Background to this inspection
Updated
4 July 2023
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 was carried out by 1 inspector, a specialist advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience’s area of expertise was older people.
Service and service type
Beaufort Grange is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Beaufort Grange 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 on the 15 May 2023 which was the first day of our inspection. We announced our visit on the 18 May 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We raised information with the local authority so they were aware of the concerns we had received and so we could gain their feedback. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed 4 people during their lunch time experience. We spoke with the registered manager, the clinical lead, 17 care staff, 17 people and 7 relatives. We reviewed people’s care plans, support plans and 41 Medicines administration charts along with incident and accident forms, quality assurance audits 1 staff file.
Updated
4 July 2023
About the service
Beaufort Grange is a residential care home providing regulated activities of nursing care to up to
74 people. At the time of the inspection there were 58 people using the service.
People’s experience of using this service and what we found
People’s care plans did not always contain important information relating to their individual needs such as catheter care and how staff were to use their equipment such as their sling. Staff received training in moving and handling although one person was observed to support someone unsafely and not in line with their training.
We found the service was supporting people with their care and most feedback from people and staff was positive. Some feedback did suggest at certain times of the day it was busy with staff supporting other people. We fed this back to the registered manager so they could review this feedback and the staffing situation.
People received their medicines safely from trained staff. Although some improvements needed to be made to recording medicines such as when and where to apply topical cream and when someone might require their angina spray.
People felt supported by staff who they described as 'nice'. The staff team felt it was a nice place to work with good support from their colleagues, although some feedback suggested improvements could be made to how management dealt with issues when raised with them.
People were supported by staff to make daily decisions although best interest decisions relating to covert administration of medicines were not being documented as being in the best interest decisions.
People were supported with referrals to health and social care professionals when required. People had access to a varied diet and hot and cold drinks were available throughout the day.
People were supported by staff who had checks prior to their employment. Incidents and accidents were completed when required and these confirmed any monitoring undertaken by clinical staff and referrals and actions taken.
Rating at last inspection and update
The last rating for this service was Good (Published 13 September 2022). At this inspection we found the service is Requires Improvement.
Why we inspected
The inspection was prompted in part due to concerns received about people getting safe care and there being enough staff. A decision was made for us to inspect and examine those risks.
We found during this inspection that people could be at risk of harm from this concern. Please see the Safe sections of this full report.
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.
You can see what action we have asked the provider to take at the end of this full report.
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 Good to Requires Improvement based on the findings of this inspection.
Enforcement and Recommendations
We have identified a breach in relation to ensuring staff provide people with safe care.
Please see the action we have told the provider to take at the end of this report.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk