Beacher Hall Care Home

We found the following examples of good practice

¿ The home was observed to be clean and free of malodour. The home had designated cleaning staff who were observed cleaning the home throughout the inspection. There was a cleaning schedule in place to ensure that all areas of the home were adequately cleaned.

¿ The service had implemented personal protective equipment (PPE) stations which were situated in the reception area of the home near the main entrance and near the garden entrance. When visitors came to the home, a designated member of staff supported the visitors to ensure they followed safe infection control, PPE guidance and to check whether they had any symptoms of coronavirus before entering the home. This included taking the visitor's temperature.

¿ The service had set up covered seating areas in the gardens of the home that were used for relatives to visit their loved ones. In the covered area there was a table with a clear screen placed between the relative and the person living in the home. This was to reduce the potential risk of spread of infection.

¿ Visitors were required to book to see their loved one to ensure that visits were spread out to avoid the potential risk of transmission to other visitors and to allow the staff team to clean and sanitise the visiting area between visits.

¿ Where people were shielding or self-isolating, PPE stations were set up outside the individual bedrooms. Each station was equipped with all required PPE in line with government guidelines.

¿ All people being admitted to the home were tested for coronavirus by the care staff on admission. People were asked to self-isolate in their bedrooms for 14 days following their admission into the home, even if a negative test was received. If people went out into the community such as for day trips, they were also offered to undertake a test on their return. People living in the home were being tested for coronavirus on a monthly basis. Staff were also being tested monthly and we were informed the home were returning to weekly testing of their staff in line with the governments 'whole home' testing approach.

¿ Individual risk assessments had been conducted on staff which identified any vulnerabilities they may have in relation to coronavirus and any mitigating action that the provider needed to implement. This was being reviewed at the time of inspection to include black, Asian and minority ethnic (BAME) people.

¿ The service had appropriate infection control policies and procedures in place. These were developed in line with current government guidance. There was prominent signage around the home for staff and visitors on what measures were being taken to minimise the risk of spread of infection and keep themselves and those around them safe. These messages were also communicated through email and on the provider's website.

Beacher Hall Care Home provides residential nursing care for younger people with acquired brain injuries and some older people. The service can provide accommodation with personal care for up to 70 people. At the time of our inspection there were 67 people living in the home.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People's experience of using this service

We found that people were safe care because their risks were managed effectively. Risk assessments demonstrated that people’s identified risks had been assessed and were being managed safely and reviewed regularly. We found that medicines were administered safely, and records demonstrated that people has received their medicines as prescribed. Staff medication training competency were up to date. Required learning was identified from accidents and near misses.

People’s needs were assessed regularly, reviewed and updated. People, relatives and professionals consistently told us the staff delivered care in accordance with their assessed needs. People were supported by well trained staff.

People experienced positive relationships with staff who treated them with kindness in their day-to-day care. Staff consistently treated people with dignity and respect and maintained their privacy.

People experienced person-centred care. Care plans were personalised and contained lots of detail around people’s interests and preferences. People had access to activities and the necessary support to follow their interests

The registered manager, deputy manager and staff consistently placed people at the heart of the service and clearly demonstrated the caring values and ethos of the service. The quality of the service was monitored through robust clinical governance processes. The service had built up working relationships with community partners.

The home was undergoing a refurbishment programme at the time of our inspection. Further improvements were needed. Bathrooms were in the process of being updated at the time of inspection. There were some mixed views from staff about the approachability of the management team, but the management had put actions into place to improve this. They had introduced anonymous feedback forms for staff to complete.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Rating at the last inspection

At the last inspection the service was rated Good (published 2 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We did not identify any concerns at this inspection. We will therefore aim to re-inspect this service within the published time scale for services rated good. We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service had a registered manager as required. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. The registered manager and the deputy manager were present and assisted us during this inspection. They worked closely together to ensure people received appropriate care and the service was operating well.

People told us they felt safe living at the home. Staff understood well their responsibilities to raise concerns and report incidents or allegations of abuse. They felt confident any concerns would be addressed appropriately. Risk assessments were carried out to ensure people's safety. Staff recognised and responded to changes in risks to people who use the service. People received effective personal care and support from staff who knew them well and were trained and supervised. There were contingency plans in place to respond to emergencies.

People and relatives told us good things about the service they received. They also felt the staff would ensure people received appropriate care when supporting them. The registered manager and the staff team spoke with a great passion about the care and support they provided to the people and their families. Staff were motivated to provide care with much kindness and consideration. People and their families really felt they mattered to the staff team and the registered manager. They had opportunities to share and discuss their views which were taken into account and actioned. The registered manager and the staff team worked together managing people’s complex health and care needs and encouraging people, relatives and staff to report any issues to them so they could address concerns immediately.

People's rights to make their own decisions, where possible, were protected and staff were aware of their responsibilities to ensure those rights were promoted. The registered manager and the staff team were knowledgeable about the Mental Capacity Act 2005 (MCA). Staff were following the principles of the MCA when supporting people to make a decision. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The DoLS provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them safe from harm. The registered manager had taken appropriate action with the local authority to determine if anyone was being restricted of their rights and liberties.

The registered manager ensured there were enough qualified and knowledgeable staff to meet people's needs at all times. The service had employed skilled staff and took steps to ensure the care and support was person-centred to people at all times. Staff were knowledgeable and focused on following best practice at the service making sure people received high quality care and support.

There were robust recruitment processes in place. All necessary safety checks were completed to ensure prospective staff members were suitable before they were appointed to their posts. People told us staff were available when they needed them most of the time and staff knew how they liked things done.

People received their prescribed medicine on time. We noted a few issues with administering and checking the medicine. The management team took swift action to ensure the service followed safe procedures for storing, handling and keeping accurate records of medicines. People had a nutritious and balanced diet and hot and cold drinks and snacks were available between meals. People had their healthcare needs identified and were able to access healthcare professionals such as their GP. Staff knew how to access specialist professional help when needed. People who use the service benefitted greatly by using the in-house physiotherapy and occupational therapy support that helped them improve their health and wellbeing.

People were able to engage in a wide range of meaningful activities and maintain links with the community regularly. People really enjoyed keeping busy and it helped them avoid becoming isolated. People could also spend time with their visitors or by themselves if they wished so. Their choices were always respected by attentive and understanding staff. It was important to the management team to ensure people's wellbeing was respected and protected. Interactions observed during our inspection between staff and people living at the service were provided with respect and friendliness. People and relatives confirmed staff always respected their privacy and dignity. People benefitted greatly from living at a service that had an open and welcoming culture.

Staff understood the needs of the people and provided care with kindness and consideration. People were encouraged to do things for themselves and staff supported them to be independent when they could. People received support that was individualised to their personal preferences and needs. The staff monitored people’s needs and care plans were reviewed regularly or as changes occurred. People and their families were always involved in the planning of their care.

People felt staff were happy working at the service and had good relationships with the team and the management. Staff agreed the management was open with them and communicated well about what was happening at the service and also with the people living there. People and their relatives felt the service was managed well and that they could approach management and staff with concerns most of the time. The management team encouraged feedback from people, families, staff and other stakeholders, which they used to make improvements to the service where necessary. The registered manager had systems in place to assess and monitor the quality of care consistently with the help of all the staff team within the service. Throughout our inspection we saw examples of appropriate support that helped make the service a place where people felt included and enjoyed living there.

Below is a summary of what we found. The summary describes what people who used the service; their visitors, and staff told us. It also describes what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

We met with seven people who were using the service; two visitors and 13 staff. We looked at the records of nine people and reviewed the files of five staff.

Is the service safe?

People felt safe receiving support from the provider. We were told that staff were skilled and competent, and were able to carry out their responsibilities effectively. Staff demonstrated a good understanding of their responsibilities in relation to safeguarding and we saw information in relation to safeguarding was available for people. We found the service to be safe.

Is the service effective?

Staff were proud to talk about improvements in people's health since being at the home and visitors were complimentary about standards of care and the relationships between people and the staff caring for them.

We saw care plans were detailed and personalised and focused on the importance of maximising dignity and independence when delivering care and support. Staff told us they had time to read care plans and found them helpful. They also told us they had enough time to carry out their allocated duties. The atmosphere within the home was calm.

Is the service caring?

Some people felt that staff were under pressure and one person said staff were not caring enough. Most people, however, were complimentary about staff and described them as "brilliant", "patient" and "marvellous". Staff told us the needs of people were their "first priority". We were given examples of the caring attitude of staff, including a time when a member of staff came in specifically to support a person who found it difficult to trust people. We observed staff engage with people, and their visitors, in a courteous, relaxed and friendly way. Specialist equipment was available to ensure people could maintain as much independence as possible. We found the service to be caring

Is the service responsive?

We were told by people who used the service, their visitors and staff, they felt able to raise and concerns or ideas with managers. People told us they felt involved in their care and had a say in how care was planned and delivered. We found evidence that managers were visible within the home and known to people who used, and visited, the service. We found the service to be responsive.

Is the service well-led?

We saw managers were accessible to staff, and staff felt able to raise any issues with managers. There were quality assurance processes in place to monitor the environment and equipment used. We saw that people's views were sought and the outcomes were published for people to see. Supervision was carried out to monitor the performance of staff and objectives were set to manage any short-falls. We found the service to be well-led.

There were effective systems in place to reduce the risk and spread of infection. The home had appropriate infection prevention and control (IPC) policies and procedures in place. We observed the home to be clean and tidy. Staff we spoke with were knowledgeable about IPC.

People who use the service benefited from equipment that met their needs and was comfortable to use because equipment was available and suitable for it's purpose. People were protected from risk of harm because equipment was used correctly and safely, and was properly maintained.

We looked at the training records of four members of staff. They all showed evidence of training such as induction and moving and handling, as well as supervision and appraisal. When we spoke with staff they told us they felt well supported by managers and they had enough training to enable them to meet the needs of the people they support.

People told us they were happy at the home and were involved in making choices about the care they received. They told us they felt safe, cared for and listened to by staff.

Staff were familiar with people's specific health and personal care needs and how people wanted those needs to be met. We looked at people's care plans, supporting documents, and individual risk assessments. We found care plans clearly documented people's needs, and how those needs should be met.

People living in the home had access to a wide range of social and physical activities both in the home and in the community. People were able to decide whether to participate in activities. The local dial-a-ride was frequently used so people could access facilities in the local area.

The provider had effective recruitment and selection procedures in place and staff were suitably qualified and experienced to care for people living in the home.

People told us they knew how to raise concerns with the provider. One person told us that when they had done so, the provider listened to their concerns and dealt with them appropriately. The provider had effective processes in place for addressing complaints.