This inspection took place on 9 May 2017 and was unannounced. This meant the registered provider and staff did not know we would be visiting the service. Beechwood Place Nursing Home provides nursing care to older people. The home is a large converted property situated in the Norton area of Malton. There are a variety of communal spaces for people to spend their time. The home can accommodate up to 35 people with some rooms providing shared accommodation. At the time of this inspection there was 28 people living at the service.
There was a registered manager in post who had registered with the Care Quality Commission (CQC) in October 2016. A registered manager is a person who has registered with the CQC 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 last comprehensive inspection on 15 February 2016, we identified a breach of regulation. The registered provider had failed to provide sufficient staff to meet people’s needs at key times of the day. Staff had not been supported in their roles and regular supervisions and appraisals had not taken place. At the time of the last inspection there was no registered manager in place. We asked for and received an action plan telling us what the registered provider was going to do to ensure they were meeting the regulations.
At this inspection, we found the registered provider had implemented their action plan and progress had been made. There was a registered manager in place. We found there was sufficient staff on duty to provide support when people needed it and people told us that staff responded to their needs in a timely manner. The registered manager had implemented a regular system of supervisions and appraisals and staff told us they were well supported by management. We found the registered provider was no longer in breach of regulation.
Pre-employment checks on employees were completed that helped to minimise the risk of unsuitable people from working with adults at risk. Staff confirmed they received induction training when they were new in post.
Staff had completed a range of training and this was delivered by a training provider through practical face to face sessions. Online training was also in the process of being implemented which staff would be able to access independently and told us that they were happy with the training provided for them.
People told us they felt safe. We found that people were protected from the risk of avoidable harm or abuse because the registered provider had effective systems in place to manage any safeguarding concerns. Staff received training on safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.
Risk assessments had been developed and contained relevant information. We found that these were in place when required and had been regularly reviewed. Accidents and incidents had been thoroughly recorded and appropriate action had been taken to reduce the risk of reoccurrence.
Where people required support with their medicines this was done safely and people received their medicines as prescribed. Medicines were stored securely and assessments had been completed on staff that ensured they were competent completing this activity.
We checked and found the registered provider was working within the principles of the MCA and applications to deprive a person of their liberty had been submitted to the local authority in a timely manner. People consented to care and support from care workers by verbally agreeing to it.
People were supported to maintain a balanced diet. People's weights were monitored and recorded on a monthly basis. We observed a lunch time routine and found that support was provided in a dignified way. People spoke positively about the meals on offer and all staff were aware of people’s specific dietary needs.
Care records contained evidence of close working relationships with other professionals to maintain and promote people’s health. We could see that referrals to these professionals had been made in a timely manner and these visits were recorded in people’s care records. People confirmed staff were proactive in seeking professional advice and we saw professionals visiting the service throughout the inspection.
Care plans were produced to meet people’s individual support needs and were reviewed on a regular basis.
People were aware of how to make a complaint and told us that the registered manager listened to concerns raised. A copy of the registered provider’s complaints policy was displayed in the reception area of the service.
People spoke positively about the activities on offer and the activities coordinators approach with people. During the inspection we saw examples of the activities on offer and other evidence such as photographs of people participating in planned activities.
People and staff spoke positively about the registered manager and recognised the improvements that had been made. Staff felt supported and were confident in approaching the registered manager with any concerns. The registered manager had gathered feedback on the service being provided from people and relatives.
We found the quality assurance systems were working well to ensure people received a consistent, quality service. Notifications had been submitted to CQC as required by legislation.