met. However, we found there was no system in place to record when they were administered. People had not come to harm from this. However, it placed people at risk of harm. We raised this with the provider who implemented appropriate systems during the assessment.

Staff were trained in the safe administration of medicines, and their competency had been assessed in line with best practice. Staff engaged positively with people when administering their medicines and respected their right to refuse. However, where people regularly declined a medicine, staff had not contacted their GP to request their medicines to be reviewed. This meant people were not always receiving their medicines as prescribed, though we did not find anyone had come to harm from this shortfall.