Beeches Retirement Hotel

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff had been recruited safely however refresher training needed to be implemented and support for staff with team meetings and supervisions needed embedding. A way of sharing lessons learned with staff following accidents and incidents needed to be implemented. The service was clean and staff wore personal protective equipment (PPE) appropriately. There were some shortages however in supplies. Staff knew people well and were aware of individual risks. People were living safely at the service supported by staff who knew how to identify risks and were confident to raise concerns when needed. People were supported to be as independent as possible within the limits of safety. Medicines were stored, administered, recorded and disposed of safely.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us that the communication between them and staff worked and following incidents or any significant events that affected them or the service, they were kept informed. A relative told us, “Yes, if anything happened they would contact me.”

Staff told us there were mechanisms in place for them to learn about accidents and incidents. A staff handover meeting between every shift and a password secure, staff only, messaging phone group were used to inform staff about issues affecting people. A member of staff said, “For example, a couple of people are struggling more and more with mobility at the moment.” This information had been passed to all staff via the messaging group. Although there were no formal de-briefing meetings to capture lessons learned, changes in people’s support needs were shared with staff.

Processes were in place for recording accidents and incidents. Details were recorded in an accident book which was also used for auditing processes and a copy placed in people’s care plans. Some analysis had been carried out for example, with location of falls. This needed further development to provide meaningful data.

Relatives told us of a smooth transition to the service form where people have being living previously. One told us, “I feel Beeches managed the move effectively.” Another relative added, “The transition was quick and It went ok.” People and their loved ones told us that appointments were made for them when needed with for example, dentists, GP’s and nutritionists. Similarly, when planned or unexpected visits to hospital were needed, these were arranged in a timely way by the service.

Staff confirmed that these arrangements were made routinely when people needed additional support from other health and social care professionals. A staff member said, “We contact support professionals for people when needed.”

The registered manager had only been in post for a few months but had already established positive working relationships with professionals to ensure that people receive the best possible support. Professionals told us that the service welcomed the support and guidance offered and systems were being introduced to ensure ongoing sustainability.

Care plans were in the process of being updated and in some case re-written. Important information about people and their health and social needs were included in plans but these were also being urgently reviewed. People had been given an opportunity to record advanced decisions about their future care needs.

People and their relatives told us the service was a safe place to live and they were protected from avoidable harm. Comments from people included, “Do not have any concerns.” “Very good here, we feel safe” and “Been at the home for some time and feel safe and well looked after.” A relative told us that their loved one had experienced a fall but went onto say, “Yes she seems to be fine. The home have done what they need to do to prevent any further falls.”

Staff were aware of people’s ability to make decisions and how to provide support to those that needed help with decision making. Mental capacity assessments however were not detailed and did not provide thorough guidance to staff. Assessments were not decision specific and did not support staff with information to help them support people. Staff were aware of the importance of getting consent from people. Staff told us what they would do if they suspected a safeguarding incident and could describe events that would amount to such an incident. A staff member said, “Would tell a senior or manager but would help the resident first. Think it could be seeing or hearing something that is not right or could hurt them, including the physical environment.” Staff knew about and were confident to use the whistleblowing process if needed. This was a process where incidents could be reported while protecting the anonymity of the staff member.

Staff responded to people’s needs, answering call bells and internal telephones. We observed staff being attentive and responding quickly in communal areas when people needed support. For example, if people needed help in moving from one area to another, staff were available to support them. The communal areas and the bedrooms that we saw were free from clutter or any trip or other obvious hazards.

Mental capacity assessments were out of date and not always decision specific. This was being addressed as a priority by the registered manager but needed time to be completed and then to embed into staff knowledge. Policies were in place for safeguarding and whistleblowing and were accessible to staff. Systems were in place to include relatives and relevant professionals in the event of a safeguarding incident. The registered manager knew who to approach at the local authority for advice if needed. Personal emergency evacuation plans (PEEPs) were in place and had been recently updated. PEEPs were individual evacuation plans for people in the event of an emergency.

People were encouraged to be as independent with daily tasks as possible without compromising their safety. Relatives told us of safety issues that their loved ones were living with before moving into the service and now they felt previous risks were being managed. For example a relative told us, “She went in there straight from hospital due to her having a fall at home so we know she is in the best place.” Another said. “Yes, my mum had various things wrong and they were all dealt with by the home.”

Staff knew people well and were aware of the specific risks they lived with. Any incidents or updates relating to people’s health and wellbeing were discussed at handover meetings so all staff were kept up to date with any changes. However some staff told us of concerns about agency staff not having time to familiarise themselves with people and their risks. Staff also told us that call bells sometimes were not responded to quickly at busy times. There was no formal induction for new agency staff to allow them to understand people’s specific support needs.

On the day of our visit to the service due to two separate incidents, immediate referrals were made to other professionals for support. Staff managed these incidents well and people received the support they needed. People were supported by staff with moving around the service, minimising the risk of potential falls and during mealtimes, with some people receiving one to one support.

Most care plans contained a ‘new admission form.’ This highlighted people’s care and support needs and detailed any risks relevant to them. For example, risks relating to mobility, nutrition and skin integrity. Care plans contained a ‘general’ risk assessment which provided some detail of specific risks to people. There were some inconsistencies in care plans and most risk assessments had not been reviewed or updated. This was being addressed by the registered manager.

People told us that the service was homely and that they felt safe living there. People‘s rooms were personalised but clear of any hazards. Similarly, communal areas were clear and safe for people to move around. Relatives told us that the home environment was safe. Comments included, “No to worn carpets, didn’t see any exposed wires” and “Each time I have gone in it looks pretty clear. Definitely nothing in my mums room, hallway or lounge. It seems ok.”

A part time member of maintenance staff worked at the service and responded to any repairs needed each day. They told us that they were able to respond quickly on their non-working days if needed as they lived locally. A maintenance book was used by staff for recording repairs that were needed. Larger jobs for example, boiler maintenance and electrical testing was carried out by contractors. A full time cook carried out the legally required safety checks in the kitchen each day. The cook told us they provided daily choices and knew about people’s likes, dislikes and any specific dietary needs.

The service was clean throughout, cleaning staff were employed and covered 7 days each week. There were personal protective equipment (PPE) stations on each floor with an extra-large store cupboard with extra supplies. The bedrooms that we saw were clean and free from hazards. A call bell system that everyone had access to was seen throughout the service.

Maintenance safety certificates were in place and in date covering for example, gas and electricity safety testing and legionella checks. Fire safety equipment was checked and regularly tested and was in date and the most recent fire safety report including actions, was in date with actions having been completed. Some staff had been designated fire warden responsibilities with one on duty every shift.

People were aware of the recent changes to staff and were supportive of the new managers one saying, “Getting to know the new staff but all seem friendly.” Relatives told us that in their experience there appeared to be enough staff working at the service and that they were attentive to their loved ones. A relative said. “Yes there was always staff around to help.” Relative feedback about staff skills and training however was mixed with one telling us, “The actual care assistants could do better. They don’t have certain training like medicine management and I they don’t speak much English.” However, the registered mananger told us that care assistants are not medicines trained.

Staff told us that at certain times of the day they were very busy and could do with more support. A member of staff told us, “Could do with more in the morning, it’s sometime difficult to answer the call bells.” Another added, “Not enough. Some people have lived here for a long time now and their needs are greater than when they arrived but staffing has not changed.” The deputy manager said that there was some dependency on agency and bank staff but that more regular staff were now being used. A new activities staff member was being recruited and there were enough domestic staff to cover 7 days a week.

Throughout our on site assessment staff were busy but were able to respond to people’s needs and requests for support. Call bells were answered in a timely way and people were supported when they needed help to move around the service or with their meals. The cook spent time talking with people, asking what food and drinks they wanted for the rest of the day.

Most staff training was out of date and no refresher training had been scheduled. Some members of staff had not received safeguarding or manual handling training since 2019 and around half of staff had not been trained at all in “challenging behaviour.” Some people lived with and displayed behaviour that required specific training for staff to be able to manage. Staff told us this training was lacking. These concerns were brought to the attention of the registered manager. Staff had been safely recruited and staff files contained the required background checks and safety checks. Some staff had not received supervision meetings since the new registered manager took over and only one team meeting had been held. Similarly, the registered manager was aware and was putting new processes in place.

People and their relatives told us that the service was clean and that staff wore personal protective equipment (PPE) appropriately. A person said, “Yes as far as what I have seen. Room and hallway was cleaned yesterday.” A relative added, “I can only vouch for the fact that when I see them when I am there I have seen them with gloves on, and aprons.”

Staff told us of occasional shortages of equipment. Masks and white bin bags had been in short supply recently. Although supplies had never run out completely, staff had to make several requests for supplies to be ordered. This was brought to the attention of the registered manager. 2 domestic staff covered all cleaning at the service between them working across 7 days each week. Staff told us that they had received some infection prevention and control (IPC) training however the training matrix showed that several staff had not received training in the past 4 years.

The service was clean and we saw staff wearing PPE appropriately. There was a central store room containing PPE and PPE stations on most of the floors of the service. There were some signs or posters up around the service advising staff how to wear PPE and some relating to the recent pandemic. Some of this signage needed updating as the Home Office guidance had since been updated

IPC and communicable disease policies were in place but had not been reviewed since the 2021 pandemic. Although much of the core information remained appropriate there was a need to update the policy and review it’s contents. At a team meeting in May 2024 staff had highlighted the shortage of white bin liners. This had been noted in the minutes but there remained an issue with shortage of supplies.

Most people living at the service needed staff to support them with their medicines. Staff responsible for administering medicines explained to people and relatives what the medicines were for. A relative told us, “Yes they gave her all her medications and at one point when I asked what was being given they explained why they were giving it and what it’s for so I am happy with that.” Relatives told us that medicines were reviewed and the most comfortable way to receive medicines was constantly reviewed. One relative told us that their loved one’s medicines changed from “Pills to a pain patch” when it was necessary to do this.

Staff told us they had received training and although they were not given protected time to carry out medicine rounds, they would only be distracted in an emergency. Staff were knowledgeable about people and their medicines and were able to tell us the processes involved for ‘as and when required,’ (PRN) medicines. Staff told us they could request medicines reviews from the GP whenever needed. Staff were competent in administering and recording medicines and we observed safe practice during a medicines round.

Processes were in place for the safe storage, administration and disposal of medicines. Medicine administration records (MAR) had been completed correctly showing date and time of administration, signed by the member of staff and included a running count of remaining medicines. PRN protocols were in place and staff knew the correct procedures for administering PRN medicines and when to review. The medicine folder had a section for each person with a photograph and clear lists of medicines required and times to administer. Controlled drugs and a record book was kept safely in a locked cabinet in a locked room.