Beeches Care Home

Updated 13 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

Two inspectors and an Expert by Experience took part in the inspection process. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Beeches Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Beeches Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals at the local authority who had been working with the service. We used information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 6 people living at the home and 9 relatives about their experience of care provided by Beeches Care Home. We spoke with 15 members of staff including a partner, the registered manager, the compliance and quality manager, an administrator, kitchen staff, a housekeeper, nurses, senior care workers and care staff. We observed people’s interactions and the care they received. This helped us understand the experience of people with limited communication.

We observed medication administration and checked medication storage and recording systems. We reviewed a range of records including 7 people’s care records and recruitment information for 5 staff.

We looked at records relating to health and safety such as fire safety information, testing records and servicing documents. We checked the environment, equipment, facilities and cleanliness; to assess if the home was safe and fit for purpose.

We remotely reviewed information relating to the management of the service such as policies and procedures, audits, meeting minutes, complaints and training. We sought additional evidence and clarification from the management team via email and telephone.

Updated 13 December 2023

About the service

Beeches Care Home is a residential care home, providing accommodation for persons who require nursing or personal care. The service provides support for up to 40 people including older people, younger adults and people living with dementia. At the time of our inspection there were 27 people using the service.

The property was set over 2 floors with lift access to the upper floor. There was a communal dining room and lounges, a shared shower room and accessible rear courtyard.

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

The provider did not have adequate systems and processes to monitor and manage fire safety, health and safety or infection prevention and control (IPC). Staff deployment was not always effective. We received feedback about low staffing levels and the impact this had on safety and quality of care. Recruitment and medicines were not managed safely. The provider failed to learn from incidents, accidents and safeguarding concerns.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Care records were detailed, though we found some inconsistencies with information and people did not always get the care they needed. Records we reviewed raised concerns around people’s fluid intake, and we received mixed feedback about the food. Staff had an induction and training was refreshed annually, but they did not receive periodic supervision to monitor competence. The home required maintenance and refurbishment and was not fully adapted to meet people’s needs.

People and their relatives were not always consulted when planning or reviewing care and treatment. We observed caring interactions and staff spoke about people with dignity and respect, but staff did not have time to talk with people and care could be task focused. A person living at the home told us, “The staff are a lovely group of people, but they don’t always have enough time to give us their full attention.”

There was a lack of meaningful activities, and people did not always receive personalised care in a way that met their preferences. People had limited opportunities to express their views around the quality of care and appropriate action was not always taken in response to concerns. Complaints were not analysed to help prevent reoccurrence. Staff did not receive training around end-of-life care and information about people’s advanced wishes was missing from care records.

The provider and registered manager had not maintained good standards. Systems to monitor the quality of care were not utilised and audits had not picked up some of the issues identified during inspection. Action was not taken in a timely manner to resolve issues or drive improvement. Systems and processes failed to engage people, their relatives or staff and promote good outcomes. Staff worked hard as a team and people generally spoke about them positively.

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 good (published 21 April 2021)

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk and safe care and treatment. This inspection examined those risks.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We identified breaches in relation to person-centred care, safe care and treatment, premises and equipment, good governance and staffing. We made recommendations in relation to learning lessons when things go wrong, receiving and acting on complaints and consent.

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

Follow up

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.