We carried out a review of the data available to us about Beatrice House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Beatrice House, you can give feedback on this service.
We found the following examples of good practice.
¿ Visiting procedures were in place to prevent infection entering the home. A nominated relative could book a slot to visit their family member in line with the new government visiting directive.
¿ The use of single occupancy bedrooms and en-suite facilities promoted social distancing and minimised infection transmission risks.
¿ The staff were aware of the safety measures they would need to take for admitting a new person to the home, or admitting a person back into the home from hospital.
¿ Personal Protective Equipment (PPE) was available throughout the home. Staff wore PPE that met current guidance.
¿ Staff took a COVID-19 test three times a week and people every 28 days. If people or staff tested positive, they would be required to self-isolate in line with government directives.
¿ The premises were clean and hygienic. In-depth cleaning was maintained.
¿ Staff had received a range of training in Infection Prevention Control (IPC) procedures that included, COVID-19 awareness, donning and doffing and testing processes.
¿ The IPC policy was reviewed regularly. COVID-19 specific guidance for staff was updated as the need arose.
Beatrice House is a residential care home and was providing personal care to two people with a learning disability at the time of the inspection. The service can support up to three people.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People were kept safe by staff who knew how to report concerns of abuse and manage risks to their safety. There were sufficient numbers of staff to support people. Medications were given in a safe way and there were safe infection control practices in place.
People’s needs had been assessed and reviewed where needed. People were supported by staff who had received training relevant to their role. 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.
The service applied 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 using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People were supported by staff who knew them well. People had access to activities that met their individual interests and end of life wishes had been explored. Complaints made had been investigated.
There were systems in place to monitor the quality of the service. The provider had given people opportunity to feedback on the service. The registered manager displayed a commitment to improving care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 10 February 2017).
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.
Beatrice House is registered to provide accommodation with personal care to three people with a learning disability, and autistic spectrum disorder. At the time of our inspection three people were using the service.
There was a manager in post and she was present during our inspection. 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 and associated Regulations about how the service is run.
At our last inspection in January 2016 we found that the provider was meeting the regulations of the Health and Social Care Act 2008. However some improvements were needed which we found had been made at this inspection.
Relatives we spoke with told us they had no concerns about the safety of their family members. Staff were aware of their responsibilities to report any concerns about people’s safety, and they confirmed they had received training in relation to safeguarding people from abuse. There was enough staff on duty to meet people’s needs and preferences. People received their medicines as prescribed by their doctor.
Staff felt supported and had received training to enable them to have the skills and knowledge for their role. People’s human rights were respected by staff because staff applied the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards in their work practice.
People were treated with kindness, and respect and staff promoted people’s independence and right to privacy. People were supported to maintain good health; we saw that staff alerted health care professionals if they had any concerns about their health or well-being. People were supported to eat and drink in accordance with their preferences and dietary requirements.
There was a complaints policy in place and staff and the registered manager were aware of the signs to look out for which may indicate people were unhappy. Relatives knew how to raise any concerns they may have, and they had confidence that any issues would be addressed.
Relatives thought the service was managed well and in people’s best interests. They described the registered manager as approachable, open and transparent. Systems were in place to gain feedback from relatives, staff and professionals so that any improvements could be made. Audits were undertaken regularly to monitor the quality of the service provided.
The provider is registered to accommodate and deliver personal care to three people. At the time of our inspection three people lived at the home. People lived with complex needs relating to their learning disability and/or autistic spectrum disorder. All three people had lived at the home for more than one year.
At our last inspection in August 2013 the provider was meeting the regulations that we assessed.
The manager was registered with us as is required by law. 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.
Although the registered manager and staff had received training on procedures they should follow to ensure the risk of harm and/or abuse was reduced they were not always following them. They had not notified us or the the local authority safeguarding team of an incident they had termed as ‘neglect’ as they should have done to ensure the person’s safety.
The provider had not been proactive in addressing the excessively hot water temperature in the bathroom to prevent any risk of scalding.
The staff had been trained to manage medicines safely. Medicines were given to people as they had been prescribed.
Staff were provided in sufficient numbers to meet people’s needs.
The recruitment processes the provider followed ensured that unsuitable staff was not employed.
Staff received induction training and the day to day support and guidance they needed to ensure they met people’s needs and kept them safe.
Staff had received or were receiving the training they needed to equip them with the knowledge to support the people in their care safely.
Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This ensured that people received care in line with their best interests and would not be unlawfully restricted.
People were encouraged to make decisions about their care. If they were unable to their relatives were involved in how their care was planned and delivered.
Staff supported people with their nutrition and dietary needs to prevent malnutrition and dehydration.
People received assessments and/or treatment when it was needed from a range of health care and social care professionals which helped to prevent deterioration regarding their health and well-being.
People were offered and enabled to engage in recreational activities that they enjoyed and met their preferred needs.
Systems were in place for people and their relatives to raise their concerns or complaints.
The relative we spoke with and staff felt that the quality of service was good.
People at the home were consulted and offered choices about the things they want to do.
Relatives we spoke with told us that people received the care and support they needed. One told use, 'It's great. We have no problems.'
People looked relaxed around staff. All staff members had been trained in safeguarding and those we spoke with knew how identify possible abuse and what the reporting procedures were.
There were sufficient numbers of staff to meet the needs of people. Staff knew about the individual care needs of the people they were supporting and were able to describe in detail what those needs were. A relative said, 'The staff try very hard.'
During our inspection, we spoke with two staff, and the care manager. Improvements had been made to people's care plans so that these reflected their needs as well as their preferences. Care plans provided guidance as to how to meet people's specific needs, and staff understood people's needs.
We found that improvements had been made to protect people from harm. Staff were aware of their responsibilities and action had been taken to ensure that staff were confident with the procedure they should follow.
Staff training records showed that some improvements had been made in the availability of training. Gaps in training had been identified and planned for. One staff said, 'We are doing lots of training, communication has improved and we have regular supervision, generally things have improved'.
We found that improvements had been made in assessing and monitoring the quality of the service.
We spoke with four members of staff and one person living in the home. People within the home had limited communication skills due to their learning disabilities. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We spent time observing how staff interacted with and cared for people. We observed positive interactions between staff and people within the home. We saw that people were treated with respect and staff were attentive to people's individual needs and preferences.
We found that risks to the safety and wellbeing of people were not always being managed effectively. Documentation was not up to date within care plans and assessed risks not followed up. The staff we spoke with were aware of people's needs.
Staff training was out of date and formal supervision of staff was not always taking place. Staff told us that they did not feel supported by the management team.
The home's system of quality monitoring required improving. There were outstanding actions from a safeguarding investigation which had taken place in December 2011.
We saw that staff used different ways to understand what people wanted, such as using pictures, signs and objects to help the person say what they wanted. Where people could say what they wanted they were given the opportunity to do this.
On the day we visited there was a shortage of day care staff due to sickness and one person's car was being repaired. This had a big impact on the well being of the people living there, as they could not go out and do the things they wanted. We saw in records and staff told us that this was unusual and happened rarely.
Other professionals are involved in people's care. We saw that generally staff followed the advice of other professionals to ensure people were supported and respected.
Staff knew how to safeguard the people living there from abuse and harm to ensure their safety and well being.
People's medication is kept securely and given to them as they need it, to help to meet their health needs.
Staff have the training and support they need so they know how to support the people living there to meet their needs and achieve their individual goals.
We saw that the views of the people living there and their relatives were listened to and where needed improvements are made.
Regular audits are done to ensure that the home is well run and benefits the people living there.