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Archived: Beech House - Salford Inadequate

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Inadequate

Updated 18 April 2018

Beech House provides residential care for up to 36 older people. The home is situated in Salford, Greater Manchester and is located near to local transport routes. Car parking is available at the front of the home or in nearby side streets a short distance away. The home is owned by Akari Care Limited.

Beech House 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.

At the last comprehensive inspection of Beech House in January 2017, we rated the service as ‘Requires Improvement’ overall and in four of the five key questions we inspected against (Safe, Effective, Responsive and Well-led). The Caring domain was rated as Good. During that inspection, we identified breaches of the regulations with regards to person centred care, safe care and treatment, nutrition/hydration and good governance. We also issued two warning notices regarding nutrition/hydration and good governance following the inspection telling the home they must improve. The provider then sent us an action plan, informing us of the planned improvements they intended to make. We also held meetings with the provider to discuss the concerns, with the local authority also in attendance.

To follow up on these concerns and due to receiving a number of safeguarding alerts about the home, we undertook a further comprehensive inspection on 13, 14 and 20 February 2018. The first day of the inspection was unannounced, however we informed staff at the home we would be returning for a second and third day to complete the inspection. At this inspection, we identified multiple breaches of the regulations regarding person centred care, safe care and treatment, safeguarding people from abuse and improper treatment, nutrition/hydration, good governance and staffing. You can see what action we have asked the provider to take at the back of the full version of this report.

Medication was not being administered to people safely. We identified multiple instances where people did not receive their medication because it was not available in the home to be given to them by staff as prescribed.

People’s skin integrity was not always being well managed and we found guidance from district nursing staff was not being followed. We also observed one person sat in a chair without appropriate pressure relieving equipment in place which could have placed their skin at risk.

We found people were being placed at risk because they were not always receiving food and drink of correct consistency which could place them at risk of choking/aspiration.

We found several environmental risks around the home such as the kitchen area not being secure and people’s thickened drinks left unattended in the lounge area.

People were not always referred through to the falls service for further assessment when necessary. The deputy manager told us people were referred once they suffered two falls or more, however we found this had not been done for one person living at the home in a timely manner. The deputy manager made this referral during the second day of the inspection.

Staff did not always receive the appropriate training, supervision and appraisal to support them in their role.

We identified concerns relating to people’s nutrition and hydration needs with advice and guidance from other health care professionals not being followed. Drinks were not easily accessible for people in communal areas who were at risk of dehydration and one person had run out of their nutritional supplements, despite needing them following weight loss.

The home did not have a system in place to monitor which people were currently subject to deprivation of liberty safeguards (DoLS) authorisations. We found instances where mental capacity assessments had not been undertaken, despite their being concerns about people’s capacity during soc

Inspection areas

Safe

Inadequate

Updated 18 April 2018

The service was not safe.

People’s medication was not managed safely.

People were provided with foods which could place them at risk of choking/aspiration.

Appropriate systems were not in place with regards to people’s skin integrity.

Effective

Inadequate

Updated 18 April 2018

The service was not effective.

Staff had not received the necessary training, supervision and appraisal to support them in their roles.

People’s nutrition and hydration needs were not being met.

Mental capacity assessments were not undertaken when concerns about people’s capacity arose. DoLS applications were not always made in a timely manner to the local authority.

Caring

Requires improvement

Updated 18 April 2018

The service was not consistently caring.

People living at the home spoke positively about the care they received.

We observed missed opportunities for interaction between staff and people living at the home.

We observed instances where people’s dignity was not always preserved.

Responsive

Requires improvement

Updated 18 April 2018

The service was not consistently responsive.

Care did not always meet people's needs and reflect their preferences.

Accurate records were not always maintained by staff with regards to people's care.

There was a lack of activities and stimulation for people living at the home during the inspection.

Well-led

Inadequate

Updated 18 April 2018

The service was not well-led.

At the time of our inspection there was no registered manager at the home. The previous home manager had applied to register with CQC, although had since left the service.

Systems for audit and quality assurance were not operated effectively and did not highlight the concerns we found during our inspection.

Appropriate action had not been taken to ensure the passenger lift was in good working order, with concerns from the previous service check not acted upon in a timely way.

Warning notices served at the last inspection had not been met.