14, 15 and 17 October 2014
During a routine inspection
Beechey House is registered to accommodate and provide personal care for up to 16 people and caters to the needs of people living with dementia. At the time of our inspection there were 12 people living at the home.
There was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.
This was an unannounced inspection that was carried out over a three days by two inspectors.
At a previous inspection in November 2013 the provider was not meeting the requirements of the law in and we issued warning notices in respect of; people’s consent, the care and welfare of people, meeting people’s nutritional needs, safety and suitability of the premises and the monitoring of service quality. We met with the provider in January 2014 and discussed our concerns. At that time one of the providers was also the registered manager. They decided to focus on their role as a provider, and appoint a manager to run the service. A manager was registered with the Commission to run the home in June 2014.
We followed up on the service’s non-compliance with a further inspection of the home on April 2014. At that time we found improvements had been made and the service provided to people was compliant concerning meeting people’s nutritional needs, premises and monitoring the quality of service. We issued compliance actions in respect of consent to care and the care and welfare of people living at the home.
We received safeguarding concerns about the service in September 2014, which lead to us carrying out this inspection.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
At this inspection there were poor arrangements for the management and administration of medicines that put people at risk of harm. People did not always have medicines administered as prescribed by their GP.
People’s legal rights were not fully protected because legal requirements of the Deprivation of Liberty Safeguards (DoLS) had not been followed through. People were therefore detained of their liberty without proper legal protection. The provider had not complied with the requirements of the Mental Capacity Act 2005 at this or our two previous inspections.
Records did not fully detail ‘best interest’ decisions and who had been consulted in making these decisions for people who lacked capacity.
The service was not responsive to meeting people’s needs. Care plans were not up to date. For one person who was nearing the end of their life there was no plan setting out how to meet their end of life care needs. Staff therefore did not know how to consistently care for this person. Equipment was not always provided to meet people’s needs.
People’s nutritional needs were met. People who required support with eating and drinking were assisted appropriately by staff.
The staff team were trained in the protection of vulnerable adults and knew what constituted abuse and how to report concerns.
The home had a caring staff team who had worked at the home for many years. Staff received induction training and further training to ensure they were competent to care for the people living there. However staffing levels at the time of inspection were inadequate to meet people’s needs.
The systems in place and the culture at the home did not ensure the service was well-led. Staff did not feel supported and the systems to monitor the quality of service were inadequate. The provider had not taken action to address shortfalls identified at previous inspections to ensure that people received appropriate care.