The Beeches

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Where any safety incidents had occurred, there were effective processes in place to record the event, actions taken, lessons learned and identify any themes or trends. This learning was then shared with the staff team through daily meetings which took place. The registered manager understood their responsibility under duty of candour and acted in an open and transparent manner.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Staff worked in partnership with other professionals such as GPs, dietitians and speech and language therapists (SALT) to support people to access healthcare when they needed it. During the inspection the management team demonstrated, when a person’s needs changed, they promptly engaged with services to ensure people’s needs were met and health was maintained. For example, where someone had a decline in weight, we saw evidence of GP involvement and supplements being provided to people to ensure they had adequate nutritional intake. This professional guidance was then reflected within people’s care and support records.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People told us they felt safe at the service. A person commented, “Yes, I feel very safe here. If there is anything I’m worried about, it is dealt with promptly.” A relative also told us, “Our family are very assured that [relative] is looked after in a safe place.” Staff had received up to date training on safeguarding and were knowledgeable on the service’s safeguarding policy and how to respond to and report any suspected abuse appropriately. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. The registered manager understood their responsibilities and the key principles of the MCA and DoLS, and we saw any conditions were being met. DoLS were being applied for appropriately and the manager tracked the progress of these.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People had a range of detailed support plans and risk assessments in place regarding the support they received. These covered areas such as maintaining healthy skin, safe moving and handling, eating and drinking, and mobility. This information was updated and reviewed on a regular basis to ensure it remained accurate and up to date. Staff knew people’s needs and any risks well. Where people were at risk of choking, staff were observed adhering to their modified diet guidance. Where people had wounds or pressure sores, staff documented their healing progress and highlighted concerns appropriately.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The care environment was well-maintained and safe. Checks and reviews of essential services including gas, electricity and water were completed regularly. We found security on the premises was robust and there was equipment in place for people if they required it and systems were in place to ensure equipment was regularly maintained. The staff carried out regular checks on safety, including fire safety. The staff had developed personal evacuation plans to ensure the people at the service were evacuated safely in an emergency.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. A dependency tool was used to determine how many staff were required daily. We observed safe numbers of staff on duty and found in communal and dining areas had good staff presence to respond to need. Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working at the home which included Disclosure and Barring Service (DBS) checks. Staff had received appropriate training to enable them to safely carry out their roles, the induction processes was thorough, and staff received regular supervisions and appraisals, which they told us they found useful.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Prior to the assessment we received concerns relating to the service’s environment. However, during the inspection we found no issues relating to the service’s cleanliness. Staff were observed using personal protective equipment (PPE)when carrying out care tasks. The environment was clean and tidy, and we observed domestic staff carrying out their work during the assessment. Toilets and bathrooms were equipped with appropriate hand hygiene facilities such as paper towels, liquid soap and foot operated pedal bins. Hand sanitiser was available in the home and posters were displayed about the environment to encourage compliance. A person commented, “I was impressed on first sight at this home, it is clean and very welcoming and family-oriented, and my room is lovely.” However, we did find some gaps in daily and weekly cleaning schedules. The registered manager was aware of this and was in the process of making documentation more robust.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People received their medicines safely and as prescribed, with a person commenting “I’m happy with how my medicines are managed, they are always on time.” Medicines profiles were in place for each person and were person-centred, including preferences for administration, capacity assessments, and best interest decisions where applicable. Medicines were counted at each administration, and spot checks confirmed that stock balances were accurate. PRN (as required) protocols were in place for oral and topical medicines, including guidance on application sites. Staff told us they had received effective training in medicines management and knew what action to take if a medicine error had occurred.