Archived: Beeches Care Home (Nottingham)

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 72 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events.

We found there were some issues with reporting incidents. We saw evidence that staff were supporting people appropriately when incidents occurred, however we identified, and the manager confirmed, that not all incidents had been entered onto the incident reporting system. This meant that the manager may not have had effective oversight of incidents and therefore may have not identified themes from incidents that could lead to learning and improved outcomes for people.

Where incidents were documented, appropriate investigations were undertaken to understand and learn from them. Staff told us, “Mistakes are discussed either, individually through supervision or direct feedback, or as a team during meetings or handovers. The focus is usually on learning and improving practice.”

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 understood their role of advocating on behalf of people in the case of emergency, this included providing the relevant information to other healthcare professionals. Staff explained, “Staff must immediately call emergency services, inform family members, and prepare a "hospital grab bag" containing medication lists, personal details, and key documents like Deprivation of Liberty Safeguards (DoLS) or Do Not Attempt to Resuscitate (DNAR). A staff will be assigned to accompany the resident or ensure a comprehensive handover report is passed to paramedics for the safety of the resident.”

Relatives described to us a smooth and safe transition for their loved ones into the home.

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.

Staff understood how to recognise and report signs of abuse to ensure the safety of people living at the home. They were supported with safeguarding training and the provider had a safeguarding policy in place.

Staff said, “signs to be aware for abuse may differ from person to person some may be withdrawn, jittery/nervous, loss of appetite, appear to be frightened some may be reluctant to have their care needs met or their demeanourmay have changed and personalities may present different than usual, if abuse is suspected it would be reported to the line manager immediately.”

The provider understood their duty to report concerns to relevant agencies, such as the Care Quality Commission, local authority and police, if applicable.

The provider met their obligations under the Mental Capacity Act and Deprivation of Liberty Safeguards, ensuring people were not being restricted or cared for without the proper legal framework in place.

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.

Concerns we found at the last assessment had been resolved and risks related to people’s health and wellbeing were now managed well.

People’s risks were assessed and, where possible, discussed with them. For example, for a person with capacity and a smoker, documentation showed that the risks associated with smoking had been discussed with them and they were offered protective clothing and a no flame lighter to reduce risk.

Where people had been identified as at risk from falls, equipment to reduce this risk was in their rooms. For example, fall mats and sensors. All staff had also completed falls awareness and prevention training.

The provider held a clinical risk register to have a clear overview of identified risks associated with individuals’ health and wellbeing.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Regular checks were carried out on fire safety equipment, such as emergency doors and fire extinguishers. Required checks on gas, water and electrics were evidenced as having been carried out. As well as compliance checks on equipment used to support people during transfers, such as hoists.

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.

People we spoke with felt there were plenty of staff and felt staff attended promptly when they pressed their buzzer. People told us staff knew what they were doing and had no concerns when it came to competency. One person explained, “I have two people to assist me, and they always seem to do it well.”

Staffing was calculated based on people’s individual needs and associated risks to ensure there were enough staff to safely support people.

The provider ensured staff kept up to date with training that was relevant to their role.

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. We observed the home to be kept clean, and staff used appropriate personal protective equipment (PPE). People told us, “They put gloves on and an apron when they look after me,” and “Yes it’s very clean, the cleaners come round all the time.”

Staff had completed infection prevention and control (IPC) training and the provider had an IPC policy in place. IPC concerns were picked up on the managers daily walkaround and were discussed at the daily flash meeting to ensure any areas that required deep cleaning were addressed promptly.

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.

Concerns we found at the last assessment had been resolved and medicines were now managed, stored and administered safely. People who had their medicines when required (PRN) had protocols in place, the clinical lead was aware that a few required completing and actioned this.

Some people received their medicines covertly; this meant they received their medicines in a disguised form without their knowledge. Where staff supported people with medicines covertly, the correct legal documentation was in place.