Beechville

Beechville is a residential care home providing accommodation for persons who require nursing or personal care up to a maximum of 63 people. The service provides support to older people, including people living with dementia. At the time of our inspection 53 people were using the service.

Accommodation is provided over 2 floors; Oak and Maple households are on the ground floor with 31 ensuite bedrooms and Cedar and Sycamore households are on the first floor with 32 ensuite bedrooms and passenger lift access. Shared areas include lounges, a conservatory, hair salon, library room, breakfast bar, TV room and an activities and games room. Beechville also offers respite care for people wishing to stay at the home on a short term basis. The provider is Methodist Homes, which is a charity.

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

Systems in place helped safeguard people from the risk of abuse. Assessments of risk and safety and supporting measures in place helped minimise risks. Staff managed people’s medicines safely. Staff followed infection prevention and control guidance to minimise risks related to the spread of infection. Staffing levels were sufficient to meet people’s needs and managers recruited staff safely.

Care plans included information about support required in areas such as nutrition, mobility, and personal care to help inform care provision. Staff made appropriate referrals to other agencies and professionals when required.

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.

People told us they were well treated, and their equality and diversity respected. People felt staff respected their privacy and dignity and took into account their views when agreeing on the support required. Staff identified people’s communication needs and addressed these with appropriate actions.

The provider and manager responded to complaints appropriately and used these to improve care provision. The provider and manager were open and honest, in dealing with concerns raised. The manager was available for people to contact, and undertook regular quality checks, to help ensure continued good standards of care.

The provider and manager followed governance systems which provided oversight and monitoring of the service. These governance systems and processes ensured the service provided to people was safe.

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

Rating at last inspection

The last rating for this service was good, (published 05 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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

Follow up

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

The home is a two-storey purpose built home situated in its own grounds in a residential area of Lostock, Bolton. The home is on the main road that connects the towns of Horwich and Bolton. There is adequate car parking at the front of the home.

We found the following examples of good practice.

Professional visitors to the service were screened for symptoms of infection, tested for COVID-19, supplied with masks and given access to hand sanitizer prior to entering the home. Information about the processes was clearly communicated to them. Visitors had minimal contact with staff and none with other people using the service.

Individual visit plans were in place for people who used the service and their relatives. Closed window visits were facilitated via a booking system, which ensured there was adequate time between visits for thorough cleaning of the indoor area.

The layout of the premises allowed cohorting and isolation to be facilitated within the home. Signage around handwashing and personal protective equipment (PPE) use was visible around the home. Regular enhanced cleaning took place to help reduce risks relating to the spread of infection.

Staff wore appropriate PPE within the home in line with guidance. PPE was disposed of safely, following local protocols. Staff took breaks separately and only two were allowed in the staff room at any time. Risk assessments had been carried out on high risk groups.

Staff had a good understanding of symptoms of COVID-19 and had undertaken training in Lateral Flow Device (LFD) testing and test and trace. There was a designated Infection control lead at the home, who took responsibility for ensuring processes were followed as required.

Admissions from hospital, other care homes and the community were undertaken safely in line with current guidance. The service had a good understanding of when to access advice and assistance.

Further information is in the detailed findings below.

Beechville is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Beechville is registered to provide accommodation for up to 63 older people who require personal care. Some of the people were living with dementia. There were 61 people using the service at the time of the inspection. The home is a two storey purpose built home situated in its own grounds in a residential area of Lostock, Bolton. The home is on the main road that connects the towns of Horwich and Bolton. There is adequate car parking at the front of the home.

We last inspected Beechville on 21 August 2015 and the service was rated as good.

The registered manager had left the home in January 2018. A new manager from another of the Methodist Homes had been appointed. In the interim period the home was being managed by the Area Support Manager (ASM) who was available to facilitate the inspection. The ASM had been at the home for two weeks. The ASM had experience of managing a care 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.

On arrival at the home there are two sets of doors before people enter the large, comfortable reception area. The reception area has a coffee bar and is used for activities.

The service used the local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow.

The home was clean, tidy and fresh. The environment was maintained at an excellent level and homely in character.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities. However the infection control nurse who was at the home at the time of the inspection found areas of concern with regard to some poor practice. Most of these were addressed by the end of the inspection.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP). A PEEP informs the fire service what room people live in and what assistance they require to evacuate them safely.

People were offered a well balanced and nutritional diet and encouraged to eat and drink to ensure they were hydrated and well fed.

Staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The ASM was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

We observed there were good interactions between staff and people who used the service. People told us staff were kind and caring.

We saw from our observations of staff and records that people who used the service were given choices in many aspects of their lives and helped to remain independent where possible.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed. Plans of care contained people’s personal preferences so they could be treated as individuals.

We saw visitors were welcomed into the home and people could see their visitors in private if they wished.

Some staff had been trained in end of life care to help them to provide support to people who used the service and their family at the end of their life.

Activities were provided which were suitable to the age and gender of people who used the service.

Audits, quality assurance surveys and meetings helped the service analyse performance to help improve the service.

There was a suitable complaints procedure for people to raise any concerns.

Beechville was a purpose built home set in extensive mature grounds. Accommodation was provided on four suites, with Maple and Oak on the ground floor offering care to people with a dementia related illness. Sycamore and Cedar are on the first floor and provided residential care.

On arrival we found the home to be warm, clean and tidy. We were told most people were up and had been served breakfast. We observed there was a flexible time for breakfast being served. This gave people the opportunity to have a lie in if they wished.

We observed sufficient numbers of staff were on duty, these included volunteer staff and students who were on college placements. The staff were supported by a team of ancillary staff.

We sampled a selection of care records and found they contained clear and concise documentation to inform staff how each person wished to be cared for.

We spoke with several people who used the service. One told us, 'It's marvellous here; it's like a five star hotel'. Another told us, 'I have not been here very long, but what I have experienced so far has been very good. The staff appear to be very kind and caring'.

We saw information displayed in the foyer, including a service user guide and the complaints procedure. We also saw number of compliment cards which had been received from relatives. Some comments included, 'Thank you for the wonderful care that was given to X by all the staff. X was treated with dignity and respect at all times. Another read, 'Many thanks for the love, care, kindness and respect you all showed to X in their last days, you were wonderful'.

A new manager had recently been appointed. The manager was in the process of registering with the Care Quality Commission. Staff we spoke with complimentary about the new manager, one member of staff told us, 'I like her (the manager) approach, she is very supportive and has some good ideas'.

We spoke with the students on placement, one said, 'This is my first placement but I have really enjoyed working here, it's been a good experience.'

We observed that there were sufficient numbers of staff on duty. We saw that care staff interacted well with people who use the service. They treated people respectfully, offering privacy, dignity and choice.

Whilst on the visit we saw equipment being used. This was done efficiently and competently. Equipment was appropriate and appeared to be well maintained. People were transferred from wheelchairs to easy chairs safely. All equipment was stored correctly after use.

We checked a number of care files and found that people's personal preferences were recorded within their care plans these records were kept within the persons bedroom and available for relatives at all times.

People told us;

"My X is really settled here and well looked after, she has been here since it opened, it is far better than where she was before".

"Mother is happy here they see to all her needs efficiently and nothing is too much trouble". "I sign all the paperwork monthly but the girls always go through it with me before I do, they keep me fully informed which puts my mind at rest".