Archived: Beechcroft Care Centre

Updated 14 April 2021

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 Care Act 2014.

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 on both days by two inspectors.

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

Service and service type:

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection-

We spoke with four people who used the service and three relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager, deputy manager, registered nurses, senior care workers, and care workers. We also spoke with the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at two staff files in relation to staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We reviewed copies of people’s care and records, rotas, incident reports and audits. We spoke with the registered manager. We also spoke with three support workers, one registered nurse and three relatives of people using the service via telephone.

Updated 14 April 2021

About the service

Beechcroft Care Centre is a residential nursing home providing personal and nursing care for up to 30 people with the following support needs: learning disabilities or autistic spectrum disorder, physical disabilities, younger adults. At the time of our inspection there were 15 people living at the service, and one other person who had been living with their parents during the Coronavirus pandemic. There were three lodges (Beechcroft, Chestnut and Hazel) which made up the service. During our inspection Chestnut Lodge was temporarily closed and everyone lived in Beechcroft and Hazel lodges. Each lodge had its own dining area, lounge, medicines room and kitchenette. People had their own en-suite rooms.

Beechcroft Care Centre is owned and operated by the provider Sussex Healthcare. Services operated by the provider had been subject to a period of increased monitoring and support by local authority commissioners. As a result of concerns previously raised, the provider is currently subject to a police investigation, although this does not affect Beechcroft Care Centre specifically. The investigation is on-going, and no conclusions have yet been reached.

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

People were not receiving safe care and treatment. We found risks around people’s feeding tubes, behaviours that may challenge others, constipation, epilepsy, reflux, choking, and monitoring people's health needs were not being managed safely. Systems to protect people from possible neglect or abuse were not effective.

Staff did not have the competencies to support people with behaviours that may challenge others. Lessons had not been learned consistently. We found learning from a hospitalisation had not been shared with the registered manager. Some issues we raised during previous inspections were still present, despite the provider giving us assurances these had been put right. The culture at the service was not always person centred. Outcomes for people were not positive and there were times we saw people supported in a way that was not safe.

Audits had not been effective in highlighting issues found at this inspection or improving the care and support people received at Beechcroft Care Centre. Management of the service was not effective and had not ensured the necessary improvements were made.

Beechcroft Care Centre was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People’s experience of care was not always person centred such as at mealtimes or during activities.

Medicines were being managed safely, and people’s medicines were being counted and stored correctly. People had been receiving support with physiotherapy in the two months before our inspection. The provider was working with other agencies to deliver care to people. The service was clean, and people were being protected from infection control risks, including Covid-19.

The model of care and setting did not maximise people’s choice, control and independence.

Staff wore uniforms and had name badges to say they were care staff when supporting people. The service is bigger than most domestic style properties. There were identifying signs on the road before the service’s private drive, the service grounds and on the exterior of the service to indicate it was a care home.

The service didn’t always apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons. People did not always receive person centred care at mealtimes or with their activities.

Rating at last inspection

The last rating for this service was Inadequate (published 9 December 2020).

At the last inspection we found multiple breaches of regulations. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 11, 12 and 13 December 2019 and an announced focused inspection in September 2020. Breaches of legal requirements were found at both inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding service users, and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has stayed at Inadequate. This is based on the findings at this inspection.

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

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, safeguarding people from abuse, good governance, and staffing at this inspection.

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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.