Archived: Beech Close

Updated 19 July 2022

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 was carried out by two inspectors and an 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

Beech Close 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. Beech Close 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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

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 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 a person using the service, two relatives in person and four relatives by telephone, we sought their views about their experience of the care provided. We spoke with the registered manager, the service manager and briefly with agency staff. We sought staff views via e-mail and received feedback from staff.

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.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service were examined.

Updated 19 July 2022

Beech Close is a residential care home providing personal care to up to 42 people. The service provides support to older people and older people living with dementia. At the time of our inspection there were 20 people using the service. Beech Close comprises of six units, of which four are in use. Each unit provides bedrooms, bathing facilities and an open plan kitchenette, lounge and dining area.

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

People’s quality of life, quality outcomes and their preferences were affected by the environment in which they lived. People struggled to have baths or showers as bathing facilities did not meet people’s mobility needs, and there were issues with the reliability of water temperatures for the accessible shower facility. Areas of the home were not in use due to repairs being needed.

Central heating and hot water systems were not fit for purpose. The central heating had to be on at all times, irrespective of the weather and the external temperature. This was to ensure there was hot water at the home. The hot water heating system did not operate independently of the heating system. The provider informed us following our site visit that remedial work had been undertaken to address this.

The provider was aware of the environmental challenges and the actions required. A report commissioned by the provider for potential development plans for the service was in place. However, no decisions had been made based on the report findings.

Opportunities were available for people and family members to share their views. However, feedback had not brought about changes to concerns expressed by people with regards to the environment and the premises, and its impact on their quality of life.

People's privacy and dignity was not always maintained and not all staff demonstrated kindness or compassion. A contributory factor was a majority of staff were agency staff, who were unfamiliar with people's needs. Staff supporting people did not always recognise or understand people's needs and the support they required, or respond to people when they became distressed or anxious.

Opportunities for staff to access training to enable them to promote people’s safety and quality care was limited. Reasons for this included; staff shortages, the Covid-19 pandemic, and poor internet connections to access online e-learning.

People’s assessed needs required improved support from staff for the management of oral health, as people were not being routinely supported. People’s care records could be used to better reflect person centred care by including greater detail as to people’s individual needs and preferences, and the role of staff in supporting them.

Systems and processes were in place to promote people’s safety through ongoing assessment and monitoring. Staff followed good practice guidance for infection prevention and control. Systems and processes for the recruitment of staff were in place and followed.

People’s needs were assessed and kept under review. People had access to support from a range of health care professionals, which included regular reviews of their prescribed medicines. People’s dietary needs were met.

People were supported to have maximum choice and control of their lives, within the limits created by the improvements required to improve the equipment and premises. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and family members spoke positively of the kindness and care demonstrated by staff.

People and family members were involved in decisions about their care, which included the reviewing of care plans and decision related to the going monitoring and treatment of their health, and decisions related to end of life care.

Opportunities were available for people to take part in activities within the home.

Quality monitoring systems and processes were in place, which included a range of audits to identify where improvements were needed. People’s views were sought, and we found examples where people’s comments had been acted upon and listened to. Family members spoke positively of effective communication between the registered manager and staff in relation to general issues and specific issues related to their relative’s care.

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

Rating at last inspection

The last rating for the service under the previous provider, Shaw Healthcare (de Montford) Limited was Requires Improvement, published on 1 February 2019. Beech Close was registered with us under the new provider, North Northamptonshire Council on 1 April 2021 and this is the first inspection.

Why we inspected

This was a planned inspection based on the provider's registration date.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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 monitor the service and will take further action if needed.

We have identified breaches in relation to staff training, unsuitability and maintenance of the premises to meet people’s needs, and the treating of people with dignity and respect.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.