Background to this inspection
Updated
14 August 2019
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.
Inspection team
Two inspectors and a specialist advisor conducted the inspection on day one. Day two of the inspection was carried out by one inspector. A specialist advisor is a person who has specialist knowledge of people who use this type of service. Their expertise was in nursing and governance.
Service and service type
Beechwood 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.
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.
The provider was in the final process of selling Beechwood to a new provider and members of staff including the registered manager were transferring to the new provider under the Transfer of Undertakings (Protection of Employment) Regulations 2006 TUPE.
Notice of inspection
The first day of the inspection was unannounced. The second day was announced.
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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with eight people who used the service, one relative and a volunteer about their experience of the care provided. We spoke with ten members of staff including the registered manager, regional manager, deputy manager, nurse, team leaders, care worker, domestics and the cook.
We carried out observations in the communal areas of the care home. We reviewed a range of records. This included three people’s care plans and multiple medication records. We looked at four staff files in relation to recruitment, staff supervision and appraisal. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found in relation to supervision and appraisal processes.
Updated
14 August 2019
About the service
Beechwood is a care home providing personal and nursing care for up to 26 adults with physical disabilities, acquired brain injuries, sensory impairments and learning disabilities in one adapted building. At the time of our inspection there were 17 people living at the service.
People’s experience of using this service and what we found
The providers systems and processes had not been robust, which put people at risk of financial abuse. Once this had been identified these systems had been improved to protect people from harm. A separate review of a specific incident is currently underway and was not reviewed as part of this inspection.
At this inspection we checked and found improvements had been made to audit systems and processes. The provider and registered manager must now demonstrate they can consistently meet the regulation and demonstrate continuity in a well led service.
There was a large number of staff vacancies at the home and the provider relied heavily on agency staff to ensure staff numbers were maintained. Staff recruitment was safe and there were enough staff to provide people with the person-centred support they needed. Staff received the training and support they needed to carry out their roles effectively.
Care plans were person-centred and were reviewed regularly although people and were appropriate their relatives were not always involved. They gave detailed information to staff to guide them on the care and support people needed.
People felt safe living at the home. The home was clean. Risks were managed. Medicines were managed safely. Staff helped people to stay healthy and people had access to a range of health care professionals.
Staff interacted with people in a kind and sensitive manner. People seemed relaxed and comfortable in the company of staff. People spoke positively about the staff who supported them. Everyone was positive about the registered manager and the way the service was organised and run.
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.
There was a range of activities on offer, both in the home and in the community to help prevent people becoming socially isolated and to keep people active. People were supported to have access to work opportunities.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (report published 20 July 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
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.