CQC report explained · a nursing home
What the CQC found at Beechcroft
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2022
Rated Requires Improvement; the home is no longer in special measures after major improvements, but care records were still not reliable.
This was an unannounced focused inspection on 3 March 2022. Inspectors spoke with six people, seven staff members and relatives, and reviewed care, medicines, staffing, training and management records.
The home had improved from its previous inadequate rating. Inspectors found safer risk assessments, medicines management and staffing. People had support with food, healthcare and decision-making, and the home was clean and well maintained.
The inspection still found problems with some records about people's care and treatment. Records were sometimes incomplete, contradictory or not updated promptly. The overall rating changed to Requires Improvement, and the home was no longer in special measures.
Safer risk management
People had individual care plans and risk assessments. Staff had guidance about people's needs and what to do in an emergency.
“People had individualised care plans in place that were used to assess the risks present in their care and provided guidance for staff” from the report
Safe medicines
Inspectors found that medicines were managed and given safely, with guidance available for staff and regular audits.
“People's medication was administrated and managed safely.” from the report
Enough staff
The home had increased its staff team and used agency staff only to a limited extent. Inspectors found enough staff to meet people's needs promptly.
“There were sufficient staff on duty for the service to be safe and to meet people's needs in a timely manner.” from the report
Respect and choice
Staff supported people to make decisions, sought permission and used the least restrictive approach when restrictions were needed.
“People were supported to make as many decisions for themselves as possible.” from the report
Positive culture
People, relatives and staff described staff as attentive, flexible and approachable. Inspectors also saw activities and celebrations taking place.
“There was a positive culture at the home.” from the report
Incomplete care records
needs fixingSome records about care and treatment were not fully completed or updated on time. Some contained contradictory or incomplete information, and staff said having several records was confusing.
“We found examples when records were not being fully completed, being updated in a timely manner or contained contradictory and incomplete information.” from the report
Alternative nutrition checks
minorThe provider was recommended to offer other ways to assess people's nutritional wellbeing when they did not want to be weighed.
“When people do not want to be weighed, we recommend that the provider makes arrangements to offer alternative methods for assessing people's nutritional wellbeing in line with best practice guidance.” from the report
- 01What changes have been made to the records system since the inspection, and how do you check that records are complete, accurate and consistent?
- 02How will you make sure recent improvements to risk assessments and care plans are maintained over time?
- 03How do you assess people's nutritional wellbeing if they do not want to be weighed?
- 04How many permanent staff are usually on duty, and when do you use agency staff?
- 05How are relatives involved in reviewing and updating their family member's care plan?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the other ratings were carried over from the previous inspection. This explanation was written from the published report of 2 April 2022 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, December 2021
Rated Inadequate and placed in special measures; inspectors found serious risks in care, medicines, staffing and management.
This was a focused inspection carried out on 7, 8 and 10 September 2021. Inspectors reviewed care and medicines records, staffing and management information, spoke with staff and the manager, and contacted people and relatives.
The overall rating fell from Requires Improvement to Inadequate. Inspectors found serious problems with risk assessments, care planning, nursing records, medicines, consent under the Mental Capacity Act, staffing levels, dignity and management oversight. They also made safeguarding referrals for three people.
People and relatives said staff were kind and caring, and inspectors saw this too. Infection control arrangements, recruitment checks and links with health professionals were positive. However, the home was placed in special measures and the provider was told to make urgent improvements.
Kind interactions
People and relatives said staff were kind and caring. Inspectors also observed staff being kind, caring and patient when supporting people.
“Of those interactions we did see we observed staff being kind, caring and patient when supporting people.” from the report
Infection control
The home had COVID-19 infection control procedures, safe admission and visiting arrangements, and appropriate use of protective equipment.
“Appropriate Infection prevention control policies and procedures (IPC) for COVID-19 were in place.” from the report
Safe recruitment
The report says the home carried out appropriate checks before employing staff.
“Staff were recruited safely. Appropriate pre-employment checks were carried out to ensure staff employed were safe to work with vulnerable people.” from the report
Health professional support
People were referred to other health and social care professionals when needed.
“People were referred to and received support from other health and social care professionals.” from the report
Risks and medicines
seriousCare records did not always explain people's risks or the care they needed. Medicines, including thickening agents and high-risk medicines such as Warfarin, were not always managed safely.
“The management of medication was unsafe. This was a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Staffing levels
seriousThere were not enough suitably qualified, competent and familiar staff. The home relied heavily on agency staff, and one relative reported a 25-minute wait after using the call bell.
“There were not enough staff on duty who were suitably qualified, competent and familiar with people's needs and care to support them safely.” from the report
Consent and restraint
seriousThe Mental Capacity Act was not always followed. Some decisions about resuscitation, deprivation of liberty and bed rails did not have the required evidence of capacity or best-interest decisions.
“People's legal right to consent to their care was not always protected in accordance with the Mental Capacity Act 2005.” from the report
Privacy and dignity
seriousBedroom doors were sometimes left open when people were undressed. Continence products and a catheter bag were visible to people passing by.
“People's right to privacy and dignity were not always promoted in the delivery of their care.” from the report
Weak improvement action
seriousManagers knew about problems with care planning, wounds, records and staffing for several months, but did not act effectively enough. Inspectors said governance arrangements were not robust.
“The governance arrangements in place were not robust, managerial oversight was poor and risks to people's health and welfare were not managed sufficiently to protect them from harm.” from the report
- 01What changes have you made to risk assessments and care plans, especially for wounds, catheters, nutrition, skin care and bed rails?
- 02How are Warfarin, as-needed medicines and thickening agents now stored, prescribed, recorded and administered?
- 03How many permanent staff are normally on duty, and how do you make sure agency staff understand each person's needs and risks?
- 04How do you now record mental capacity and best-interest decisions, including decisions about bed rails and do-not-resuscitate instructions?
- 05What evidence can you show that the warning notice and urgent action plan have been completed and checked?
This was a focused inspection of Safe, Effective, Caring and Well-led; Responsive was not inspected and its previous rating was carried forward. This explanation was written from the published report of 1 December 2021 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 Beechcroft
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- April 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2021InadequateSafe: InadequateEffective: InadequateWell-led: Inadequate
- March 2021Inspected but not ratedSafe: Inspected but not rated
- November 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- May 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- March 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Inspected but not ratedSafe: GoodEffective: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 5 January 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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