Beggars Roost Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Systems were in place to keep people safe and free from discrimination. People were protected from the risk of abuse and avoidable harm. Accurate, complete, and detailed records were kept in respect of each person’s care. People received a consistent approach to safe care and treatment in line with their care plans. Risks to people had been fully assessed and mitigated. Concerns were reported appropriately and investigated. Safe recruitment processes ensured staff were suitable for their roles. There was enough staff to meet people’s needs in a safe and timely way. Staff were suitably trained and had their competencies assessed regularly.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service operated in line with the providers policies and procedures about safeguarding and equality and diversity. These topics were covered in staff induction and ensured staff were able to identify and report safeguarding concerns and protect people from discrimination. There was a system for refresher training which ensured staff knowledge was kept up to date. Records showed staff had recorded and reported concerns appropriately. There was signage around the home about how to raise a concern, including links to outside agencies where appropriate. Records demonstrated appropriate referrals had been made to the local authority in line with safeguarding guidance. Statutory notifications had been sent to CQC in line with regulatory requirements. The registered manager demonstrated a good understanding of their responsibility to be open in the event of anything going wrong. They reviewed feedback and incidents, so any learning would be taken from them, and the service would continue to develop. Outcomes of investigations were shared with people and staff to ensure lessons were learnt.

Staff understood their responsibilities to keep people safe and how to do this. They had a good understanding of current safeguarding information and guidance. Staff were able to recognise the signs of potential abuse and knew the action to take. The registered manager promoted transparency and honesty. They told us about the open culture within the home and how this supported people and staff to speak up. Staff said they were encouraged to have open and honest conversations about anything they had witnessed that did not feel right or any concerns they might have. Staff knew how to whistle-blow and how to raise concerns with the local authority and Care Quality Commission.

People felt safe and protected from improper treatment. They received safe care from staff who were kind and compassionate. A person told us their fears about moving into a care home had been unfounded as, “From the moment I moved into Beggars Roost the care has been second to none”. People said they knew how to raise a concern about their care, although no one could recall having to do so. People told us the need to complain was unusual but if they did, they were confident matters would be resolved. A person said, “I would soon tell matron if I was not happy about something”. Another person told us the staff and manager were very approachable and they felt able to raise anything with them. Relatives had no concerns about their loved one's safety.

The culture of the service focused on providing person centred care and support to people. We observed people working in a person-centred way and putting people’s needs and wishes first. We observed staff supporting a person to eat safely whilst mitigating their risk of choking. Bed rails and pressure mats were in place for people who were at risk of falling. We observed staff following safe moving and positioning techniques to support people to stand, transfer and use the hoist safely.

Staff demonstrated a good knowledge and awareness of the risks to people they supported. For example, risk of fire posed to smokers who are prescribed topical ointments that are flammable. Staff told us they discussed risks with people and provided advice on how to keep safe. Information was used to inform and update people’s care records. The registered manager was aware of their responsibility to ensure the quality and safety of services provided. There was a flexible approach to risk management which promoted people’s independence and provided opportunities for new experiences. Staff were familiar with how to report accidents and incidents and the importance of recording accurate information so lessons could be learnt and mitigated.

There were systems and processes for quality monitoring and auditing. Provider led processes were in place to monitor and analyse accidents and incidents. Information from audits was used to identify key issues and mitigate risk. Quality audits were undertaken and actions arising were followed up. This ensured good governance of risk management and continued service improvement.

People were involved in decisions about their safety and wellbeing. People told us staff spoke with them about risks and how these could be mitigated. A person told us, “I have these bedrails to stop me falling out of bed, it’s a long way to tumble so it’s for the best”. A person who prefers to spend time alone showed us a call bell which they said enabled them to have a degree of privacy without being checked up on every 5 minutes. They showed us how staff had positioned items such as drinks, snacks, and TV control within arm’s reach to reduce the need for stretching and reaching which could cause them to fall.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were safe systems and processes for the recruitment of staff. Appropriate recruitment checks were undertaken to ensure staff were safe to work with people and suitable for their roles. This included undertaking appropriate checks with the Disclosure and Baring Service (DBS) and obtaining suitable references. DBS checks provide information including details about convictions and cautions held on the Police National Computer. Checks were made to ensure nurses were registered with the Nursing and Midwifery Council (NMC) and were fit to practice. This information helps employers make safer recruitment decisions. Rotas were planned in advance to ensure the right number and skill mix of staff were on duty. Rotas were flexible to adapt to change and ensured safe staffing levels were maintained. Quality and assurance processes were in place to monitor and improve the quality and safety of the care provided. Staff were suitably trained and had their competencies assessed regularly. The culture of the service fostered the continuous development of staff skills, competence, and knowledge. Staff received supervision which provided the opportunity to discuss their personal development, identify any gaps in their knowledge and talk about their wellbeing. There was a robust induction programme for new staff and comprehensive range of ongoing training and development opportunities. Governance processes were in place to ensure staff training remained up to date and staff had the skills and knowledge to carry out their role.

There were enough staff to keep people safe and meet their needs. People were supported by a core team of staff who were familiar and knew them well. People told us the culture at Beggars Roost was caring and kind. We received consistently positive comments about the registered manager and staff. Comments included, “All the staff are very caring and very nice; they always have time to chat and have a laugh”. A person said of one staff, “She is lovely, like a good friend”. Another described staff as very good, picking out one member of staff who they described as “delightful”. People told us there were always staff around. They received a good response to calls bells and staff were always on hand if they needed anything. A person said, “I can ask for a cuppa anytime, even at 3am, and they always bring me one”. A person told us about a time they had slipped from a chair and couldn’t get up, they said, “The staff were marvellous they were on it straight away. In a flash I was back in my chair, no fuss, they were experts”. People told us they were supported by skilled and competent staff who knew them well and treated them with kindness. Staff were described as “very competent” and “skilled in what they do”. A person said, “They all seem to know what they are doing, and we help them along when they are new”. Relatives told us they usually saw the same staff when they visited, and they had no concerns about staffing levels. They described staff as welcoming and friendly.

Staff recognised the importance of ensuring people received consistent care from familiar staff. To achieve this, they picked up extra shifts and worked flexibly to reduce the need to use agency staff. The registered manager was also a qualified nurse. They sometimes provided clinical cover to ensure there was a registered nurse on duty 24 hours a day. Many of the staff had worked at the service for a long time. One staff told us they had worked at the service for over 30 years. Staff told us it was a good place to work, and they received good support from the registered manager.

During our assessment we observed there to be enough staff on duty. We saw call bells being answered promptly, and people said this was usually the case. Staff took time to sit and talk with people and facilitate activities. People received support consistent with their care plans. For example, food and drink was served in line with guidelines to support people’s swallowing and reduce the risk of choking. Fluid charts were checked regularly to ensure people were drinking enough. Staff supported people to transfer safely using equipment such as stand aids and hoist. Staff practice was observed to be safe, competent, and professional.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.