Beechwood Specialist Services

Updated 11 September 2021

The inspection

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Beechwood Specialist Services is a ‘care home’. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided. We spoke with three members of staff including the registered manager and the operations manager.

We checked the safety of the environment. We reviewed a range of records. This included three people’s care records and a variety of records relating to the management of the service, including quality and safety audits.

After the inspection

We spoke with two relatives about their experience of the care provided. We spoke with three staff members. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 11 September 2021

About the service:

Beechwood Specialist Services is registered to provide nursing and residential care to up to 60 people with a variety of mental and physical health needs. At the time of our inspection 33 people were living at the service.

People’s experience of using this service and what we found:

At our last inspection the provider had failed to robustly assess the risks relating to the health safety and welfare of people. We also found governance systems were not effective at ensuring regulations were met. Not enough improvement had been made at this inspection and the provider was still in breach of Regulations 12 and 17. An additional breach of regulation relating to consent was identified at the last inspection but not considered as part of this process.

The environment and systems in relation to fire had not been safely managed. Staff did not consistently adhere to the relevant guidance for the use of personal protective equipment (PPE). Some staff failed to wear face masks correctly and maintain social distancing as required. Evidence of appropriate review of risk following incidents was missing from care records. Staff had not received recent training to ensure they could safely intervene when people were at risk of harm. Action was taken by the provider when these concerns were shared.

The service did not have robust and effective systems in place to monitor, assess and improve the safety and quality of service being provided. This placed people at unnecessary and avoidable risk of harm. Because some records were not sufficiently completed, it was unclear if the manager and provider had notified The Care Quality Commission (CQC) of all significant events which had recently occurred. Some aspects of the service had improved since our last inspection but, further improvement is still required to meet regulations.

Staff demonstrated kindness and respect in their interactions with people. It was clear they provided care in an individualised manner. Staff and relatives spoke positively about the level of communication from managers at the service.

Some aspects of environmental safety had improved following the last inspection. For example, the building was noticeably clean. Cleaning schedules had been increased to address the additional risk posed by COVID-19. Medicines were managed safely at the service and people received their medicines as prescribed by competent staff.

The people we spoke with and their relatives told us they felt the service was safe. Staff were safely recruited subject to the relevant checks.

Rating at last inspection and update:

At the last inspection the service was rated requires improvement (report published 28 June 2019).

During the last inspection we found breaches of Regulations 11, 12, and 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had not been made and the provider was still in breach of regulations.

The last rating for this service was requires improvement (published 28 June 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected:

We carried out an unannounced comprehensive inspection of this service on 29 and 30 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve consent, safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. The Key Question Effective which contains the breach of regulation 11 was not inspected at this time.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beechwood Specialist Services on our website at www.cqc.org.uk.

Enforcement:

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the safety and management of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up:

We will meet with the provider to discuss our findings and how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.