21 and 23 January 2015
During a routine inspection
This inspection took place on 21 and 23 January 2015 and was unannounced. This was the first inspection of the service since the location was registered with the Commission in September 2014.
Beechwood Care Home is registered to accommodate a maximum of twenty seven people and provides care to older persons some of whom may be living with dementia. Nursing care is not provided. Ten people were accommodated at the service at the time of our visit.
The service did not have 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. The service was being managed on a part time basis by a manager registered with us in respect of another location operated by the same provider.
The people we spoke with, relatives and a visiting professional were complimentary about the care provided by staff. For example, one relative said, “The staff are very nice; they are always welcoming at any time of the day and very, very caring. (Name) is very happy there, there are no problems it is brilliant.” A visiting professional we spoke with told us, “The care is good; they call us in whenever they need us.”
Staff understood how to ensure people were protected from abuse and how to respond to concerns about their safety. Staff were recruited appropriately and were knowledgeable about people’s needs. There were some gaps in staffing levels which were being addressed by recruitment of new staff.
Medicines arrangements and infection control were not being managed safely.
CQC monitors the operation of Deprivation of Liberty Safeguards (DoLS). The Mental Capacity Act 2005 and the DoLS were being followed. The service ensured that people’s rights were protected by making sure they were represented appropriately. Staff had not been fully supported as they had not received up to date training. Staff appraisals were overdue and staff one to one meetings with their manager had fallen behind schedule.
Staff had a caring and reassuring approach. People’s privacy and dignity was upheld at all times. Relatives told us they felt involved in people’s care as appropriate.
Staff had a good understanding of people as individuals and care was provided in a way that was tailored to individual needs and choices. For example, we saw people's meals were prepared in accordance with their plan of care and their food preferences were taken into account at the time each meal was made. However, because access to food stocks was restricted at certain times of the day people’s choice was also limited at these times. Some people found the menus lacked variety.
The service did not have a programme of regular activities. People’ s comments included; “It’s boring” and “Not much to do”.
Records were not being adequately maintained.
The service had a part time manager but staff told us they did not feel well led. Neither the provider, nor the manager had effective systems for checking and maintaining the quality of the service by use of regular auditing and consultation with people, representatives or external professionals as appropriate. Relatives told us they felt their suggestions on ways to improve the service had been disregarded. Records were not being maintained satisfactorily.
We found six breaches of the Health and Social Care Act 2008 (Regulated Activites) Regulations 2010. These related to management of medicines, safety and suitability of premises, infection control, records, supporting workers and assessing the quality of the service. You can see what action we told the provider to take at the back of the report.