The Beaufort Care Home

The Beaufort Care Home is registered to provide personal and nursing care for up to 29 people aged 65 and over. Nursing care is provided. At the time of the inspection 16 people lived at the home and 1 of those people was in hospital.

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

The provider's systems and processes designed to identify shortfalls, and drive improvements still needed to be strengthened to ensure they were fully effective. The 2 continued breaches of regulation demonstrated more lessons needed to be learned to ensure people always received safe, good quality care. Management changes had occurred since our last inspection. The operations manager told us this was the reason progress had been slow. The new manager demonstrated commitment to improving outcomes for people and had clear plans in place to achieve this.

People told us they received their medicines when they needed them, but aspects of medicines safety continued to require improvement. The manager took some immediate actions to improve medicines safety and further improvement actions were planned.

The management of risks associated with people’s care had improved but further improvement was needed to demonstrate risks were always well managed. Risks associated with the environment were well managed.

More needed to be done to make sure people always received personalised care. The manager told us improving the content in care records was 1 of their main priorities. Staff knew people well and people had more opportunities to do things they enjoyed and were of interest to them.

Staff were recruited safely, and enough staff were available to provide the care and support people needed. The home was clean, but staff did not always work in line with the providers expectations to ensure infection prevention and control risks were minimised.

People continued to feel safe, and relatives told us safety had improved. Staff understood their responsibilities to keep people safe. Staff received an induction when they started work at the home and had completed the training, they needed to provide effective care.

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 spoke positively about the food available, and their dietary needs were catered for. Staff supported people to eat and drink to maintain a balanced diet. People had access to a range of health professionals which supported them to remain healthy and well.

Staff enjoyed working at the home. They demonstrated a caring approach and they spoke about people in a respectful way. People felt listened to and were happy with the care and support they received. People’s right to privacy was respected and their independence was promoted.

People and their relatives knew how to complain, and complaints received had been resolved in line with the providers policy. Feedback from people and their relatives was welcomed. The manager was exploring different ways to improve communication. Staff told us they felt supported, and the culture at the home was improving.

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 inadequate (published 20 January 2023) and there were 4 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 we found the provider remained in breach of 2 regulations.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified continued breaches in relation to safety and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider and also request an action plan from them to understand how they will make improvements. We will work alongside the provider and local authority to monitor progress and continue to monitor information we receive about the service, which will help inform when we next inspect.

The Beaufort Care Home is registered to provide personal and nursing care for up to 29 people aged 65 and over. Nursing care is provided. At the time of the inspection 21 people lived at the home.

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

The quality and safety of the service had deteriorated since our last inspection and some previously demonstrated standards had not been maintained. The provider's systems and processes designed to identify shortfalls, and drive improvement remained ineffective. The lack of provider and management level oversight of the service meant action had not been taken to address the breaches of the regulations we had identified in January 2022. Opportunities to learn lessons had been missed. Relatives felt some improvements had been made since the manager had worked at the home but further improvement was needed to ensure people always received good quality, compassionate, individualised and safe care as a minimum standard.

People did not consistently receive good quality safe care. The limited availability of staff negatively impacted on people's safety and experiences. Risks associated with people's care were not always assessed and well managed. Medicines and staff recruitment were not consistently managed safely in line with the providers procedures and best practice guidance. Improvements required in relation to the prevention and control of infection had not been made.

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 felt safe. Permanent staff knew the people they supported, and people spoke highly of them. However, people did not always receive personalised care that met their needs. Some care records lacked the information staff needed to provide care safely. In addition, other care records had not been completed, contained gaps or inaccurate information. People continued to have limited opportunities to follow their interests and do things they enjoyed. Complaints were managed in line with the provider's policy and procedure. Staff had been trained to support people at the end stage of their lives.

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 11 March 2022) and there were 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 we found the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to staffing levels at the home and people's care and support needs not being met. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Beaufort Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the way people’s care was provided, safety, staffing and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The Beaufort Care Home is a care home and is registered to provide personal and nursing care for up to 29 adults. At the time of the inspection there were 19 people using the service and two people who lived at the home were in hospital.

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

The quality and safety of the service had deteriorated since our last inspection and processes to monitor the quality and safety of the service were not always effective. Some lessons had not been learned and the provider was unable to demonstrate people always received the care they needed.

Peoples needs were not always met. Some people and five relatives were dissatisfied with some aspects of the care and support provided. People did not have enough opportunities to follow their hobbies or take part in things they enjoyed. The management team gave assurance action would be taken to improve outcomes for people.

People told us they felt safe living at The Beaufort Care Home and safeguarding procedures were in place to protect them. Staff had completed training to help them understand the types of abuse people could experience. Whilst risks associated with people’s care had been assessed, some of the information staff needed to provide safe care was not up to date at the time of our visit.

The management of people's medicines was not consistently safe. Despite our findings people told us they received their medicines when they needed them and the nurse on duty during our visit administered people’s medicines safely.

National guidance to prevent and control the spread of infection was not always followed. Effective measures were in place to make sure care home workers and other professionals visiting the service are fully vaccinated against COVID-19, unless they were exempt.

Enough staff were on duty to provide safe care and staff who worked at the home had been recruited safely. Staff knew people well, but peoples care records did not always contain accurate information. Prompt action was taken to address this during our visit.

Most people and their relatives knew how to make a complaint and felt able to do so. Complaints had been managed in line with the providers procedure. People spoke positively about the registered manager. Five of the eight relatives we spoke with felt the communication between them and the management team needed to improve. The regional operations was taking action in an attempt to make improvements and promote an inclusive and empowering culture.

Staff told us they felt comfortable to raise any issues or concerns with a member of the management team and overall, they felt supported and valued by their managers. The provider and registered manager understood their responsibility to be open and honest when things had gone wrong. and they worked with other organisations including GPs and social workers to benefit people.

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 January 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to people’s care not meeting their needs. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Beaufort Care Home on our website at www.cqc.org.uk

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Beaufort Care Home is a residential care home registered to provide personal and nursing care for up to 29 people aged 65 and over. At the time of the inspection there were 16 people using the service. The provider took over the registration of this home on 13 May 2020.

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

The provider and registered manager had made changes in the home since taking over the registration in May 2020. Further time is needed for the provider to demonstrate the sustainability of the continued and ongoing improvements.

People’s risk had been identified and recorded, however we have made a recommendation about the management of oral care.

The overall management of preventing infection control was effective, however staff were not always following best practice in the use of Personal protective equipment (PPE).

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 did not support this practice. Capacity assessment and best interest decision required further clarity to demonstrate how the assessment processed had been followed.

People felt safe and received their medicines as needed. There were enough staff to provide people with care and support. People’s needs had been assessed and staff had been trained and supported in their role and had been recruited safely. People enjoyed their meals and were supported to maintain their nutrition. Healthcare professionals were involved in people’s care and treatment.

People were relaxed and comfortable in the home, staff were able to spend time sitting and chatting with people. Staff knew people well and understood the care people needed and wanted.

Care had been planned around the person and their preferences were known and recorded. Complaints had been reviewed and responded in line with the providers policy. People enjoyed the activities on offer, or enjoyed pursuing their own hobbies and interests.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 13 May 2020 and this is the first inspection.

The last rating for the service under the previous provider was inadequate, published on 9 January 2020.

Why we inspected

This was a planned inspection based on the previous rating. We also looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Beaufort Care Home on our website at www.cqc.org.uk.

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.