Beacon House provides accommodation and personal care for up to 34 older people who may be living with a dementia. At the time of our inspection there were 24 people living at the home. The home offers both long stay and short stay respite care. Beacon House does not provide nursing care. Where needed this is provided by the community nursing team.This inspection took place on the 29 September and 3 October 2016, the first day of our inspection was unannounced. One adult social care inspector carried out this inspection. Beacon House was previously inspected in December 2013, when it was found to be compliant with the regulations relevant at that time.
Beacon House did not have a registered manager at time of our inspection. There had not been a registered manager in post since March 2016. Following the inspection the registered provider confirmed a new manager had been appointed and they had started the process to be registered with the Care Quality Commission. 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. The deputy manager, who had worked at the home for a number of years, managed the home on a day-to-day basis. A senior manager who was overall responsible for the management of the home supported the deputy manager.
People said they felt safe and well cared for at Beacon House, their comments included “I do feel safe” and I’m very happy”. Another said the staff were “very kind and looked after me very well”. Relatives said they did not have any concerns about people’s safety. One relative said “I have no concerns about the care [person’s name] receives, they really care about people and it shows”. Another said, “you couldn’t wish for better care”.
People were protected from abuse and harm. Staff had received training in safeguarding vulnerable adults and demonstrated a good understanding of how to keep people safe. The policy and procedures to follow if staff suspected someone was at risk of abuse or harm were displayed. This contained telephone numbers for the local authority and the Care Quality Commission. Staff told us they felt comfortable raising concerns and were confident these would be dealt with. Recruitment procedures were robust and records demonstrated the home had carried out checks to help ensure staff employed were suitable to work with vulnerable people. Everyone we spoke with felt the staff were well trained and able to meet their needs.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Some of the people who lived at Beacon House were living with a dementia, which affected their ability to make some decisions. Staff had received training and demonstrated a clear understanding of the principles of the MCA in their practice. Staff sought people's consent and made every effort to help people make choices and decisions. However, not all the records we saw demonstrated that best interest decisions were specific, made in consultation with appropriate people, such as relatives or were being reviewed. We raised this with a senior manager who agreed the way the home was currently recording best interest decisions was not as clear as it could be and told us they would change the way best interests decisions are recorded in future.
People told us they were happy living at Beacon House, staff treated them with respect and maintained their dignity. Throughout our inspection, there was a relaxed and friendly atmosphere within the home. Staff spoke affectionately about people with kindness and compassion. People and relatives told us they were involved in identifying their needs and developing the care provided. People's care plans were informative, detailed and designed to help ensure people received personalised care. Care plans were reviewed regularly and updated as people's needs and wishes changed. Staff consistently used people's preferred names when speaking with them and knew how each person liked to be addressed. When staff needed to speak with people about sensitive issues this was done in a way that protected their privacy and confidentiality.
People received their prescribed medicines on time, in a safe way. There was a safe system in place to monitor the receipt and stock of medicines held by the home. Medicines were disposed of safely when they were no longer required. Staff had received training in the safe administration of medicines.
Risks to people's health and safety had been assessed and regularly reviewed. Each person had detailed risk assessments, which covered a range of issues in relation to their needs. Each person had a personal emergency evacuation plan (PEEP) and the provider had contingency plans to ensure people were kept safe in the event of a fire or other emergency. The deputy and senior manager carried out a range of health and safety checks on a weekly, monthly, and quarterly basis to ensure that any risks were minimised.
People told us they enjoyed the meals provided by the home. Comments included, “the food is marvellous”, “It’s great” and “very nice”. One person said, “we even have old fashion egg custard; all you have to do is ask”. People were freely able to help themselves to snacks and drinks when they wanted, and we saw people who were not able, being offered snacks and drinks throughout the day.
People spoke positively about activities at the home and told us they had the opportunity to join in if they wanted. The home had a programme of organised activities that included arts and crafts, music sessions, exercise classes, quizzes, singing, reminiscence and trips out to places of interest in the home’s minibus.
People, relatives, and staff spoke highly of the management team and told us the home was well managed. Staff described a culture of openness and transparency where people, relatives and staff, were able to provide feedback, raise concerns, and were confident they would be taken seriously.
The home had notified the Care Quality Commission of all significant events that had occurred in line with their legal responsibilities. Records were stored securely, well organised, clear, and up to date.
We have made a recommendation that the provider seek guidance to refresh their understanding of the Mental Capacity Act.