CQC report explained · a nursing home
What the CQC found at Beechdale House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, with some records and activity arrangements needing attention.
This was an unannounced inspection on 29 January 2020. Inspectors spoke with people living in the home, relatives, visiting health professionals, staff and managers. They observed care and checked care records, medicines, staff files, incidents, audits, training and safety checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people received safe care from staff who understood their needs. Medicines, staffing, recruitment and infection control were managed safely.
People received effective and personalised support. Staff helped people access health services, make choices, eat and drink enough, and take part in activities. Inspectors noted that some care records needed updating, the activity coordinator role was vacant, and some best-interest records did not clearly show who had been involved. Immediate action was taken on the record issues.
Safe staffing and medicines
Staffing levels were considered sufficient for people's needs. Medicines were ordered, stored and given safely, with improvements since the previous inspection.
“People received their prescribed medicines safely and medicines were ordered, stored and managed in accordance with national best practice guidance.” from the report
Kind and respectful care
Staff knew people's routines and preferences. Inspectors saw people being offered choices and having their privacy, dignity and independence respected.
“People were cared for by staff who knew their care needs, preferences and daily routines.” from the report
Personalised support
Care planning included people's health needs, history, interests and communication needs. The home provided choices, community activities and support with healthcare appointments.
“People received care and treatment that reflected their individual needs, preferences and routines.” from the report
Open management
The management team was visible and involved in the service. Inspectors found effective systems for monitoring quality, responding to incidents and planning improvements.
“The systems and processes that monitored quality and safety were effective and plans were in place to continually drive forward improvements.” from the report
Some care records needed updating
needs fixingInspectors found that some records were not fully up to date. The report says this did not affect safe care, and the home took immediate action to improve them.
“Whilst some care records needed updating, this had not impacted on the safe care and treatment provided and immediate action was taken where required, to make improvements.” from the report
Best-interest records were unclear
needs fixingSome records did not clearly show who had been involved in decisions for people who could not consent to a specific decision. The manager amended the documents during the inspection.
“However, it was not clear who had been involved in these discussions and decisions.” from the report
Activity coordinator vacancy
minorThe activity coordinator had recently left. Managers and senior staff were organising activities while a replacement was being recruited, so ask how regular activities are being maintained.
“At the time of our inspection, the activity coordinator had recently left, and a replacement was being recruited.” from the report
Some people were unsure how to complain
minorThe complaints procedure was displayed, but some people did not know how to use it. The home had investigated the complaints it received.
“Whilst some people were unsure of the procedure to make a complaint, the provider's policy and procedure was on display for people and visitors.” from the report
- 01How have you made sure all care records are now up to date, and how often are they reviewed?
- 02How do you record who is involved in best-interest decisions for people who cannot consent?
- 03Who is organising activities while the activity coordinator role is vacant, and what activities are currently available?
- 04How will my relative and our family be told how to make a complaint?
- 05What further refurbishment and decoration work is planned for the lounge and dining room?
This was an unannounced inspection covering all five CQC questions, including both the premises and the care provided; Safe had improved from Requires Improvement while the other ratings remained Good. This explanation was written from the published report of 13 February 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, August 2017
Rated Good overall, but inspectors found that safe care was not consistent and rated this area Requires Improvement.
Inspectors visited the home without warning on 12 July 2017. They spoke with people living there, relatives, staff and a healthcare professional. They also observed care and checked care records, medicines records, training records and quality checks.
People generally felt safe and said staff were kind, skilled and responsive. Inspectors found good support with food, healthcare, decision-making, activities and personal preferences. The home had improved since the previous inspection, including its activities, communication and environment.
The main concerns were unsafe moving and handling, risk assessments that were not always reviewed, and gaps in medicines checks and records. Some care records lacked detail or were not completed consistently. The overall Good rating means the home was meeting the required standard in most areas, but Safe was rated Requires Improvement.
Safeguarding awareness
Staff had received safeguarding training and knew how to recognise and report concerns. The home had also reported safeguarding matters appropriately.
“Staff had received adult safeguarding training and were knowledgeable about the safeguarding policies and procedures that were available to support them.” from the report
Staff training and teamwork
Staff received a detailed induction, ongoing training and support. Staff said communication and teamwork had improved.
“We're working much better as a team, better organised and we have good handover meetings, we're kept up to date about people's needs.” from the report
Kind and personal care
Inspectors saw staff respond with kindness and reassurance. Staff knew people's needs, preferences and routines.
“We observed staff interactions with people who used the service and found staff to be caring, kind and sensitive towards people.” from the report
Activities and choice
The home had improved its activities and offered one-to-one sessions, social activities and outings. People could choose whether to take part.
“Other regular activities included armchair yoga, bingo, crafts, games, darts, and bowls, sing songs, pamper sessions, hairdresser day, gardening and walks, plus a visiting singer.” from the report
Improved leadership
People, relatives, staff and professionals described improvements in the home. The manager was seen as approachable and supportive.
“There have been so many improvements, its better in so many ways.” from the report
Unsafe moving and handling
seriousInspectors saw staff hold people under their armpits during transfers. This was not safe practice, and one person reported shoulder pain afterwards.
“Staff were seen to hold people under their arm pits; this is known to be an unsafe move and not in safe moving and handling best practice guidance or training procedures.” from the report
Risk records not always up to date
needs fixingSome risk assessments had not been reviewed as often as required. One pressure ulcer record also lacked photographs or an objective assessment of healing.
“However, this was not consistent for the pressure ulcer risk assessment score where these had not been reviewed for two people whose care we reviewed.” from the report
Medicines checks and records
seriousLiquid medicines and creams were not dated when opened. Some handwritten medicines records did not have the required two checking signatures, and a medicines trolley was left with its keys in it.
“We found liquid medicines and topical creams were not labelled with their date of opening.” from the report
Incomplete care records
needs fixingSome care plans did not contain all the information staff needed. Repositioning records for a person with pressure ulcers were not completed consistently.
“We found a record of re-positioning for a person with two pressure ulcers was not consistently completed.” from the report
Consent was not always sought
needs fixingSome people said staff did not always ask for consent before providing care. Inspectors also saw staff fail to ask before putting protective clothing on some people.
“People told us they were not always asked for their consent before care and treatment was provided.” from the report
A person left in an unsuitable position
needs fixingOne person was left in a wheelchair for several hours, including over lunch, where they could not see the television. Inspectors said support could have been better.
“A person was transferred to their wheelchair and was then left from 10.55am until 3pm (including over lunch.)” from the report
- 01What training and checks are now in place to make sure staff use safe moving and handling techniques every time?
- 02How do you make sure liquid medicines and creams are dated when opened, and that handwritten medicines records are checked correctly?
- 03How often are each person's risk assessments reviewed, especially for pressure ulcers and falls?
- 04How do you check that repositioning records are completed clearly and consistently?
- 05How do staff make sure people are not left in unsuitable positions or without appropriate support for long periods?
This was an unannounced inspection covering all five key questions and the overall quality and safety of the home. This explanation was written from the published report of 4 August 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 Beechdale House Care Home
5 rated inspections over 5 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2016Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 2 December 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
90 live-in carers within about an hour of Nottingham
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 £1,270 a week. 73 can care for a couple. 11 years' experience on average.
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.