Archived: Beech Close Care Home

At our last inspection in June 2016, this service was rated overall good. At this inspection, we found that the service had deteriorated and there were areas which required improvement, the service has received an overall rating of requires improvement.

The inspection took place on the 10 December 2018 and was unannounced.

There was a registered manager in post. 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 2008 and associated Regulations about how the service is run. At the time of the inspection the registered manager was on a planned leave of absence, two registered managers from the provider's other services were covering in their absence with the support of an operational manager.

The systems in place to monitor the quality and standard of the service are not always effective. People’s experience of daily life at the home are not fully captured to enable the provider to address any shortfalls.

Staffing levels are not always sufficient to meet people’s physical, social and emotional care needs safe and in a timely way. People would like more activities to keep them stimulated.

We have made a recommendation for the provider to consider in relation to the deployment of staff.

People are supported by staff who are friendly, kind and compassionate but who sometimes lack the insight around ensuring people’s privacy and dignity is maintained.

Detailed care plans are in place, which enable staff to provide consistent care and support in line with people’s personal preferences and choices. End of life care plans need to be enhanced further.

People are supported to have maximum choice and control of their day to day lives and staff support them in the least restrictive way possible; the policies and systems in the home support this practice.

People have formed positive therapeutic relationships with staff and feel they are treated as individuals. Family and friends are welcome at any time and to take part in events at the home.

Staff are appropriately recruited and people are protected from the risk of harm and receive their prescribed medicines safely. Staff understand their responsibilities to keep people safe from any risk or harm and know how to respond if they have any concerns.

Staff understand the need to undertake specific assessments where people lack capacity to consent to their care and / or their day-to-day routines. People’s health care and nutritional are carefully considered and relevant health care professionals are appropriately involved in people’s care.

Staff have access to the support, supervision and training they require to work effectively in their roles. Development of staff knowledge and skills is encouraged.

The service has a positive ethos and an open culture. People know how to raise a concern or make a complaint and the provider has implemented effective systems to manage any complaints that they may receive.

Beech Close provides care and support for up to 42 people who are physically and mentally frail; some of whom may be living with dementia. There were 40 people living at the service when we visited.

The service has a registered manager. On the day of the inspection the registered manager was on annual leave. 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 2008 and associated Regulations about how the service is run.

People felt safe living at the service. Staff were aware of the processes in place to report incidents of abuse; and had been provided with training on how to keep people safe from abuse and harm. Processes were in place to manage identifiable risks and to promote people’s independence.

The service’s recruitment procedure was robust to ensure that staff were suitable and fit to be employed. Systems were in place to ensure people’s medicines were managed safely and given at the prescribed times.

Staff were provided with induction and essential training to keep their skills up to date. They had regular one to one meetings to support them in their roles.

People’s consent to care and support was sought before any care was provided. This was in line with the requirements of the Mental Capacity Act (MCA) 2005. They were supported with food and drink and to maintain a balanced diet. When needed, staff supported people to access health care facilities.

People had developed good relationships with the staff team who treated them with kindness and compassion. Systems were in place to ensure that their views were listened to; and their privacy and dignity was upheld.

Before coming to live at the service people’s needs were assessed. This was to ensure that the care provided would be personalised and responsive to their needs. The service had a complaints procedure which was accessible to people and their relatives.

There was a positive, open, inclusive and transparent culture at the service. Arrangements were in place for the service to maintain links with the local community. There was a quality assurance system in place to monitor the care provided and to drive continuous improvements.

We found that staff supported people appropriately and spoke to them in a friendly and respectful manner. Staff spent time with people talking with people and encouraging them to be involved in activities.

We saw the provider had systems in place to protect people from harm. Staff were trained and supported and delivered care which met people's needs. Staff understood people's needs and preferences and respected their choices.

The provider had systems in place to monitor the quality of the service and to find out the views of people who used the service and their representatives.

Relatives we spoke with told us that they found the care at the home very good and that staff attended to people's needs in a respectful and dignified way. A relative we spoke with said, 'This place is very good. Even though the building needs a bit of doing up it is always clean and has very caring staff.'

We saw that the provider had systems in place to protect people from harm. Staff told us they that they felt well supported. There was a staff training programme.

We found that the provider needed to make improvements to the surroundings and facilities at the home where people lived. The provider's quality assurance programme needed improvements to make sure the provider took timely actions to address shortfalls to ensure the quality of service people received.