Beechmount is a ‘care home’, operated by South West Care Homes Ltd. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. People living at Beechmount were older people, most living with physical health conditions associated with older age and dementia. The service accommodates up to 25 people in one adapted building, with a lift to access most of the rooms on the first floor. 19 people were living at the service at the time of the inspection.
At the last inspection on 6 November 2017, Beechmount was rated good in all areas. On this inspection we found this had been sustained.
Why the service was rated good:
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.
Systems were being operated effectively to assess, monitor and improve the quality and safety of the services provided, and mitigate the risks to people from their care or the environment. Assessments identified risks to people and how they could be reduced, for example from skin damage, falls or choking. Staff were aware of the principles of safeguarding people from abuse and how to report concerns about people’s well-being.
People in the management structure, such as the registered manager and care manager had a ‘visible presence’ in the service daily. Lines of accountability and responsibility were understood and there was a clear organisational structure. The management of the service had recently been strengthened by the appointment of area and deputy area managers to the provider’s senior management team, and a new care manager based in the service. People and relatives told us the management team was responsive, kind and listened to them.
The service was continuing to develop the services and care provided. Advice on good practice was sought and visiting professionals told us the service contacted them appropriately and followed their advice to support people’s needs. People’s healthcare was supported, and staff had clear guidance in the service’s care plans on how to support each person with a range of needs, including distress or anxiety associated with living with dementia. The service made arrangements to support people at the end of their life in accordance with their wishes. Care plans included information about people’s wishes regarding their care and support and we saw these were followed.
People received their medicines as prescribed. Safe storage was provided, and staff had regular competency assessments to ensure their administration practice was safe. Where people wanted to manage their own medicines, assessments of risk were undertaken.
People were supported by sufficient numbers of staff on duty to meet their needs. A full recruitment process was in place which ensured staff were recruited safely. This included the taking up of disclosure and barring service (police) checks and previous employment references, and assessments of risk where some information was not available. Staff received appropriate training to help them understand and support people’s needs.
People’s rights with regard to the Mental Capacity Act 2005 and under equality legislation were respected. Staff had received training in the Mental Capacity Act 2005 and applications had been made under the Deprivation of Liberty Safeguards (DoLS) where appropriate to deprive people of their liberty. Conditions associated with the authorisations were being followed.
Systems were in place for the proper management of complaints. The service learned from incidents and accidents, which were analysed to see if a repetition could be avoided; actions were taken where identified. People and staff were supported to share their views of the service at meetings, and through a series of questionnaires. These were then analysed and action plans drawn up to address any issues raised.
Some areas of the building were looking tired, but action was under way to redecorate the hallways and landings and re-carpet the lounge. Work had already started in these areas. The registered manager told us they had some ideas for extending environmental adaptation for people living with dementia when these areas were finished.
Activities were provided that met people’s interests and wishes. Visitors were welcome to visit at any time and have a continuing involvement in their relations care if they wished. Feedback from people living at the service and visitors was positive, and told us the service was kind and caring towards people. Some relatives told us their relation had received poor care in previous services and they had been very pleased with the support they had received at Beechmount.