Beechfield Lodge

Beechfield Lodge is a care home in Salford which is registered with CQC to provide care for a maximum of 60people. There were 55 people using the service at the time of the inspection.

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

People living at the home and relatives said they felt the service was safe. There were enough staff to care for people safely and correct staff recruitment procedures were followed. Risks were effectively managed at the home and accidents and incidents were monitored.

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. Staff supervisions and appraisals took place and staff received enough training to support them in their roles. People were supported to maintain good nutrition, hydration and health.

We received positive feedback about the care provided from relatives and people living at the home. Staff were described as kind and caring and treated people well. We observed plenty of caring observations between staff and people living at the home.

Systems were in place to manage complaints. The feedback we received was that the care was person centred and that people were able to participate in a range of activities at the home. Regular trips and outings also took place.

There were systems in place to monitor the quality of service through audits, meetings, surveys and competency checks. The home worked in partnership with other organisations to ensure positive outcomes for people.

Rating at last inspection:

The last rating for the service was good (published October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The rating remains good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Beechfield Lodge on our website at www.cqc.org.uk.

Follow up:

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

At the entrance of the home, information was displayed to inform visitors about any infection control procedures to be followed. Temperature checks were taken, with questionnaires completed where visitors declared they had not displayed any recent symptom of COVID-19, or felt unwell. Lateral flow (a COVID-19 test where the results can be obtained quickly) testing was carried out as needed.

Various methods had been used to enable people to keep in touch with their family and friends during the pandemic. This included video calls and window visits.

Zoning arrangements were used when people had tested positive for COVID-19 and needed to self-isolate in certain areas of the home. COVID-19 testing was in place for both staff and people using the service. People living at the home had all received their first dosage of the COVID-19 vaccination.

Appropriate arrangements were in place for new admissions to the home, such as requesting confirmation of a negative COVID-19 test before each person moved into Beechfield Lodge.

Enough personal protective equipment (PPE) was available and we saw staff wore it at all times during our visit. Hand sanitizers were distributed throughout the building to promote proper hand hygiene practices.

We observed the home to be clean and tidy, with domestic staff carrying out their duties throughout the day. Windows were opened at various times during the day to assist with ventilation and outdoor facilities were used when better weather allowed.

There were enough staff to care for people safely, with staff receiving additional infection control training from the local authority during the pandemic. Despite a reduced occupancy at the home, staffing levels had not been reduced to ensure additional pressures were not placed on staff during what had been a difficult period.

Risk assessments were completed where certain groups may be at higher risk of contracting the virus. An appropriate infection control procedure was in place and regular infection control audits were undertaken to ensure standards were maintained. Continency planning arrangements had also been put in place to help reduce the likelihood of any future COVID-19 cases and promote learning.

At the last inspection in July 2014 the service was rated Good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports’ link for Beechfield Lodge on our website at www.cqc.org.uk.

At this unannounced inspection on the 29 September 2017 we found the service remained Good. The service met all relevant fundamental standards.

The service had a registered manager. 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 were protected from abuse and all told us they felt safe. Staff were knowledgeable about how to recognise signs of potential abuse and were aware of the reporting procedures. Assessments identified risks to people and management plans to reduce the risks were in place.

Risks had been identified and management systems were in place to monitor risk and reduce incidents ensuring peoples safety. There were also detailed assessments to follow in case of an emergency.

At the time of the inspection there were sufficient staff on duty to meet people’s needs. However the dependency tool lacked detail to determine people’s dependency.

People and their relatives we spoke with told us they though there were sufficient staff on duty. Recruitments procedures ensured the right staff were employed to meet people’s needs safely.

Systems were in place to ensure management of medicines was safe. Staff received training and competency assessments to administer medications safely. The provider completed regular audits of the system to ensure standards were maintained. Although the audits did not cover topical medications and these systems could be improved.

We observed staff took account of people’s individual needs and preferences while supporting them. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Staff were aware of peoples nutritional needs and people were supported to maintain a balanced diet. People were supported to maintain good health and had access to health care services.

People were treated with respect. People we spoke with and their relatives told us staff were kind, considerate and caring. Staff we spoke with able to tell us how they respected people’s preferences and ensured their privacy and dignity was maintained.

People told us they could take part in activities of their own choice and that there were also organised group activities taking place during our inspection.

There was a system in place to tell people how to raise concerns and how these would be managed. People told us they would feel comfortable raising any concerns with the management team.

Systems were in place to monitor and improve the quality of the service provided. Areas for improvements had been identified and action plans were in place these were followed by staff. The provider also had a quality team who monitored the service to ensure continued improvements.

Staff were clear about their roles and responsibilities and had access to policies and procedures to inform and guide them.

Further information is in the detailed findings below.

We spoke with three night staff who told us there were two people who liked to get up early and this was documented in their care plan. The night staff we spoke with told us they would only assist a person to get up early if they were asked to do so by the person.

We spoke with a visiting district nurse who told us staff contacted them in a timely manner if they were concerned that a person was at risk of developing a pressure ulcer. Comments included: 'They are very good at following instructions.' 'People are well cared for.' 'When staff are concerned they fax over a referral for a visit.'

We spoke with staff who told us they felt there were enough staff on duty to meet people's care needs. Comments included: 'It would always be nice to have more staff but I think we are fine.' 'Sometimes a shortfall with sickness when we can't get cover but it is not often.'

One visitor said 'The care is very good and there seems to be plenty of activities at the home'. The person who was using the services told us they regularly took part in activities, when possible but preferred to stay in their room.

We found that people had their preferences recorded and were offered choices. The provider acted in accordance with people's wishes and people who use the service received care in a way that met their needs and preferences.

The people we spoke with told us they felt the home was clean and safe. One visitor told us 'The room and the home is very clean, I always recommend this to other people'.

The people told us the staff were cheerful, happy and positive. They also told us they had no concerns about the services they received and were confident they could speak to the staff if they had any concerns. The person who was using the service told they felt sometimes the staff were rushed and looked hurried, especially at night.

People were cared for by staff that had been through the appropriate recruitment checks.

There was an effective complaints system available, in case anyone wished to raise a complaint.

We observed people engaged in activities including armchair exercise, tai-chi and a music quiz.

People living in the home told us: 'I'm what you would call spoilt rotten.' 'I get lovely meals.' 'I just like it all here, everyone's always cheerful.'

Care plans contained a number of agreements to gather consent to care and treatment, which were signed by the individual or relatives. These included agreement to medication and night checks.

We observed equipment in use by individuals and staff throughout the day. People were using walking frames independently and, where people did require support, we observed staff communicating with people, explaining what equipment they were using and worked with people at their own pace.

We looked at the staffing rotas for January 2013 and found that the staffing levels reflected the details provided by the manager. There were enough qualified, skilled and experienced staff to meet people's needs.

A relative told us during our inspection that: 'When you are here as much as we are, you see things even when staff don't know you are there. They are nice with everyone, the way they talk to people. And just the simplest things like knocking on doors, it makes a difference.'