Beechdale House Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed five quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last assessment, which was requires improvement. The assessment of these areas indicated areas of improvement since the last assessment, our rating for the key question therefore has improved to good. Safety risks to people were managed well. Managers assessed and reviewed safety risks to people and made sure people, and those important to them, were involved in making decisions about how they wished to be supported. Medicines were managed safely. People received their medicines in the way they would wish, as they were prescribed, in a safe way. There were enough staff to support people with their identified needs. Managers reviewed staffing levels regularly to make sure there were always enough suitably skilled and experienced staff on duty. Staff received relevant training to meet the range of people’s needs at the service. Staff received support through supervision to support their continuous learning and improve their working practice. Managers made sure recruitment checks were undertaken on all staff to ensure only those individuals that were deemed suitable and fit, would be employed to support people at the service. There were processes in place to review incidents and then make improvements where required. Staff were provided with the opportunity to reflect after incidents, to ensure learning and improvement could occur.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People we spoke with told us they felt safe living in the service. We received no concerns about safety or raising any issues. We saw that people living at Beechdale House had no unlawful restrictions imposed on them. They were free to complete their own routines and live their lives as they wished. Some people would be at risk if they did not have continuous supervision. Where this was the case, we saw staff had applied the suitable Deprivation of Liberty Safeguards. These safeguards ensure people who cannot consent to their care arrangements in a care home or hospital are protected if those arrangements deprive them of their liberty.

Staff understood how to respond to allegations of abuse. Staff told us that they had no concerns about the safety of the service, but if they did, they were confident the management team would act appropriately. Staff were confident in using whistleblowing processes if they felt concerns were not being responded to. The registered manager understood how to respond to allegations of abuse. They had a clear process of how to investigate and keep people safe. Staff knew where to find the safeguarding policy. They were aware of the policy guidance, and knew how to follow it to keep people safe from potential abuse.

We saw people and staff had positive relationships. There was an open culture of communication and we saw no evidence that people were at risk or fearful of the staff team.

If an allegation of abuse was made, there were appropriate policies in place to guide the staff team. Records showed that incidents were quickly investigated and referred to the local authority safeguarding team if needed. We saw some more recent falls incidents where the registered manager had improved their review and assessment documentation. This ensured people were referred onto specialist teams where required. The management team was positive this process change would improve their oversight of safeguarding within the service.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

The environment was managed safely for people. We received no negative feedback at this site visit about the general cleanliness of the service and people’s bedrooms, the laundry service or access to bathing or showering for people. People’s bedrooms had been improved significantly by the provider since our last assessment visit. The provider had purchased new mattresses, bedding and bed clothes to enhance people’s personal spaces. There was an ongoing refurbishment plan in place to redecorate and refloor the whole building, which would further improve the lived environment. We saw that the call bells in people’s bedrooms were always working and easily accessible. This meant people could request staff support if needed.

The provider told us they had made significant investment in improving the service since our last assessment visit and had an ongoing refurbishment plan in place. The provider had employed a full time maintenance person to continue embedding the environmental improvement works, and had a tracker to ensure these works were completed. Staff knew how to monitor the safety of the environment, and where to report any maintenance concerns to. The management team described a clear process for monitoring the safety of the environment. For example, the registered manager documented their regular checks around the building daily and explained how they passed concerns to the maintenance person to resolve. We saw that any areas they had picked up, had been resolved to keep people safe. Staff knew how to respond in the event of an emergency evacuation. For example, if a fire alarm sounded, staff could explain how people would be supported to move into a safe space.

Windows had now been fitted with restrictors by the provider, so they were unable to be opened wide. This safety feature prevents people from falling or climbing out and is in line with guidance from the health and social care executive (HSE). Furniture which required securing to the wall to prevent any risk of this falling over and injuring people had been fixed into place by the maintenance person. Some people at Beechdale House used equipment (like walking frames or hoists). We saw these pieces of equipment were well maintained, clean and stored appropriately. The home was safe in the event of a fire. Corridors were clear of any blockages, allowing people to follow easy to read escape routes. Staff had access to fire-fighting equipment which had been recently serviced.

The environment was kept safe, by regular checks and maintenance. We saw there had been regular checks to ensure the home was safe in the event of a fire; for example, by checking the alarms and completing test fire evacuation procedures. People had access to call bells to call for support if needed. Some people also had sensor mats in place for support with the management of falls. Documentation showed these call bells and sensor mats were regularly checked, to ensure they were working and effective.

The service was staffed by a sufficient number of trained staff on each shift to ensure people’s identified needs were being met. The provider had reviewed their dependency levels for people and increased their night staffing accordingly to ensure people would be supported effectively in the event of an emergency. People’s personal emergency evacuation plans had all been reviewed and updated, so they were personalised, and reflective of people’s identified needs. The fire safety plan for horizontal vertical evacuation of the building in the event of a fire was clear and staff had received updated fire safety training. Staff had received suitable training to do their role. The management team ensured there were always suitably skilled staff working. Once staff were trained, there were ongoing processes in place to assess their competency. If needed, further support and training was then given to improve staff skills. If staff were not providing the expected level of care, there were clear processes in place to monitor and improve staff performance. The service employed some nurses. These nurses were registered with the regulatory body (The Nursing and Midwifery Council). The management team completed regular checks to ensure their nursing registration was maintained. We observed during our visit that people were supported by staff in a timely manner when they requested assistance from staff in communal spaces, or by requesting assistance using their call bells.

People told us that the home was kept clean and well maintained. We observed people were being supported with access to bathing and showering when we visited the service. We saw staff respecting people’s choices and preferences regarding personal care. People told us, and we observed, that staff wore personal protective equipment as needed.

Staff knew what personal protective equipment they should wear and when. Staff knew how to put on and remove this equipment, in a safe way. This protected people from the spread of infection. Staff had received food hygiene training; they were able to explain what actions they took to reduce the risk of food borne infections. The kitchen was kept clean and hygienic by an experienced team who understood people’s specific dietary requirements.

The home was being kept clean and hygienic by the domestic staff team. Where there were areas which were more challenging to deep clean due to the ongoing refurbishment works; for example, the communal bathrooms; the provider had plans in place to ensure people were being protected from the impact of any risk of harm. We found an unlocked cupboard in a communal bathroom, containing sanitary items which may cause harm to mobile people. We raised this with the provider, and this was immediately rectified during our visit, with a message added to the staff handover regarding securing these cupboards during personal care provision. We saw that staff had access to personal protective equipment (like gloves) throughout the home. This allowed them to support people in a hygienic way. We saw any dirt or spillages in the home were quickly resolved. The home was safe in the event of a fire. Corridors were clear of any blockages, allowing people to follow easily to read escape routes. Staff had access to firefighting equipment throughout the home and fire alarms were in place throughout the building. We saw the kitchen was managed in a hygienic way to ensure people did not get food borne infections. The most recent check from the food standards agency, had rated the service 5 stars on the 12 January 2023.

There were clear processes and policies in place, to ensure the environment was kept clean and hygienic. This protected people from the spread of infection. If an infection outbreak occurred (for example diarrhoea and vomiting), there were clear processes in place to reduce the risk of this spreading to other people at the service. Staff had received training in infection control, how to put on protective equipment and how to keep people safe in the event of an infection outbreak.

We saw that staff gave people their medicine at regular times, and as their prescriptions required. We saw that people received their ‘as needed’ medicines like paracetamol for occasional pain relief in line with their changing symptoms. We saw staff explain to people during the medicines round what the medicines were for and asking people if they were experiencing any pain.

Staff were able to explain how they supported people to take their medicines safely. One staff member explained how they had requested a GP review of a person’s medicines to assist with their sleeping pattern and to reduce their physical distress. Staff ensured medicines were stored in a locked area, to prevent people accessing them unsafely. We found that prescribed thickeners used for people to reduce the risk of choking were now being stored correctly. Staff knew who to report medicine concerns too. For example, if they felt a person’s medicine was no longer effective, they understood where to document this, and which health professionals to contact. Where medicines needed to be stored at a certain temperature, this had been done. For example, some people required their medicines to be stored in a fridge. Staff had checked the fridge temperature on a daily basis to ensure it was working as expected. Some people at the service were prescribed controlled drugs. These are subject to enhanced restrictions due to the addictive nature of these medicines. We saw staff had followed national legal requirements by storing these medicines in an extra secure place. Where medicines needed to be stored at a certain temperature, this had been done. For example, one person required their medicine in a fridge. Staff had checked the fridge temperature daily to ensure it was working as expected.

Staff kept clear records of when they had given prescribed medicines. We saw medicines were given as prescribed. Staff did regular checks of the amount of medicine in stock. This ensured that suitable stock levels were always in place, and more medicine could be ordered from the pharmacist as needed. Some people required ‘as needed’ medicine and staff had clear written guidance on how these should be administered. For example, one person required a specific medicine when they experienced periods of agitation. Staff had clear guidance on what symptoms the person would show, how much dosage should be offered and when, what steps to take prior to administering the medicine and how the person preferred to receive the medicine. People in receipt of ‘as needed’ medicine for pain relief had pain scale documents in their medication care plans, which were individual to each person. This meant staff could effectively assess those people who may be unable to verbally express their pain levels before administering medicines. Where people were receiving prescribed creams for healthy skin management, there were body maps in place, with clear instructions in place for staff regarding the application sites and frequency. Staff had received training on how to administer medicines safely. The management team had regularly assessed the staff’s competency, to ensure they were following best practice.