Beaumont Court Care Home

Beaumont Court Care Home is a residential care home providing personal care for up to 49 adults. At the time of the inspection 48 people were living at the service, including older people and people living with dementia.

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

We found no evidence during the inspection that showed people were at an increased risk of injury in relation to falls or the management of any distressed behaviours.

There were systems in place for the assessment and management of risk and staff had a good understanding of people’s needs and how to support them to keep them safe.

Staff worked with a range of health and social care professionals when people’s needs changed or their health deteriorated with the relevant referrals being made in a timely manner.

Staff were positive about the level of information and guidance they had about people’s conditions and how they needed to manage any incidents. Staff were confident any issues or incidents would be followed up by the management team to ensure the relevant professionals were involved.

Staff discussed people’s needs during daily handovers, meetings and supervision to ensure they were aware if people were at an increased risk of having a fall or how to follow best practice if a person became distressed.

The management team reported all incidents to the relevant local authorities and informed people’s relatives. Staff discussed incidents to reduce the risk of repeat events and the management team reminded staff about their responsibilities regarding monitoring and welfare checks.

Rating at last inspection

The last rating for this service was good (published 11 December 2019). The service also had infection prevention and control inspections carried out in October 2020 and February 2022 as part of our response to the COVID-19 pandemic.

Why we inspected

The inspection was prompted in part by an increase in notifications from the provider in relation to incidents related to falls and altercations between people who used the service. We undertook this targeted inspection to check on these incidents.

We found no evidence during this inspection that people were at an increased risk of harm from these issues and there were systems in place to monitor the service and work closely with the relevant health and social care professionals. The overall rating for the service has not changed following this targeted inspection and remains good.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Beaumont Court Care Home on our website at www.cqc.org.uk.

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 coronavirus and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Beaumont Court Care Home accommodates people in one building across two floors, with 42 rooms each having their own en-suite bathroom, with six rooms on the first floor having a toilet and sink. People in these rooms had access to a communal bath and shower room. There were also communal living rooms, a communal dining area, a main kitchen and access to a secure garden.

We found the following examples of good practice.

There were protocols in place to ensure visitors could enter the home safely, with a requirement to take or show a negative lateral flow device (LFD) COVID-19 test before entering the home. Relatives were kept updated and given information about any changes in visiting procedures and guidelines in the home.

There was a designated visiting room in the home where people could meet their relatives safely. Staff also continued to support people to keep in touch with relatives who were unable to visit through telephone and virtual calls.

We saw the provider was aware of their responsibilities regarding the requirement to ensure visiting professionals were vaccinated against COVID-19. A visiting health professional who visited during the inspection was unable and unwilling to show proof of their vaccination status upon entry and staff involved explained they would not be able to enter the home.

The service was taking part in regular COVID-19 testing for people and staff.

The provider carried out regular stock checks to ensure staff had a sufficient supply of personal protective equipment (PPE). Staff had ongoing IPC training and we observed staff following best practice during the inspection.

The registered manager told us they had continued to be well supported by the local authority and a range of health and social care professionals, with continued weekly conference calls which included advice and guidance from Public Health and the local authority IPC team.

The provider told us they were proud of the hard work and dedication of their staff team during challenging periods throughout the pandemic, which had helped to keep people safe. The registered manager said, "Although we were quite shocked from the recent outbreak, we are confident in the processes we need to follow. We have learnt to live with this and we are going to get cases and it can be disheartening, but we feel more confident managing it now."

Beaumont Court Care Home accommodates people in one building across two floors. 42 bedrooms have en-suite bathrooms and six bedrooms have their own toilet and sink, with access to a communal bath and shower room. There are communal living rooms, a communal dining area, a main kitchen and access to a secure garden.

We found the following examples of good practice.

¿ There were robust protocols in place for visitors upon entry to the home. Staff took visitors temperatures and were required to complete a questionnaire, which included the guidelines to be followed during the visit. A mobile sink had been put into the reception area to ensure visitors could wash their hands properly before entering. A personal protective equipment (PPE) station was also in the reception area in case visitors did not have their own PPE.

¿ Socially distanced garden and window visits had been taking place via an appointment booking system. Visitor numbers were limited at any one time to prevent the transmission of infection transmission. The provider had also been innovative and had arranged for relatives to see and speak to their family members through a protective hatch in the reception area.

¿ The provider had arranged for staff to attend additional training to better understand the needs of people living with dementia and to reduce the risk of the spread of infection.

¿ The activities coordinator had provided people with accessible information about COVID-19, including staff’s use of PPE, to help reduce any distress or anxiety.

¿ There was information available to staff about how to support people where their needs may have changed due to COVID-19. This included a contact number for the Care Home Liaison team for any additional support and advice.

¿ The registered manager regularly encouraged staff to discuss any concerns they had and understood the importance of staff wellbeing. Staff had access to a confidential helpline via the local authority and the commissioning authority had liaised with the registered manager to arrange virtual counselling sessions where needed.

¿ The registered manager had been well supported by the commissioning authority and a range of health and social care professionals, with weekly conference calls since the pandemic started. This included advice and guidance from Public Health England and an infection prevention and control lead nurse from the Clinical Commissioning Group.

¿ Staff had managed-well and contained outbreaks within the home. We received positive feedback from staff about the support they had received. Staff told us they had benefitted from regular reminders about hand hygiene, PPE and social distancing, which they felt had been a crucial factor in how the home had managed, especially during the peak of the pandemic.

Beaumont Court is a residential care home providing personal care for up to 42 adults. At the time of the inspection 38 people were living at the service, including older people, people with physical health conditions and those living with dementia.

Beaumont Court accommodates people in one building across two floors, with each person having their own bedroom and en-suite bathroom. There were also communal living and dining rooms, a main kitchen and access to a secure garden. The provider had submitted an application in August 2019 to add a further six bedrooms to their registration, which was being processed by CQC at the time of the inspection, so they were not currently in use.

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

We observed positive interactions between people and the staff team throughout the inspection, with staff showing compassion and kindness and being aware about people’s needs. We saw there was a warm and welcoming environment, with people comfortable in the presence of staff.

People were supported to access healthcare services and staff made the necessary referrals if people’s health changed. Health and social care professionals highlighted the improvement in communication and willingness of staff to be involved in training initiatives.

People were supported to take part in a range of events and activities, both within the home and within the local community. Links had been created with local organisations to create opportunities for people to be involved with and improve their wellbeing.

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.

We received positive feedback from people, relatives, staff and health and social care professionals about the changes that had been made since the last inspection and the improvements that had been made since the new manager had started.

People were cared for by a motivated staff team who felt appreciated and supported to carry out their duties. One staff member said, “We know we can achieve more when we work as a team and the manager has helped us understand that.”

The provider had recently started using a new digital care planning system to record the care and support that people received. Although it was still in the process of being fully implemented across the home, staff felt it had a positive impact on the amount of time they could spend with people.

We have made a recommendation about the decoration of the home to ensure the provider works towards a more dementia friendly environment.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 5 December 2018) and there were two breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This was the first inspection since the provider took over the service from Gateway Housing Association and registered it with the Care Quality Commission (CQC) on 29 April 2018. The service was previously called Peter Shore Court and at the previous comprehensive inspection in November 2016 the service was rated as ‘Requires Improvement’. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Peter Shore Court’ on our website at www.cqc.org.uk’.

Beaumont Court Care Home 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. Beaumont Court accommodates 42 people in one building across two floors, with each person having their own bedroom and en-suite bathroom. There were also communal living and dining rooms, a main kitchen and access to a secure garden. At the time of the inspection the care home was supporting 41 people with physical health conditions and those living with dementia.

There was a manager in post at the time of our inspection and they had submitted their application to be a registered manager on 16 October 2018. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the time of the inspection the service was in a period of transition. A new manager was in post who was trying to create a settled environment. The provider was aware of the mixed feelings and differences in the morale of the staff team who were getting used to changes and new ways of working. The majority of staff feedback received was positive about the takeover and the direction the service was going in.

The provider had quality assurance processes in place to monitor the service. The provider acknowledged there were areas that needed improvement and the service was still a work in progress since they had taken over.

The provider did not meet the CQC registration requirements regarding the submission of notifications about serious incidents, for which they have a legal obligation to do so.

Risk assessments were in place to identify and manage areas of risk to people. However, information was not consistent throughout people’s care records as some assessments had not been updated. Risk assessments did not always provide staff with guidance on how to minimise risk.

Safeguarding investigations that had been carried out were not always recorded accurately or were clear about the response to the concerns and what the outcome was. Supporting documents relevant to the investigation were not always available or stored within the safeguarding log.

Although the provider used a dependency tool to assess staffing levels, we received mixed feedback about the staffing structure across the service with the changes that had been made since the takeover. Although more people were present in communal areas on the ground floor for the staff team to monitor throughout the day, we did observe times when staff were less visible on the first floor.

The service had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service.

People received their medicines safely from staff who had completed refresher training with a new pharmacy and had their competency assessed. Medicines records were completed and checked by staff on a regular basis to minimise medicines errors. However, some poor practice was observed in relation to medicines administration and recording.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Best interests meetings were held in relation to decisions where people did not have the capacity to consent to their care.

People were supported to have a balanced diet, which took into account their preferences as well as any medical, cultural and nutritional needs.

Staff had completed the provider’s mandatory training programme and received regular supervision to support them in their role.

People had regular access to healthcare services and other health and social care professionals, with weekly visits from the GP or practice nurse. Staff worked closely with district nurses if they had any concerns about the change in people’s health.

The provider had recruited an activities coordinator since the takeover and we received positive feedback about the impact this had on reducing social isolation. We saw that people were encouraged to take part in a range of daily activities and regular events and the activities coordinator was passionate about their job.

Care records were still in the process of being reviewed and updated at the time of the inspection. The provider acknowledged the inconsistencies we found and an action plan was in place to ensure monthly evaluations were completed and information reflected the care and support people received.

People and their relatives we spoke with knew who to speak to if they wanted to make a complaint. The provider gave people and their relatives the opportunity to give feedback about the care and treatment they received. However, any minor issues or concerns that were raised were not formally recorded. We were made aware after the inspection of a previous complaint that had been made by a relative, but there was no record of this and the provider had not told us about it during the inspection.

People and their relatives told us staff were kind and caring. We observed positive interactions throughout the inspection and staff were patient and understanding and provided emotional support to people when needed.

We found two breaches of the regulations in relation to safe care and treatment and notifiable incidents. You can see what action we told the provider to take at the end of the full version of this report.