The Beeches

Updated 17 November 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

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 team consisted of 1 inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Beeches is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Beeches is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 23 October 2023 and ended on 02 November 2023. We visited the service on 23 October 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch England and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people and 10 of their relatives. We spoke with 6 staff members including the registered manager, senior care staff, care staff, catering staff and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 2 professionals who knew the service.

We reviewed 8 people’s care records and 5 people’s medicines records. We looked at recruitment records for 2 staff members. We reviewed policies and numerous audits and quality assurance records.

We are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked this was a suitable communication method, and people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff or relatives and the person themselves. In this report, we used this communication tool with 1 person to tell us their experience.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 17 November 2023

About the service

The Beeches is a residential care home providing accommodation and personal care to up to 22 people. The service provides support to older people including people living with dementia and people with physical disabilities. At the time of our inspection there were 21 people using the service.

The service is set across 3 floors and has a mix of both ensuite bedrooms and shared bathrooms. It has kitchen and laundry facilities, a shared lounge and dining room and conservatory space as well as a large garden. There is an office onsite.

The service is also registered to provide personal care to people in their own homes. At the time of the inspection, no people were receiving this service. The provider told us they intend to be resuming this service in the near future.

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

Since the last inspection a new registered manager had been appointed. Changes and improvements to systems, processes and the environment had been made. People told us improvements had been made and this had a positive impact on the quality of care and the environment. Some of the changes were yet to be fully implemented or embedded.

People told us they felt safe living at The Beeches because staff treated them well, were kind and regularly checked on them during the night. Staff knew how to keep people safe and what to do if they had any concerns. Some staff were not sure about what all types of abuse looked like or who they could report to externally such as CQC.

Risks to people’s health and welfare were assessed but accompanying guidance for staff about risks to people’s health or mobility needed to be clearer.

People were mostly supported to safely administer and manage their medicines. However, there were some discrepancies that had not been identified during audits. The registered manager was aware of these and had already put additional measures in place to address this with the staff team.

People were supported by staff who were trained in all aspects of their role. People and relatives felt staff were knowledgeable about how to support them in ways they preferred. People felt there were not always enough staff to spend time with them or to take them out. The provider was in the process of recruiting more staff.

People had access to health professionals who worked closely with the staff and management team to ensure all health concerns were investigated straight away. People with specific dietary requirements had clear guidance for this and all staff were aware of how to support them safely.

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.

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

Rating at last inspection and update: The last rating for this service was inadequate (published 19 May 2023) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 19 May 2023. During this inspection the provider demonstrated improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. When we last inspected The Beeches on 20 February 2023 breaches of legal requirements were found. This inspection was undertaken to check whether they were now meeting the legal requirements.

We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.