Beaconsfield Court

Beaconsfield Court is a residential care home providing the regulated activity accommodation for people who require nursing or personal care to up to 32 older people, including people who may live with dementia or a dementia related condition. At the time of our inspection there were 29 people using the service in one adapted building.

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

People and relatives were complimentary about the care provided by staff. They trusted the staff who supported them. They said staff were kind, caring and supportive of people and their families. A relative told us, "The home is excellent. I’m confident the care is consistent. Personal care is fine", and "Staff are friendly, they always chat to [Name]. Always somebody coming and going. Plenty of activity."

There were sufficient staff to support people safely. A person commented, "Staff pop in frequently with a cup of tea. There are always people around. I engage with the staff really well", and "Attention from staff is prompt.”

Records provided guidance to ensure people received safe, person-centred care and support from all staff members. Risks were assessed and mitigated to keep people safe. Staff contacted health professionals when people’s health needs changed.

Staff received safeguarding training and were clear on how and when to raise their concerns. Where appropriate, actions were taken to keep people safe. Staff recruitment was carried out safely and effectively. Medicines were managed safely.

An infection control system was in place. However, not all areas of the home were clean and well-maintained and there were signs of wear and tear.

We have made a recommendation about continuing with the refurbishment programme ensuring the appropriate environmental design to meet all people’s needs.

People's diversity as unique individuals with their own needs was respected by staff. The staff team provided support discreetly and with compassion. They respected people’s privacy, and people were supported to maintain contact with relatives. A relative commented, “We can rest in peace knowing that our [relative] is well looked after.”

There was a cheerful and welcoming atmosphere at the service. Staff spoke very positively about working at the home and the people they cared for. Relatives and staff said communication was effective to ensure they were kept up-to-date about any changes in people’s care and support needs. A relative told us, "I can contact the home at any time. Carers take the calls and pass them on. They’ve got their finger on the pulse at the home. It’s like a family. Gives peace of mind and quality of life.”

There was a strong and effective governance system in place. People, relatives and staff were confident about approaching the registered manager if they needed to. They recognised that their views and feedback were valued and respected and used to support service development. Strong processes were in place to manage and respond to complaints and concerns.

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.

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 23 March 2018).

Why we inspected

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

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.

Recommendation

We have made a recommendation about continuing with the refurbishment of the environment and ensuring it is appropriately environmentally designed.

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:

• Systems were in place to prevent people, staff and visitors from catching and spreading infections. All visitors had to wear appropriate PPE, provide evidence of a current negative COVID-19 test, complete a health declaration form and have their temperature checked prior to entering the home. Additional cleaning of all areas and frequent touch surfaces was being carried out.

• The provider was following national guidance for anyone moving into the home. Staff worked closely with healthcare professionals to ensure appropriate and safe admissions procedures were being followed.

• Staff supported people’s social and emotional wellbeing. The registered manager told us how people living at the service were resilient. The home had a visiting pod which was well utilised and had stringent cleaning measures to ensure people were kept safe. The provider and staff kept family members up to date about the latest guidance and their relative’s health via regular telephone calls, letters and social media. We saw staff supporting one person to enjoy a telephone call with their family.

• Staff wellbeing was a priority and the provider and registered manager ensured staff received appropriate guidance and support. All staff, including catering and housekeeping staff had undertaken additional training in infection prevention and control. This included putting on and taking off PPE, hand hygiene and other COVID-19 related training. The deputy manager had also carried out spot checks to ensure staff were following current guidance relating to PPE.

• There was a robust communication system in place to ensure staff received consistent updates in relation to infection control policy and practice. The provider had just introduced new recruitment processes to ensure prospective staff had been vaccinated as part of the COVID-19 vaccination programme.

Further information is in the detailed findings below.

Beaconsfield Court 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.

Beaconsfield Court accommodates up to 32 older people providing personal care in one adapted building across three floors. On the day of our inspection, there were 30 people using the service. Some of the people were living with a dementia type illness.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

We last carried out a focussed inspection at Beaconsfield Court on 22 November 2016 and rated the service as Good. At this inspection the service met all regulations and continued to be rated Good.

Staff and management team understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding adults. People we spoke with told us they felt safe at the service.

Accidents and incidents were appropriately recorded and investigated, and risk assessments were in place for people who used the service that described potential risks and the safeguards in place to mitigate these risks.

Medicines were managed safely. Trained staff administered people’s medicines. Records accurately accounted for the medicines people had been given.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff.

Staff were suitably trained and training was arranged for any due refresher training. Staff received regular supervisions and an annual appraisal.

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.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Beaconsfield Court . Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People’s needs had been assessed and personalised care plans developed. Care plans were evaluated to check they reflected people’s needs. People had the opportunity to be involved in the review.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs. The newly opened coffee shop area with tables and chairs where people and visitors could sit with hot drinks enabled a lovely environment for people to maintain relationships with those close to them. The service maintained good links with the local community.

People who used the service and family members were aware of how to make a complaint and we saw any complaint or issue was dealt with promptly by the management team.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys.

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. There was a registered manger for the service who was on annual leave at the time of our inspection. We undertook the inspection with the deputy manager of the service.

At our last visit to the service in October 2015, we found there were not sufficient staff to meet the needs of people using the service. The registered provider submitted an action plan to CQC stating when and how they intended to take action to meet the regulation. This included a review of staffing levels by the Assistant Operations Director and the Managing Director, a review of dependency levels of people who used the service and early morning visits to the service to review staffing levels. The registered provide told us they were going to provide additional staffing between 8am and 2pm.

At this visit we saw the registered provider had implemented this increased staffing and there were now five care staff on a morning shift along with a senior care worker for 29 people. We witnessed staff were able to spend time talking with people and undertaking one to one activities. Staff told us there was less pressure and the increased staffing levels had made a positive difference to the quality of the service.

We reviewed records that showed the registered provider had committed to maintain the staffing levels and regularly reviewed the dependency needs of people using the service. We saw this requirement was now met.

We saw staff interacting with people in a friendly and caring manner and observed staff upholding people's privacy and dignity by ensuring they knocked on doors and explaining to people what was happening next. There was also lots of laughter and friendly chat between members of staff and residents and their visitors.

We saw that people's views were taken into account in the planning and delivery of their care and that people were kept informed about developments in the service.

There was a system in place for the acting manager to check the quality of the service being provided and this was shared with staff and people using the service.