CQC report explained · a residential care home
What the CQC found at Beechcare
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People’s health risks, medicines, staffing and the safety of the environment were managed well. Staff knew how to protect people from abuse and learned from incidents.
- Effective?
- Good
- Staff had relevant training and support. People received help with eating, drinking, healthcare, communication, personal goals and their specific health needs.
- Caring?
- Requires improvement
- This question was not inspected during this visit. The previous rating was carried forward.
- Responsive?
- Requires improvement
- This question was not inspected during this visit. The previous rating was carried forward.
- Well-led?
- Good
- Management had improved care planning, staff training, incident monitoring and oversight of the service. Inspectors found one incorrect piece of information in a support plan, which was removed.
What inspectors found, April 2023
Beechcare is rated Good after inspectors found major improvements, with safe, effective and well-led care.
This was an unannounced focused inspection on 10 March 2023. One inspector observed care, spoke with relatives and staff, and checked care plans, medicines records, rotas and other records.
Inspectors found the home had improved since its previous Inadequate rating. People’s health risks, medicines, staffing and infection control were managed safely. Staff had received more relevant training, and care plans contained better information.
The home supported people to make choices, build independence and work towards personal goals. Inspectors also found kind care, involvement from relatives and advocates, and better systems for monitoring incidents and the quality of care.
The overall rating changed from Inadequate to Good. The home had been in Special Measures, but it is no longer in Special Measures and was no longer breaching regulations at this inspection.
Improved safety
Health risks were assessed and managed, including risks linked to constipation and malnutrition. Staffing levels had improved and agency staff were no longer needed.
“People were kept safe and their health needs were well managed.” from the report
Relevant staff training
Staff had training in areas including autism, learning disabilities, epilepsy, dysphagia and communication. They also received supervision and appraisals.
“People were supported by staff who received relevant and good quality training in evidence-based practice.” from the report
Promoting independence
Staff focused on what people could do and supported them to work towards personal goals and greater independence with daily activities and personal care.
“Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.” from the report
Kind and respectful care
Inspectors found that staff understood people’s individual needs and protected their privacy and dignity. Relatives gave positive feedback about the support.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Better management oversight
The home had improved its systems for checking care, reviewing incidents and keeping staff training up to date.
“The home manager had worked hard since the last inspection to improve the monitoring of the service.” from the report
One inaccurate support plan entry
minorOne support plan contained incorrect information. The manager removed the error, but families should check that support plans remain accurate and current.
“However, we found one incidence where one person's support plan detailed incorrect information.” from the report
Recording of monthly meetings
minorThe home was still improving how it recorded people’s monthly meetings with key workers and was setting up folders with photographic evidence for families.
“The home manager was in the process of improving how they recorded people's monthly meetings with their key workers.” from the report
Registered manager application
minorThere was no registered manager in post during the inspection. A new manager had been in post since the previous inspection and was applying to register.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Has the new manager now completed the application to become registered?
- 02How do you check that every person’s support plan is accurate and updated when their needs change?
- 03How are people’s monthly meetings with key workers recorded, and when will the new records be available to families?
- 04How do staff support each person to work towards their independence and personal goals?
- 05How do you keep staff training up to date for autism, learning disabilities, epilepsy, dysphagia and communication needs?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 28 April 2023 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, February 2023
Rated Inadequate and placed in special measures; inspectors found serious safety, staffing and management failures.
Inspectors visited the home without notice on 26 and 29 July 2022. They observed care, spoke with relatives and staff, and checked care plans, medicines records, rotas and other documents. They found four people living there at the time.
The home was not always safe. Risks linked to weight loss, constipation, epilepsy, choking and behaviour were not properly assessed or explained to staff. There were also too few suitably trained staff, missed one-to-one support, and safeguarding incidents that had not always been recorded or reported.
Care was not consistently effective, caring or responsive. Staff did not always promote independence, activities were not recorded reliably, care plans were inconsistent, and relatives said concerns were not always acted on. The home had no registered manager, and its systems for checking and improving care were not effective.
The overall rating fell from Good at the previous inspection, published on 15 November 2018, to Inadequate. The home is in special measures and CQC said it would normally re-inspect within six months if the provider's registration was not cancelled.
Medicines
Staff followed processes for administering, storing and recording medicines. The report also says medicines were reviewed in line with STOMP principles.
“People were supported by staff who followed systems and processes to administer, store and record medicines safely.” from the report
Recruitment checks
The provider completed pre-employment checks before staff started work, including DBS checks.
“The provider ensured pre-employment checks were completed before staff began working at the service.” from the report
Clean environment
Inspectors found the home, including bedrooms and communal areas, to be clean and well equipped. Rooms were personalised and there was space for wheelchairs.
“People's care and support was provided in a clean and well-equipped environment.” from the report
Communication and choice
Some staff understood people's individual ways of communicating. Picture cards and other visual information helped people express choices.
“People were enabled to make choices for themselves and staff ensured they had the information they needed.” from the report
Unmanaged health risks
seriousImportant risks were not properly assessed or managed. Examples included missed nutritional supplements, constipation lasting seven days, missing epilepsy guidance and choking risks.
“People were not always kept safe from the risk of harm.” from the report
Insufficient trained staff
seriousThere were not enough suitably trained staff to provide required one-to-one support or follow behaviour support plans. One incident occurred when a person who should have had one-to-one support was not being supported at the time.
“The provider had failed to ensure there were enough competent and trained staff deployed to support people.” from the report
Safeguarding reporting
seriousStaff did not always record or report incidents, and some staff supported people before completing safeguarding training. The provider did not always identify or report safeguarding concerns to the local authority.
“Safeguarding incidents were not always reported by staff.” from the report
Weak management oversight
seriousThere was no registered manager, several managers had overseen the service, and governance systems did not identify or correct serious problems.
“Governance processes were not effective and did not help to hold staff to account, keep people safe or provide good quality care.” from the report
Inconsistent care and activities
needs fixingCare plans and daily records were not consistent. Activities were not always recorded, and the sensory room was being used to store equipment rather than being readily available.
“The provider could not be assured people were taking part in activities that were relevant to them.” from the report
Concerns not acted on
needs fixingRelatives said that complaints and concerns were sometimes acknowledged but did not lead to effective changes.
“Relatives told us they felt nothing changed after they had raised concerns to the managers and provider over a period of a few months.” from the report
- 01What has been done to ensure every person has current risk assessments and clear guidance for choking, epilepsy, constipation, weight loss and behaviour support?
- 02How do you now make sure there are enough trained staff to provide every person's required one-to-one support?
- 03What safeguarding training have all permanent and agency staff completed, and how are incidents now recorded, reported and reviewed?
- 04Who is managing the home now, and how are senior managers checking that care plans, incidents, health referrals and staff practice are up to date?
- 05How have you improved the way complaints are investigated and acted upon, and how will families be told what has changed?
This began as a focused inspection of Safe and Well-led after concerns about people's health and support needs, but further concerns led inspectors to assess all five key questions. This explanation was written from the published report of 2 February 2023 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 Beechcare
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- April 2023Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- February 2023Inadequatedown from GoodSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 2 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.