Archived: Beech View Care Home

Whenever we undertake a full inspection of a care home we look to ensure that the service is safe, effective, caring, responsive and well-led. When we visited in July 2014 we found some aspects of the service were not safe because the staffing levels were inadequate to meet people's needs.

Is the service safe?

The numbers of staff on duty for each shift had been increased. The manager reviewed the staffing numbers regularly to ensure the staffing numbers continued to be appropriate. This ensured people's care and social needs were always met and staff were available to help them when they needed support. Because of a number of staff vacancies, further recruitment was taking place. Shifts were either covered by permanent staff, the provider's bank staff or agency staff.

Below is a summary of what we found. The summary describes what the people using the service and the staff told us, what we observed, and what we found in the records we looked at. There were six people living at Beech View Care Home at the time of our inspection. Due to their complex needs they had limited ability to express their views about their care and treatment, or how they were involved in the service.

The registered manager was supporting another service at the time of our inspection. A senior member of staff from another service was providing management support to the home, they told us, for one or two days per week. On the day of inspection there were two staff on duty throughout the day. The senior member of staff who provided management support was available in the home from late morning.

If you want to see the evidence that supports our summary, please read the full report.

This is a summary of what we found:

Is the service safe?

We found that staff were aware of what to do if they witnessed abuse, and had received training with regard to safeguarding adults. We saw that there were safeguarding policies, procedure and details of the local authority guidance available for staff.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The complex needs of the people living at Beech View meant that people lacked capacity to make some decisions. We saw that best interest meetings had been held for some people and there was clear documentation to support the decision making process. We were told by a senior member of staff that they were liaising with the local authority DoLS team and were in the process of making applications for two people.

We spoke with staff who felt supported, in that they received regular supervision, training and appraisals. We were told by the staff we spoke with that there were insufficient staff on duty during the day to care for the six people living in the home. Staff told us they sometimes had to cancel planned activities, and they had to spend more time providing support for people with increased needs. They told us there had been agreement from the provider to increase the level of staffing during the day, but staff had not yet been recruited to provide the additional support required. We have asked the provider to tell us what they are going to do to meet the requirements of the law, to provide sufficient numbers of staff to support people.

Is the service effective?

We saw that people were relaxed and comfortable with the care staff. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. Staff received training to meet the needs of the people in the home, and training was arranged by the provider in response to identified changing needs.

Is the service caring?

We saw that the care staff were kind, attentive and supportive to the people they were caring for.

We spoke with staff who understood the importance of ensuring they had obtained a person's consent before they provided care and support. Staff told us that some people they supported could not communicate verbally, but they could make their wishes known by other methods of communication. For example one staff member told us, "[Person who used the service] uses body language and basic signs to let us know what they want."

Is the service responsive?

People's needs were assessed before they moved into the home. Care plans, risk assessments and health action plans were in place and were reviewed on a regular basis.

Activity programmes were displayed, and a wide range of activities had been agreed with people who lived in the home. We were told by staff that recently, they had not been able to provide the full range of activities for all of the people who lived in the home, because there insufficient staff were available at times.

Is the service well-led?

People who used the service, their representatives and staff were asked for their views about their care and treatment. We read the feedback received to date and saw that this was positive.

We saw that people who used the service had 'residents meetings'. We read the minutes from the most recent meeting, held in June 2014. All of the people who used the service had been in attendance, and their views, comments and suggestions were recorded.

There was evidence that learning from incidents: investigations took place and appropriate changes were implemented. We also saw that the provider completed a six monthly review of accidents, and actions were agreed. We saw confirmation of actions taken following the review period for September 2013 to February 2014.

There was a complaints procedure in place, and all people who used the service were given details about how to make a complaint in an information booklet called a service user guide.

A representative of the provider completed monthly quality assurance visits, a report was made of the visit, and actions were agreed and documented.

People shared with us their experiences about living in the home and we spoke with three people. Everyone expressed positive comments.

We also looked at surveys that had been completed by people in every three months and family surveys that were completed in 2013.

We spent time in various parts of the home, including communal areas such as the lounge and dining area so that we could observe the direct care, attention and support that people who lived at the home received. There was a constant interaction between staff and people in the home. People were relaxed, happy and comfortable in each other's company.

We spoke to people about how staff assisted them and what the care staff were like. Comments were positive about the care and support they received. One person told us 'The staff help me and we have lots of fun'.

Each person we met and spoke with told us they felt safe living at the home and one person told us 'I feel safe here and happy'. We observed and heard staff talk to people in a manner that showed empathy and respect. People told us that staff treated them very well and were always polite.

People that we spoke with during our visit told us "The best thing about living here is the fun staff we have working here' and 'Somebody is always around day and night to help me'