This unannounced inspection took place on 26 November and 7 December 2018. Beechcroft Care Home provides accommodation, nursing, personal care and support for up to 30 people. At the time of this inspection 23 people were living at the service some who were living with dementia. The building is made up of two converted Victorian houses arranged over two floors with lift access.At the last inspection on 30 August and 7 September 2017 the service was rated Requires Improvement overall and in each key question apart from Good in Caring. We found three breaches of regulations relating to safe care and treatment, person centred care and good governance. We had also made two recommendations about the accessibility of information and staffing levels. We had asked the provider to take action to make improvements to the service, and this action had not been fully completed at this inspection.
During this inspection the service remained Requires Improvement and we found breaches in relation to person centred care, the environment and safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report
There was a registered manager at the service who was employed in October 2018. 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 were not always kept safe because of the risks found in the environment. We found several areas within the home that needed decorating, and maintenance issues that posed a risk to people’s health and wellbeing. The provider addressed some issues immediately, however, further work was needed to ensure the environment remained safe and comfortable for people using the service.
There was an activity plan in place for people. There were two part-time activity co-ordinators who provided people with a wide range of activities to take part in. However, we found that people who were unable to take part or those with dementia did not have individual time or meaningful activities available for them.
Staff carried out quality checks of the service. The registered manager completed an audit of the service, however action was not always taken to resolves issues found.
People had assessments in place and these recorded risks associated with people’s health and wellbeing needs. When people’s health care needs changed new care plans were developed or existing care plans were updated. People had access to health care support when their healthcare needs changed. However, we found on one occasion a person’s health had not improved despite previous medical treatment and additional treatment was not sought in a timely way.
People said staff were kind and compassionate. We observed staff cared for people in a way that was respectful which promoted their dignity and privacy.
Medicines were administered to people as required. There were established systems in place for the safe management of medicines.
There were sufficient staff deployed to meet people’s individual needs. Safer recruitment processes were followed to ensure suitable staff were employed at the service.
People said they enjoyed the meals that were provided to them. There was a menu available that people could choose their meals they enjoyed eating.
Staff were supported through regular training, induction and supervision. The registered manager had put plans in place for staff appraisals in 2019. Nurses were supported to maintain their registration with the Nursing and Midwifery Council which is the regulator for nursing and midwifery professions in the UK.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People gave staff consent to receive care, treatment and support. People who lacked the ability to make decisions for themselves had a mental capacity assessment and a best interest meeting if this was what was required.
There was a complaints system in place. People were supported to make a complaint about the care they received or if they were unhappy about an aspect of the service.
People’s end of life care and support needs were recorded. When people required specialist palliative care, staff provided this for them.
The registered manager supported staff through regular team meetings and offered support to them on a daily basis. The registered manager was aware of their responsibilities regarding the registration with the Care Quality Commission. Staff maintained a working relationship with organisation external to the service.