Archived: Beech House - Bristol

Beech House is a care home that provides personal and nursing care for up to 55 people. The service is provided in accommodation over two floors. At the time of the inspection, 51 people were living at the home.

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

Those people who used the service expressed unreserved satisfaction and spoke highly of all staff and services provided. Comments included, “I am so grateful to everyone, Beech House is indeed outstanding, brilliant and fantastic”, “I would unreservedly recommend the home to others and would happily reside here myself”, “It’s absolutely gorgeous. Extremely good” and “Having had experience of other care homes I have been astonished at the standard of Beech House. This is very much my home now and a very happy one. After the first four days of being here, I called my daughter and told her I am definitely not coming home!”.

The service provided an effective service. Innovative and creative ways to train and develop their staff was based on research and best practice guidelines to enhance quality and safety of the service provision. Improved practice and creative ways had been considered to encourage people who were reluctant to eat or may require help with specific dietary needs for example a soft diet. The home was decorated and maintained to a very high standard whilst maintaining a homely feel. People were consulted about the adaptation and design of their home and choice and preferences were respected. There were various areas to enjoy activity, events and personal private time. The service had been creative in developing areas of the home that would enhance people’s wellbeing.

The service was exceptionally caring and put people at the heart of everything they did. We were introduced to people throughout our visit and they welcomed us. They were relaxed, comfortable and confident in their home. Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that people’s life experiences remained meaningful.

The service was exceptionally responsive to people’s health and social needs. People received person centred care and support. Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals. Where necessary care and support had been changed to accurately reflect people's needs and improve their health and wellbeing. People were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

People benefitted from a service that was very well led. The whole staff team had been incredibly proud when they received their outstanding CQC rating in January 2017. The provider, registered manager, deputy and staff team maintained a clear focus on continually seeking to improve the service people received. Everyone demonstrated strong values and, a desire to learn about and implement best practice throughout the service. Good quality assurance systems were in place and based upon regular, scheduled audits, which identified any action required to make improvements. This meant the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.

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

Rating at last inspection

The last rating for this service was Outstanding (published January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

There was a registered manager in post. 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 were introduced to people throughout our visits and they welcomed us. People were relaxed, comfortable and confident in their home. We received positive comments about people’s views and experiences throughout our visits. People and relatives recently wrote in the homes survey, “Please continue to maintain your impressive standards”, “This is my home and I love it”, “Keep up the good work”, and “I consider myself very fortunate to be here”. One relative wrote to the registered manager, “We would like to express our thanks and appreciation to all staff involved in the care of our mother, for their kindness, understanding and support; it was a great comfort to us both”.

Staff involved in this inspection demonstrated a genuine passion for the roles they performed and their individual responsibilities. Visions and plans for the future were understood and shared across the staff team. They embraced new initiatives with the support of the registered manager and colleagues. They continued to look at the needs of people who used the service and ways to improve these so people felt able to make positive changes.

People experienced a lifestyle that met their individual expectations, capacity and preferences. There was a strong sense of empowering people wherever possible and providing facilities where independence would be encouraged and celebrated. People’s health, well-being and safety were paramount.

The registered manager listened to people and staff to ensure there were enough staff on duty to meet people's needs. They demonstrated their responsibilities in recognising changing circumstances within the service and used a risk based approach to help ensure the staffing levels and skill mix was effective. One relative told us, “I like how there is always a staff member in sight and someone on reception, it’s reassuring”.

Staff had the knowledge and skills they needed to carry out their roles effectively. They enjoyed attending training sessions and sharing what they had learnt with colleagues. There was an emphasis on teamwork and unison amongst the staff at all levels. Following a recent review carried out in the Poplars unit by Staffordshire university, they wrote, “There was a range of training opportunities available to staff and a core of highly- committed staff members who had been with the organisation for a number of years. All of these features contribute to the sense of a robust and dynamic organisation that reliably protects the interest of the people for whom it cares”.

People were supported to enjoy a healthy, nutritious, balanced diet whilst promoting and respecting choice. The ‘residents’ annual surveys consistently reflected how much they enjoyed the quality of food, the variety and the constant access to beverages and snacks through the day.

Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that their life experiences remained meaningful. People were supported to maintain their personal interests and hobbies.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). For people who were assessed as not having capacity, records showed that their advocates or families and healthcare professionals were involved in making decisions.

People received appropriate care and support because there were effective systems in place to assess, plan, implement, monitor and evaluate people's needs. People were involved throughout these processes. This ensured their needs were clearly identified and the support they received was meaningful and personalised. One person wrote in a recent survey, “All staff are kind and caring, nothing seems to be a chore or too much trouble for them”.

Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals and where necessary care and support had been changed to accurately reflect people's needs.

People lived meaningful lives and that suited personal interests and hobbies. The service had developed a creative and active community life at the home.

People and relative feedback was a vital part of the quality assurance system either through annual surveys, ‘residents’ meetings, complaints or reviews. People, relatives and staff were listened to and action was taken to make improvements where required. The registered manager monitored and audited the quality of care provided striving to meet the ever changing needs of people living in the home.

The manager was available throughout the day. They were very knowledgeable about people in their care, the policies, procedures and systems in place to ensure the continued smooth running of the home.

We were introduced to people, visitors and staff throughout the visit and we were welcomed. They were happy to share their experiences with us. We looked at some of the comments received from this year's survey results. People were asked if they had any suggestions to improve the service. One person wrote 'Just carry on being kind and considerate to the residents as you are all so wonderful at doing this.

Other written comments received included 'All staff are brilliant, I have been impressed across the board from the youngest kitchen staff right up to management level', 'The carers are really good' and 'It's a very happy atmosphere, very welcoming and homely'.

People were positive about their experiences. Comments included, 'I have never looked back, it was the best thing I did moving here', 'How can you fault it look around you' and 'I'm very happy living here, I have all I need and the staff are exceptional'.