25 May 2022
During a routine inspection
Beechdale Manor is a residential care home providing personal and nursing care for up to 65 people. The service accommodates people in one adapted building which is set out across three floors. The ground floor accommodates people who have a higher level of mobility and less complex needs. The first floor provides care and support for people with more complex and palliative care requirements. At the time of our inspection there were 43 people using the service. At the time of our inspection the second floor was undergoing refurbishment and was unoccupied.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Beechdale Manor was well led by a registered manager who showed strong leadership qualities. The staff team were respectful and kind. They understood people and their identified needs well.
Risks associated with people's care and support and the environment were safely managed. People were protected from the risk of harm. Opportunities to learn from incidents was shared across the staff team to ensure improvements in service delivery were made.
Medicines were received, stored, administered and disposed of safely by staff trained and competent in this area. The home was clean and hygienic. The provider was following best practice guidance in infection control standards.
There were sufficient staff deployed across the service to meet people's needs and ensure their safety. Safe recruitment practices were followed, and staff were trained and competent to carry out their roles.
People were supported with their health needs and had access to healthcare services. Care plans contained personalised health information. The service was well adapted and being refurbished to meet people's needs.
The provider and registered manager operated effective governance systems to ensure the quality,
safety and improvement of people's care when needed. Audit systems were robust, and there were opportunities for people, relatives and staff to get involved in driving improvements.
During this inspection we carried out a separate thematic probe, which asked questions of the provider, people and their relatives, about the quality of oral health care support and access to dentists, for people living in the care home. This was to follow up on the findings and recommendations from our national report on oral healthcare in care homes that was published in 2019 called ‘Smiling Matters’. We will publish a follow up report to the 2019 'Smiling Matters' report, with up to date findings and recommendations about oral health, in due course.
Mental Capacity Act: 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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Rating at last inspection and update: The last rating for this service was Inadequate (published 18 March 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that the provider made improvements to infection control within the service, safeguarding people from abuse, medications management, pressure area care management, the quality of risk assessments for service users, and improving the level of governance at the service. At this inspection we found the provider had acted on any recommendations and had made improvements in these areas.
This service has been in Special Measures since 18 March 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from Inadequate to Good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.