CQC report explained · a residential care home
What the CQC found at The Beeches
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2019
Rated Requires Improvement; inspectors found kind care and safe medicines, but infection control, personalised support and leadership needed improvement.
This was an unannounced, comprehensive inspection on 30 April 2019. Inspectors spoke with people, a relative and staff, observed care and checked care plans, risk assessments and management records.
People generally described staff as friendly, kind and caring. Risks were assessed, medicines were managed safely, staff were trained, and people had access to food choices and healthcare support.
However, the home did not always control infection safely. Inspectors also found gaps in care plans, activities and accessible information. Staffing arrangements and management oversight were inconsistent. The overall rating fell from Good at the previous inspection to Requires Improvement.
Kind and respectful care
People spoke positively about staff. Inspectors saw people being treated with dignity and encouraged to make their own choices.
“People were treated with dignity and respect and encouraged to make decisions about their care.” from the report
Medicines managed safely
People received their medicines on time. The home followed safe processes for receiving, storing, giving and disposing of medicines.
“Medicines were organised and people received their medicines when they should.” from the report
Skilled staff
Staff had training, supervision and experience relevant to their roles. Inspectors saw staff use their knowledge effectively.
“Staff had the knowledge, skills and experience to support people effectively.” from the report
People's views heard
Residents' meetings and surveys were used to gather feedback. Inspectors found examples where suggestions, such as concerns about food temperature, were acted on.
“Residents' meetings were organised and people's views were listened to.” from the report
Infection control
seriousInspectors found faecal matter left in a toilet, a faeces-stained bedsheet that had not been changed, mould and surfaces that could not be cleaned properly. Continence pads were also left unpackaged on bathroom cisterns.
“People were not adequately protected by the prevention and control of infection.” from the report
Personalised care records
seriousSome care plans did not explain how staff should respond to particular health or wellbeing needs. People's communication needs were not always recorded or supported with accessible information.
“Care plans provided information and guidance to staff about people's needs and how they wished to be supported.” from the report
Activities and staffing
needs fixingActivities were not clearly planned around people's hobbies and interests, and some people said they could not go for walks because there were not enough staff. The provider relied on agency staff and had care staff vacancies.
“We recommend that the provider reviews staffing at the home and how staff are deployed.” from the report
- 01What has been done to prevent faecal matter, mould and stained laundry being left in the home?
- 02How are continence pads now stored so they remain clean, dry and safe to use?
- 03How are care plans checked to make sure they explain each person's specific health, communication and personal care needs?
- 04How are activities matched to each person's interests, particularly for people living with dementia?
- 05Who is responsible for the home when the registered manager and deputy manager are unavailable, and how are staffing gaps covered?
This was an unannounced comprehensive inspection covering all five key questions; it also followed up concerns from the previous inspection, when the home was rated Good. This explanation was written from the published report of 14 June 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, April 2018
Rated Good overall, but well-led Requires Improvement because important incidents were not always reported and checks missed some problems.
This was an unannounced inspection on 5 March 2018. Inspectors spoke with people, relatives and staff, and checked care plans, medicines, accidents, complaints, audits and recruitment records.
The home was rated Good for safe, effective, caring and responsive care. People generally felt safe, received the medicines they needed, were treated kindly and respectfully, and had suitable food, activities and healthcare support.
The main weaknesses were in management and record keeping. Safeguarding concerns were not always reported to CQC, some care records were out of date, medicines storage checks were incomplete, and quality audits did not always find problems. Inspectors also recommended more opportunities for people to go out into the community.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff respecting privacy, offering reassurance and supporting people patiently.
“People were cared for by staff who showed them respect and promoted their privacy and dignity.” from the report
People felt safe
People said they felt safe and did not have to wait for help. Staff understood individual risks and emergency arrangements were in place.
“People told us they felt safe living at The Beeches.” from the report
Food and health support
People had choices about meals and staff understood dietary needs. Healthcare professionals were involved when people needed additional support.
“People were given a choice of foods and staff were aware of people's likes, dislikes and dietary requirements.” from the report
Supportive staff culture
Staff said they felt supported and valued. Inspectors saw staff working together and communicating well.
“The culture and communication within the staff team was good.” from the report
Safeguarding incidents not reported
seriousThe provider did not always notify CQC about safeguarding concerns and other significant incidents. This was a breach of the registration regulations.
“The lack of notification of other incidents within the service is a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.” from the report
Care records were not always accurate
needs fixingSome records did not give current or complete guidance, including information about seizures, food and fluids, personal care and people's histories. The report says most of these shortfalls were addressed after the inspection.
“People's records did not always contain up to date information or show evidence of people receiving the care they requested.” from the report
Medicines management checks
needs fixingStaff did not routinely record medicine storage temperatures, and some first aid items were out of date. Inspectors recommended stronger medicines management processes.
“There was a risk that people's medicines were not stored in the most appropriate way.” from the report
Limited trips outside
minorPeople could join activities inside the home, but external trips had not happened for several years. People said they wanted to visit places such as a garden centre, museum or seaside.
“However, people told us they would like to go out more often.” from the report
- 01How do you now make sure all safeguarding concerns and significant incidents are reported to CQC on time?
- 02How are medicine storage temperatures recorded and checked, and how do you prevent out-of-date items being used?
- 03How do you check that care plans are current and that requested personal care is actually provided?
- 04Have trips outside the home now started, and how often can residents take part?
- 05What evidence can you show that the improvements identified after the inspection were completed?
This was an unannounced comprehensive inspection covering all five CQC questions, with the overall rating Good and well-led rated Requires Improvement. This explanation was written from the published report of 27 April 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 The Beeches
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- June 2019Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 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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