Archived: Beaumont House

Beaumont House is registered to provide personal care to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single households in a shared site or building. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection only looked at people's personal care service.

Beaumont House provides rented accommodation in 47 one-bedroom flats and 13 two-bedroom flats. There is a communal lounge and dining area on the ground floor that people can use if they wish. At the time of our inspection, there were 55 people living at Beaumont House, of which 48 people were receiving personal care

People's experience of using this service

At the last inspection, we found there was a breach of regulation because poor management meant people could not be confident they would receive safe, good quality care. Managers and care staff did not communicate and work well as a team, resulting in a negative, unsettled atmosphere.

At this inspection we found the provider had taken action to address our concerns and the service was no longer in breach.

However, the provider needed more time to implement their action plan, as some improvements, such as new care plans and staff training were still being rolled out. The registered manager had helped introduce many of the changes since our last visit. However, their resignation during our inspection reflected our concerns that management of the service continued to be a challenge.

Despite recent management changes, everyone we spoke to told us the atmosphere at Beaumont House was more positive. There was a shared focus on the needs of the people being supported.

Communication had improved. People, families and staff were being encouraged to speak out, though further work was needed by the provider to ensure everyone felt able to speak openly.

The provider had strengthened the monitoring of the service, learnt from mistakes and acted when needed to promote safety and good quality care.

The provider had taken effective action to address our previous concerns around safety. Staff managed risk well and worked as a team to keep people safe. In particular, the provider had significantly improved the administration of medicine. Staff worked openly with outside agencies to safeguard people.

There were enough safely recruited staff to keep people safe and meet their needs. The provider continued to tackle recruitment and retention issues and had started to see a reduction in agency staffing.

Staff knew people well and understood their needs and preferences. The provider had responded to previous concerns about staff knowledge and had focused on developing the specialist skills required in the care of people with more complex needs. Senior staff provided care staff with effective guidance and support. Risk assessments and care plans were being amended to ensure they reflected people’s needs more fully.

Staff worked in partnership with other agencies to promote peoples’ health and wellbeing.

There was an improved understanding about the Mental Capacity Act (MCA). 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 families spoken with told us staff were caring and had remained committed through all the changes at the service. Staff were passionate about ensuring people remained independent and in control of their service.

More information is in Detailed Findings below

Rating at last inspection and update:

The last rating for this service was requires improvement (published18 January 2019) and there was a breach 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 we found improvements had been made and the provider was no longer in breach of regulation.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Beaumont House provides care and support to people living in specialist 'extra care' housing. The property consists of individual rented flats in a shared building in Walton-on-the-Naze, close to local amenities and public transport. Care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing as the flats are people's own homes; this inspection looked at people's personal care and support service. People were able to purchase lunch in a communal dining room and take part in social activities. We did not inspect the provision of meals or activities.

CQC only inspects the service being received by people provided with 'personal care'; which includes help with tasks such as support with personal hygiene and eating. Where they do we also take into account any wider social care provided. There were 61 flats at the property. At the time of our inspection, 52 flats were occupied and 52 people received personal care.

This was the first inspection of this service since the provider One Housing Group Limited registered with us to provide personal care at Beaumont House in 15 June 2017.

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. There was also a general manager who had overall responsibility for the service, including the accommodation. During this report we referred to the general manager and registered manager as the ‘management team’.

The registered manager and general manager had not clearly defined their roles and responsibilities. As a result, the overall communication and management of the service was not well coordinated and consistent. The provider had not effectively addressed these concerns at our inspection, however improvements were being introduced to resolve the issues we found.

There were a number of checks and audits on the quality and safety of the service. Whilst these had not addressed the key issues with the management of the service, the audits were detailed and were driving improvements in areas such as medicine administration and training.

When we gathered feedback about the service, everyone we spoke to was enthusiastic about the care staff provided. There was room for improvement in how the provider and management team communicated with key individuals and groups. People, families and staff told us they did not find the culture open and the registered manager and provider had not consistently gathered their feedback about the running of the service. Feedback from external professionals was also mixed, and was affected by the issues we found within the management of the service.

The provider and management team had plans in place to improve the safety of the people using the service, in particular to improve the support people received with their medicines and to focus on recruiting more staff. Whilst the measures to reduce medicine errors were not yet fully effective, skills and audits were slowly improving in this area. There was clear and detailed guidance to staff on the support people needed with their medicines.

There were enough staff to keep people safe however recruitment and retention of staff was an ongoing issue at the service. Agency staff were in use whilst the provider focused on increasing the staff team. Improvements were needed to ensure the registered manager had better oversight of the recruitment process.

Senior staff provided care staff with guidance outlining areas of individual risk. Staff raised concerns about people’s safety where necessary and worked well with the management team and external professionals to minimise risk. Measures to reduce the risk of infection were effective. Senior and care took the necessary action when accidents and incidents occurred. However, improvements were required to ensure any lessons learnt as a result were shared across the service.

Staff had attended a number of mandatory courses, however they had not been consistently supported to develop skills to meet the more complex needs of people at the service. The provider was addressing this through additional courses and improved access to clinical guidance for staff. There was no care coordinator in post at the time of our inspection which had affected staff supervision and support, though this vacancy was being filled.

People at the service had the capacity to make decisions about their care. We made a recommendation to improve practice in the relation to the Mental Capacity Act.

Staff worked well with people, families and professionals to maintain people’s health and wellbeing. They supported people to have enough to drink, though staff would benefit from developing their skills in supporting people with dementia in this area.

Support was flexible and personalised. Staff varied the care they provided depending on people’s preferences and where people’s needs changed. People felt they had input into the care they received. People felt able to complain, though there was some confusion about who they should speak to in the management team. Care plans took into account people’s preferences around their end of life care.

People received a caring service and had a choice about their support. Staff developed warm relationships with people and families and treated them with respect and dignity. Improvements in recruitment would ensure people we supported by a stable staff team who all knew them well.

At this inspection we found a breach 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 the report.