Archived: Beech Tree House Residential Home

Updated 7 October 2022

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 two inspectors.

Service and service type

Beech Tree House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Beech Tree House Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. There was an acting manager at the home.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at the information we held about the service.

We sought feedback from the local authority.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We met with 11 of the 12 people who lived at the home. We spoke with four people and two visitors. Some people were unable to fully express their views to us as they were living with dementia. We therefore spent time observing care in communal areas and interactions between people and staff.

We spoke with seven members of staff. This included the acting manager, the area clinical lead, care staff and a cook.

We made a referral to the local fire service in relation to fire safety.

We looked at a selection of records relating to people’s individual care and records relating to the running of the home. This included three people’s care and support plans, four staff recruitment files, health and safety checks, a sample of medication administration records and minutes of meetings.

The provider’s nominated individual was present for part of the first day of the inspection. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 7 October 2022

About the service

Beech Tree House Residential Home is a care home. It is registered with the Care Quality Commission to provide accommodation and personal care to up to 16 people. The home specialises in the care of older people who are living with dementia. Accommodation was set over two floors.

At the time of the inspection there were 12 people living at the home.

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

People lived in a home where the provider did not have effective oversight to identify and address concerns and shortfalls in the service. During the inspection we identified a number of issues relating to people’s health and safety and fire safety. These issues had not been identified by the provider’s quality monitoring systems and potentially placed people at risk.

A fire safety officer raised concerns regarding fire safety. Although the acting manager was able to address some issues immediately, others required the provider to take action.

The provider had not followed robust recruitment procedures to make sure staff working with people were safe to do so.

People’s needs and risks were poorly assessed and managed. People’s care plans did not all contain up to date information about their needs. There was no clear information about how risks to people would be minimised in accordance with their current needs. This placed people at risk of receiving care which was inconsistent or inappropriate.

People were mainly supported to have maximum choice and control of their lives and staff usually supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were being supported by an acting manager who was open and approachable. They had been working with the Local Authority to identify issues and make improvements.

People looked comfortable and relaxed with staff who supported them with tasks. The acting manager was working to promote a more person-centred approach to care. They were updating care plans to make sure staff had the information required to provide care and support in accordance with people’s wishes and preferences.

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 the home was good (published 27 January 2018)

On 8 March 2021 a targeted inspection was carried out to look at infection prevention and control practice. This did not identify any concerns.

Why we inspected

We received concerns in relation to the quality of people’s care including, how people’s legal rights were respected in relation to their capacity to make decisions and how people’s nutritional needs were being met. Issues were also raised about staff competency in administering medicines and records at the home. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only.

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.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

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

Enforcement action

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 and will take further action if needed.

We have identified breaches in relation to safe care and treatment, good governance, premises and equipment and fitness of person’s employed at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.