Beechcare Incorporating the Peter Gidney Neurological Centre

Beechcare incorporating the Peter Gidney Neurological Centre is a care home providing accommodation with personal care and nursing for up to 66 people. The service provides support to older people with nursing needs, including people living with dementia and adults with a range or neurological conditions, such as acquired brain injuries. The service operates across two units each with its own communal areas, one of which is dedicated to people with neurological conditions. At the time of our inspection there were 61 people using the service.

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

People and their relatives told us they felt safe living in Beechcare incorporating the Peter Gidney Neurological Centre. One relative told us, “[Relative] is definitely safe because I raised a concern about door security, and it is now on a timer.” Another relative said, “I feel [relative] is safe, they have completed risk assessments around the care and the quality of care is good.”

People received safe care and treatment from staff who knew them well. One person said, “They know me as a person to care for me.” One relative said, “They know [relative’s] likes and dislikes.” Another relative told us, “They know what [relative] likes to do and what they like to watch on television.” People and their relatives spoke positively about the staff.

Medicines and infection control were both managed safely, and lessons were learned when things went wrong. There was a range of activities offered, including group and individual activities and people could choose whether to attend.

People were involved in decisions about their care and they received care which promoted their dignity and encouraged independence. Relatives told us they were involved in their relative’s care and were kept up to date with changes, either in the home or with their loved one’s condition. The service produced regular newsletters to share information.

Effective quality assurance processes were in place to monitor the service and regular audits were undertaken. Staff had received appropriate training. There was a new manager in post and staff told us they found them approachable and supportive with an open-door policy. People and relatives agreed and told us the new manager was making improvements.

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.

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 19 November 2021) and there was a breach 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 inspection was prompted partly by a review of the information we held about this service, and to follow up on actions we told the provider to take at the last inspection.

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.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

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

Beechcare incorporating the Peter Gidney Neurological Centre can accommodate 66 people across two units, each of which has separate facilities. One of the wings specialises in providing care to people living with neurological conditions.

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

The previous registered manager left the service in December 2020. A manager was leading the service at the time of inspection and had begun their application to be registered by CQC.

Staff feedback was that the culture of the service had improved with the new management. The manager had been completing a variety of audits and introduced various meetings to promote engagement in the service and to drive improvements. There was a significant amount of change under the new management to improve the service, some changes were still in progress. Due to the recency of these changes we will check at the next inspection that the improvements have been embedded.

The provider had failed to ensure there were enough staff suitably deployed to meet people’s needs in a timely manner. We observed there were not enough staff to meet people's needs and this had impacted on people’s quality of care and dignity. Feedback from people, relatives and staff confirmed this. A relative told us, “I think that I would give 85% rating for how effective the care is as concerns of staff shortages.”

There were issues with record keeping. For example, the care recorded for people in their daily notes did not match the care needed in the care plans. Although there was no evidence of harm to people the provider could not be assured that care was being delivered in line with people’s care plans. We have made a recommendation about this.

Staff had completed the training they needed to do their jobs but told us there were additional areas for further training they needed including end of life care and training for activities. This was fed back to the manager who had requested the additional training following our inspection.

Risks to people were assessed and reviewed regularly. Staff knew people’s individual needs and how to manage and mitigate any risks. People’s medicines were managed safely.

People’s care was planned in line with best practice guidance. This covered people’s specific needs including nutrition and hydration, physical and psychological health. The support people needed from staff was documented as well as guidance from other professionals such as speech and language therapists or hospice staff.

People were safeguarded from the risk of abuse. People told us they felt safe while being supported by staff. Accidents and incidents were recorded with actions taken and lessons learnt. Infection control procedures were being followed and the service appeared clean. A relative told us, “The home is always clean and tidy; they are constantly cleaning its brilliant and the cleaning staff knows the residents.”

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 did not support this practice however these practices were being amended at the time of our inspection.

Staff were caring and did their best to support people in line with their wishes. However, the failure to ensure there were enough staff suitably deployed to meet people's needs in a timely manner meant this could not always happen. Staff knew people well and people gave positive feedback about the staff.

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

Rating at last inspection

This service was registered with us on 01 June 2020 and this is the first inspection. Prior to this inspection the service was registered as two separate units The last ratings under the previous provider was Good for the Peter Gidney Neurological Care Centre, published on 26 May 2017 and Requires Improvement for Beechcare Care Home, published on 21 December 2018.

Why we inspected

This inspection was prompted by our data insight that assesses potential risks at services, including whether a service has received an inspection within 12 months of registering with CQC..

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified a breach in relation to ineffectively deployed or insufficient numbers of staff to meet people’s needs at this inspection.

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

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.