CQC report explained · a residential care home
What the CQC found at Beech House - Halesworth
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found systems to assess and reduce risks, enough staff, safe recruitment, clean surroundings and safe medicines management.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found an open, person-centred culture, regular checks and audits, staff training and ways for people and relatives to give feedback.
What inspectors found, March 2020
Beech House - Halesworth was rated Good after a focused inspection found safe care and strong management, but it did not examine the circumstances of a recent death.
The inspection was unannounced and took place on 19 February 2020. One inspector spoke with five people living in the home, two relatives and five staff. They observed care, including lunch and medicines, and checked care, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found risk assessments, suitable staffing, safe recruitment, clean surroundings, infection control measures and safe medicines systems. People said they felt safe and staff responded promptly to requests for help.
This was a focused inspection. It was prompted partly by a specific incident after which a person died, but the inspection did not examine what happened because the incident was still under investigation. The other three question ratings were not inspected and were carried forward from the previous comprehensive inspection.
Risk management
Care records included assessments and guidance for risks such as falls and pressure ulcers. The home also used equipment and referrals to help reduce risks.
“People's care records included risk assessments, which showed risks were being assessed and measures put in place to guide staff how these risks were to be reduced.” from the report
Staffing and recruitment
People and staff told inspectors there were enough staff. Inspectors saw staff respond promptly, and recruitment checks were completed.
“We saw staff were attentive to people's needs and responded to requests for assistance promptly.” from the report
Medicines
Medicines were managed safely during the inspection. Staff had training and competency checks, and a new electronic system helped record administration and identify doses given too close together.
“The system alerted staff if medicines were being given too close together and recorded when medicines had been administered by using a bar code on the original packaging.” from the report
Open management
Inspectors found the home had an open culture. People, relatives and staff could give their views, and the management team used audits and feedback to identify improvements.
“There was an open and person centred culture in the service.” from the report
Clean environment
The home was visibly clean and had supplies and processes to reduce infection risks. Cleaning records included a programme of deep cleaning.
“The service was visibly clean throughout.” from the report
Inspectors raised no specific concerns in this report.
- 01What has been learned from the specific incident mentioned in the report, and what changes have been made while the investigation continues?
- 02How are risks of falls, pressure ulcers and distress reactions assessed and reviewed for my relative?
- 03How has the new electronic medicines system worked since the inspection, and how are errors or missed doses checked?
- 04How will you keep me informed about changes to my relative's care and any concerns raised through audits or meetings?
- 05What were the ratings for Effective, Caring and Responsive at the previous comprehensive inspection?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 10 March 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2017
Rated Good; inspectors found kind, personalised care, with some prescription creams not stored securely and staff appraisals not fully completed.
This was an unannounced comprehensive inspection on 21 June 2017. The inspector spoke with people living at the home, relatives, staff and health professionals. They also reviewed care records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe, staff were kind, and their care was personalised. Inspectors also found enough staff, suitable training, good support with food and drink, and activities linked to people's interests.
There were two shortfalls. Some prescription creams and other potentially harmful substances were not stored securely. Yearly staff appraisals had also not all been completed and signed off. The home remained Good overall, as inspectors found these issues did not outweigh the wider evidence of good care.
Enough staff
People and professionals told inspectors there were enough staff to meet people's needs promptly. Staff retention also helped provide continuity of care.
“A visiting health professional told us that there were enough staff to spend one to one time with people and that the service had good staff retention which provided people with continuity of care.” from the report
Kind and respectful care
Inspectors saw staff speaking with people in a friendly and thoughtful way. People's privacy, choices and independence were respected.
“We observed that staff continued to engage with people in a friendly and thoughtful manner.” from the report
Personalised support
Care records included people's history, interests and preferences. The home supported people to take part in activities that mattered to them.
“The service continued to ensure that people's care records were person centred to include information about them, such as their hobbies, interests and preferences.” from the report
Responsive management
Managers were visible and encouraged people and staff to help shape the service. Audits identified shortfalls and records showed that action was taken promptly.
“Where shortfalls had been identified, records demonstrated that these were acted upon promptly.” from the report
Some substances not securely stored
seriousSome prescription creams and denture cleansing tablets were not stored securely. The manager was considering lockable cabinets for bedrooms.
“However, some prescription creams were not being stored securely.” from the report
Appraisals not completed
needs fixingYearly staff appraisals had been delayed and were not all finished and signed off. The manager said this was linked to covering a vacant shift.
“However, appraisals had not yet been finished and signed off for the previous year.” from the report
- 01Have all prescription creams and denture cleansing tablets now been placed in secure storage?
- 02What changes were made after inspectors found that some potentially harmful substances were not stored securely?
- 03Have all yearly staff appraisals now been completed and signed off?
- 04How does the home make sure staffing levels change when people's needs change or extra support is needed?
- 05How are people's feedback and activity wishes used to change daily life in the home?
This was an unannounced comprehensive inspection covering all five key questions, and the previous Good ratings remained unchanged. This explanation was written from the published report of 30 November 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Beech House - Halesworth
3 rated inspections over 5 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Goodstayed GoodSafe: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 9 February 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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