Beech Tree Total Care – Ashford

Updated 7 December 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

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

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 registered manager was not at the service at time of inspection.

Notice of inspection

We gave a short period notice of the inspection, so the provider could gain consent from people to visit them in their own homes.

Inspection activity started on 21 November 2019 and ended on 25 November 2019. We visited the office location on 21 November 2019.

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 six people who used the service and two relatives about their experience of the care provided. We spoke with seven members of staff including the head of service delivery, two co-ordinators, one senior and three health care assistants.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 December 2019

About the service

Beech Tree Total Care Ashford and SKC provides personal care to people in their own homes. They were providing personal care to 150 people at the time of inspection both in the local community and in extra care housing. The extra care housing consisted of a number of housing courts where people could access support as part of their housing needs and access communal services such as a laundry and restaurant.

Everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People and their loved ones told us they were kept safe by staff. Although staff knew how to keep people safe and how to manage risks, we found people’s health related risk assessments lacked detail. Staff took action on the day of inspection to resolve this. We made a recommendation about this.

At the last inspection we found medicines were not managed safely and the provider’s oversight had not identified the shortfalls we identified. At this inspection improvements had been made, medicines were managed safely. The provider’s audits now identified any issues and action was taken to address them in a timely fashion.

People were supported by staff who knew them well and were kind and compassionate. People told us staff listened to them and gave them care in the way they preferred. This was reflected in their care plans. Staff told us they had the support and training required to carry out their role and people said staff “knew what they were doing.”

Staff supported people to eat and drink well, encouraging then to stay hydrated. Staff encouraged or supported people to contact health care professionals as appropriate. Families told us they were kept informed about their loved one’s health and wellbeing.

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. People and their loved ones told us they were involved in planning their care, including the time of support and the staff who supported them. Office staff held regular reviews with people to discuss the quality of their care and any changes in need.

The registered manager had been away from the service for some time at the time of the inspection. The head of service delivery was supporting staff and ensuring the quality of care offered was consistent and met people’s needs.

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 (published 13 December 2018) and there were two breaches 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 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.