Beechfields Nursing Home Limited

Updated 14 March 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of 2 inspectors.

Service and service type

Beechfields Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Beechfields Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 18 January 2024 and ended on 14 February 2024. We visited the location’s service on 18 January 2024.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection, we spoke with 6 people who lived at the home and 6 relatives. We also spoke with the nominated individual, registered manager, 8 staff members including nurses and care staff. We looked at 5 people’s care records and 3 people’s medicine administration records (MARs). We also viewed 2 staff files and documentation related to the governance of the service. We received feedback from 2 visiting professionals and reviewed direct feedback to the service from another visiting professional.

The provider sent us further documentation following the site visit including risk assessments and evidence of action they had taken following our feedback.

Updated 14 March 2024

About the service

Beechfields Nursing Home is a nursing home providing personal and nursing care to up to 35 people. The service provides support to older people some of whom are living with dementia, physical disabilities, and sensory impairments. At the time of our inspection there were 30 people using the service. The care home accommodates people in 1 adapted building across 2 floors.

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

People were not protected from incidents of harm and abuse. The provider failed to submit safeguarding referrals to the local authority safeguarding team in accordance with their regulatory responsibility. Incidents involving distressed behaviours were not investigated and action to reduce incidents of distressed behaviour was not taken. Risk assessments were not always completed, and medicines were not always safely managed or stored. Clinical and environmental risks were not always monitored safely. Staff were not competently trained to understand people’s health conditions.

The provider failed to ensure governance systems were robust and quality systems did not safely monitor risks to people. Lessons were not learnt from the last inspection to ensure people remained safe from harm.

People were not always treated with dignity and respect. However, people told us they were happy living in the home and felt supported by the staff team. People told us they felt included in decision making in the home and staff told us they felt able to raise concerns or make suggestions with the registered manager.

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.

The registered manager understood the duty of candour and was receptive to all concerns raised in the inspection. New systems and processes were introduced to monitor the care and support people received.

The provider worked in partnership with other health and social care agencies, including the local authority quality team who were supporting the provider to make improvements regarding their overall governance.

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 27 May 2020). 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 the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about neglect and failure to escalate concerns to health professionals. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We inspected and found there was a concern regarding people’s dignity, so we widened the scope of the inspection and reviewed the key question of caring.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, caring and well-led sections of this full report.

The provider responded to all concerns raised in this inspection and implemented new systems and processes to improve the overall governance and support provided to people. We will review the success of these systems at the next inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Beechfields Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding, risk management, respecting people’s dignity and the governance of the home at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.