Archived: Beech House - Basildon

People’s experience of using this service: Some people told us there were not always enough staff to meet people’s needs, and the registered manager needed to review the way staff were deployed around the service. In the quiet lounge there were long periods of time when staff were not present. Improvements were needed to the cleanliness of the service. The registered provider did not always assess, and manage risk in an effective way. A new system of dispensing medicines had been introduced. People received their medicines on time and in the correct way.

Some improvements were needed to the environment and décor of the service. Generally, consent had been obtained from people, but improvements were needed, to ensure people were supported to have maximum choice and control of their lives, in the least restrictive way possible.

Staff treated people in a warm, caring, and friendly way, but some care was seen to be very focused on tasks. Activities on offer to people were routine and did not always focus on people's preferences and abilities.

Systems to monitor the quality of the service continued to be in place but had not ensured the quality of the care that people received remained consistent. When complaints had been made this information had not always been used to drive improvement. People and staff were positive about the new registered manager, who had been appointed since the last inspection.

Rating at last inspection: Good. The last report was published on 14 December 2016.

Why we inspected: This was a planned inspection based on the previous rating. At the last inspection, this service was rated good. The service has deteriorated to requires improvement.

Enforcement: We found breaches of regulation around staffing, dignity and respect, and good governance. We will request an action plan from the registered provider to understand what they will do to improve the standards of quality and safety. We will monitor the progress of the improvements and will return as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Follow up: We will continue to monitor this service to ensure people receive care which meets their needs.

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

The registered manager 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 2008 and associated regulations about how the service is run.

We inspected the homes approach to managing end of life care and found this to be exceptional. We found that people’s wishes in relation to treatment were carried out and care was delivered with compassion and in a sensitive way.

People received care and support specific to their needs and were supported to participate in activities that were important to them. People and their family members repeatedly told us that they felt staff understood their individual needs and preferences, and provided care accordingly.

People repeatedly told us that staff understood their needs and preferences extremely well, and they received effective care and support from well-trained staff.

People and their family members told us the care that provided at Beech House, helped them to have a real sense of confidence and security that their care would always be personal, flexible and caring.

The registered manager and staff were exceptional in involving people to make decisions about every area of the service and they were creative in the way they obtained people's feedback. People accessed services and had links with the local community.

People told us they felt safe and secure. Staff understood the process they should follow to keep people safe and could describe the different ways people may experience abuse and the correct steps they would take if they were concerned that abuse had taken place.

Care staff took an active part in meeting people social wellbeing and this was viewed by staff as being just as important as meeting someone’s physical and personal care needs.

Needs and requests were responded to promptly, and they told us there were enough staff available to meet their care needs. On the day of our inspection, there was an ample amount of staff on shift to meet the needs of people who used the service.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service.

We found that the requisite of being passionate about delivering good care was displayed at all levels of the organisation. People had developed caring relationships with the staff that supported them. Relatives told us that there was a positive atmosphere and people were encouraged to take part in the activities they wanted to pursue. Activities inside and days out of the service were offered to people.

The registered provider worked within the principles of the Mental Capacity Act and followed the requirements of the Deprivation of Liberty Safeguards.

Staff treated people with dignity and respect and maintained people's independence by encouraging them to care for themselves where possible.

People lived in an environment that met their needs and told us they enjoyed the food on offer. All living areas were clean and functional. The provider told us that they wished to improve the décor of the home and were planning to do this.

Medicines were managed safely and staff members understood their responsibilities. The Registered Manager undertook regular audits and improvements were carried out when these were needed. The quality of the service was monitored and assessed consistently.

People who used the service, their family members, and visitors were made aware of how to make a compliment or complaint and were regularly consulted about the quality of the service they received.

We saw that people's care needs were assessed and planned for with any risks associated with their care being minimised as far as possible. The service was caring and responsive to people's changing needs. Staff sought support from other professionals or agencies when needed. Staff had a good knowledge of people's individual needs and offered them appropriate support.

We found that attention was needed to ensure that people's medicines were always managed effectively with robust monitoring procedures in place. The provider took immediate actions to address the issues identified.

The service was kept clean and provided a hygienic place for people to live.

People told us that they liked and got on with the staff at Beech House. We found that staff were well trained and supported in their role.

We found that the service listened to people's views. There were systems in place to monitor the quality of the service to ensure that it was consistent, effective, of good quality and safe.

We were told by two relatives that they knew how to complain and that they found the manager and staff to be approachable and professional.

We found that consent had not always been recorded within people's care plans and that people's nutritional and dietary needs had not been fully assessed.

We found that infection control processes were not adequately protecting people from the risk of cross infection.