We carried out a review of the data available to us about Beech Tree Total Care – Ashford 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 Beech Tree Total Care – Ashford, you can give feedback on this 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.
Beech Tree Total Care Ashford and SKC is a domiciliary care agency. It provides personal care to people living in extra care housing units, in their own houses and flats in the community. It provides a service to a range of people including older adults. Not everyone using Beech Tree Total Care Ashford and SKC receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection there were 130 people using the service.
Beech Tree Total Care Ashford and SKC was last inspected on 27 and 28 June 2017. This was the first inspection of the service, under a new registration due to changes to the details of the providers registration on 19 June 2017, therefore the service could not be rated.
There was a registered manager in post at the time of 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 2008 and associated Regulations about how the service is run.
People did not consistently receive their medicines as prescribed, and documentation relating to prescribed creams was not routinely completed. Audits completed by senior staff and the registered manager had not been proactive in identifying the shortfalls we raised during inspection.
Staff understood how to recognise and report abuse. Any potential instances of abuse had been reported to the local authority safeguarding team. People were supported safely around risks. Staffing levels met people’s assessed needs, and people told us they received the support they required.
Staff had been recruited following the providers robust recruitment processes. Staff received the training, support and supervision to allow them to complete their role effectively. Staff knew how to protect people from the risk of infection. Accidents and incidents had been reported, and action taken to reduce the likelihood of them reoccurring.
People’s needs were assessed before they received a service. The assessment focused on supporting the person to remain as independent as possible. Staff had formed positive working relationships with external professionals to ensure people received ongoing healthcare support. Where required, people were supported to eat and drink sufficient to maintain a balanced diet.
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. Staff had an understanding of people's equality and diversity needs and told us they would challenge discrimination in any form.
People were supported in a person centred way. People told us they were treated with kindness and compassion. Where possible people received support from a consistent staff team, that knew people well. People were supported to be involved in their care and treatment. People told us their privacy and dignity were respected. People told us they valued their staff. Staff encouraged people to remain as independent as possible.
People knew how to raise concerns and complaints. Complaints were used as a tool to drive improvements at the service. People were supported to have a dignified, pain free end of life.
There was a positive and inclusive culture at the service. People, their relatives and staff were engaged in the running of the service, and spoke highly of the service.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of this report.
At the time of our inspection, Beech Tree Total Care Ashford and SKC was providing care for 180 people and there were 84 care assistants providing care.
This was the first inspection of Beech Tree Total Care Ashford and SKC since it was registered on 16 June 2017. This service is registered under the provider Care at Home Services (South East) Limited. The service has been inspected but not rated as the provider had taken control of the registration on 19 June 2017. The new provider had taken on all previous staff including the registered manager. This ensured continuity for people using the service.
At the time of our inspection, there was a registered manager at the service. 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.
The provider had systems in place to protect people against abuse and harm. Risks to people's safety were being assessed. Risks were personalised to people’s individual needs. Environmental risks were assessed so that staff could work safely. Appropriately trained competent staff were managing medicines.
The provider had effective recruitment systems in place to ensure that staff were of suitable character to work with vulnerable adults. Staff had undergone training to gain the skills and knowledge to provide people with the care and assistance they needed. Systems were in place to monitor staff training to identify when it needed to be renewed.
The registered manager had systems in place to identify when people may lack mental capacity to make specific decisions over their care. Staff demonstrated good knowledge of the Mental Capacity Act 2005.
People were supported to have adequate food and drink. People were being referred to health and social care professionals when required.
People told us they were satisfied with the care staff and the support they provided. Relatives told us they were happy with the service their loved ones received. Staff understood the importance of communicating appropriately with people. Staff had built positive relationships with people to fully understand their needs.
Staff respected people's privacy and dignity. The provider had ensured that people's personal information was stored securely and access only given to those that needed it.
The provider had ensured that there were systems in place to fully investigate any complaints. The provider had appropriate auditing systems that could identify any shortfalls within the service. No complaints had been received under the new provider.
The registered manager was approachable and took an active role in the day to day running of the service. Staff were able to discuss concerns with the registered manager at any time and felt they would be addressed appropriately. The registered manager had an understanding of statutory notifications with the Care Quality Commission.