CQC report explained · a nursing home
What the CQC found at Beech House Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2019
Beech House Nursing Home rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
The inspection was an unannounced visit on 12 February 2019. One inspector spoke with nine people living at the home, a relative and four staff members. They also observed care and checked care records, medicine records, staff training records and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicine arrangements, suitable risk checks and good infection control. People said staff were kind, respectful and responded to requests promptly.
The home had improved since the previous inspection in November and December 2017, when it was rated Requires Improvement. Improvements included staffing, medicines, legal safeguards for people whose liberty was restricted, care quality checks and the environment.
Improved quality checks
The home had strengthened its systems for checking care quality and acted on issues found. Inspectors said action plans had addressed shortfalls within the required timescales.
“Regular audits and checks were carried out by the registered manager.” from the report
Kind and respectful care
People described staff as kind and caring. Inspectors saw staff listening to people, respecting their wishes and responding warmly.
“We observed staff interacting with people in a warm and caring manner.” from the report
Prompt support
People said staff responded quickly when they needed help. Inspectors saw people being assisted without rushing and staff spending time with them.
“People were assisted in an unhurried manner and we observed staff spending quality time with people.” from the report
Safer medicines arrangements
A medicines problem identified at the previous inspection had been corrected. Prescribed creams were being given and records were completed.
“People received their prescribed creams and records were completed when the cream was administered.” from the report
Personalised activities and links
People could take part in activities and trips that matched their interests. The home also maintained links with local community groups.
“People had opportunities for social stimulation and were able to maintain links with the local community.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you continue to check that medicine administration records remain complete, including records for prescribed creams?
- 02How do you review staffing levels at different times of day to make sure people receive prompt assistance?
- 03How are Deprivation of Liberty Safeguards applications and renewals monitored for people who need them?
- 04How are care plans reviewed with residents and relatives when people's needs or preferences change?
- 05What action is taken when audits or complaints identify a new area for improvement?
This was an unannounced inspection of the overall service, including both the premises and care, and all five CQC questions were assessed. This explanation was written from the published report of 1 March 2019 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, March 2018
Rated Requires Improvement in all five areas; inspectors found kind and skilled care in places, but medicines, dignity, activities and quality checks were not consistently reliable.
Inspectors visited without warning on 29 November and 7 December 2017. They spoke with people, relatives and staff, observed care, and checked care plans, medicines, accidents, infection control, recruitment and quality records.
The home had enough staff overall, but people sometimes waited too long for help. Inspectors found unsafe medicines practice, incomplete guidance, poor cleaning of some equipment and a trip hazard. Some care plans did not reflect current needs.
People had access to healthcare and enough food and drink. Staff had relevant training, and people were involved in care decisions. However, inspectors saw that people were not always treated respectfully or engaged in activities, and some complaints were not fully resolved.
The home was rated Requires Improvement for Safe, Effective, Caring, Responsive and Well-led. This was the second consecutive Requires Improvement rating. The provider breached Regulation 17 because its checks did not identify or drive the improvements needed.
Protection from abuse
Staff knew how to recognise possible abuse and what action to take. The home made appropriate referrals when concerns were raised.
“People were kept safe from the potential harm of abuse or ill-treatment as staff knew how to recognise and respond to such concerns.” from the report
Staff training
Staff received training relevant to the people they supported. This included dementia, end of life care and guidance on swallowing difficulties.
“Staff attended training that was relevant to the people they supported and any additional training needed to meet people's needs was provided.” from the report
Healthcare and nutrition
People had access to healthcare, and the home monitored weight loss and made referrals when needed. People could choose meals and have alternatives.
“People were supported to eat and drink enough to maintain their health” from the report
Involvement in care
People and relatives were involved in assessments and care planning. Staff knew people's preferences, backgrounds and dietary needs.
“People were involved in making decisions about their care and had information they needed in a way they understood.” from the report
Approachable management
People and staff said they could share their views. The manager was regularly present and people found them approachable.
“People had regular contact with the registered manager whom they found approachable.” from the report
Medicines were not always safe
seriousA medicated cream prescribed for one person was used for someone else without a prescription or medicines record. Guidance for some medicines given covertly was also incomplete.
“People did not always receive safe support with their medicines.” from the report
Quality checks missed problems
seriousThe provider's monitoring systems failed to identify several concerns found by inspectors. This was a breach of Regulation 17.
“The provider did not have effective quality monitoring systems in place to identify and drive good practice.” from the report
Delayed help
needs fixingPeople sometimes waited longer than expected for assistance, including help to go to bed and support with meals.
“Although those we spoke with told us there were enough staff around they didn't always get timely support.” from the report
Respect and dignity
needs fixingInspectors saw staff moving people without explaining what was happening and people sitting for long periods without meaningful interaction.
“We also saw people sat for prolonged periods of time without any valued interactions with those they lived with or staff members.” from the report
Too little to do
needs fixingSome people had long periods without activities or stimulation when the activities coordinator was not available. Some people said they were often bored.
“There was little to occupy those choosing to remain at Beech House.” from the report
Care plans were not always current
needs fixingOne person's deteriorating skin condition did not have a care plan, and staff had not passed the change in condition to the appropriate clinician at first.
“People did not always have care and support plans that reflected their current needs.” from the report
- 01What has changed since the inspection to prevent medicines being given without the correct prescription, label or medicines record?
- 02How do you now check that care plans reflect changes in skin condition and other current needs?
- 03How do you make sure people receive timely help with going to bed, meals and other requests?
- 04What activities are offered to people who stay at the home when the activities coordinator is not present?
- 05How do you now check that your quality monitoring identifies problems and confirms that improvements have worked?
This was an unannounced inspection covering all five key questions and checking progress since the previous inspection. This explanation was written from the published report of 8 March 2018 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 Nursing Home
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 18 November 2010.
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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