Archived: Beech Lodge Nursing Home

We found the following examples of good practice.

¿ There was clear information In the entrance of the service for visitors regarding following safe infection control practices. There was a body temperature scanning device in place, personal protective equipment (PPE) and hand sanitiser available for all visitors.

¿ People were supported to keep in touch with their relatives via telephone calls, video links and posting of messages and activities on the closed social media page for the service. When lockdown restrictions had been eased socially distanced garden visits were successfully introduced so relatives could visit people without walking through the home. These visits were planned and risk assessed to ensure the safety of both people at the service, staff and relatives.

¿ When people were at end of life special visits were facilitated to allow family members to be with their loved one at this sensitive time.

¿ People admitted to the service were supported following government guidance on managing new admissions during the Covid 19 pandemic. The provider had specific Covid 19 care plans in place for people to provide guidance for staff caring for them.

¿ When people were admitted to the service, if they had a positive Covid 19 test or if they displayed Covid 19 symptoms, they were isolated for a period of fourteen days. The provider had successfully divided the service into zones. People who were being isolated were supported in a separate zone to the rest of the service. Staff supporting them had their own changing room and staff room, and did not work in any other areas of the home to ensure the risk of further spread of Covid 19 was minimised.

¿ Staff were clear about how to manage the risks of the spread of infection. They were able to demonstrate they wore personal protective equipment in line with Public Health England (PHE) guidance. There were PPE stations throughout the service with hand washing and hand sanitizer facilities available. Staff had received extra training in donning and doffing PPE and key members of staff had undergone extra training via a webinar on managing ICP practices during Covid 19. These staff then shared this knowledge with the rest of the staff.

¿ Staff members who were a higher risk if they contracted the virus either through their ethnicity and/or underlying health conditions were supported by the provider to work safely. One member of staff told us they had been shielding for a period of time. They were supported by the registered manager with regular telephone calls. When they felt ready to return to the service they had a detailed risk assessment and plan completed to ensure they could return to work safely.

¿ The recent outbreak of Covid 19 at the service had been managed well and the plans in place to support people had been utilised safely. There was evidence to show how staff who tested positive, or had displayed symptoms of Covid 19 had shielded in line with the government guidance and were symptom free before returning to work.

¿There was an enhanced cleaning programme in place at the service and the service was visibly clean. The housekeeping team wiped high use touch points hourly throughout the day to reduce the spread of infection.

¿ The registered manager had a clear communication programme in place to keep people and their relatives up to date with events at the service. They wrote to relatives regularly to inform them of changes and spoke with them on the telephone.

Beech Lodge Nursing Home provides residential and nursing care for up to 37 people, including older people and people living with dementia. There were 35 people living at the home on the day we inspected.

At the last inspection the service was rated as requires improvement.

At this inspection the service has improved and is rated good.

Our last inspection took place on 19 April 2016. We found that the provider was in breach of the regulations as they had failed to notify us of significant incidents relating to the service relating to safe care and treatment. At this inspection we found the provider had made the improvements needed to comply with this regulation. The registered manager had reviewed the legal requirements and had submitted appropriate notifications about all relevant events.

There was a registered manager for the home. 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.

People’s rights under the Mental Capacity Act 2005 were respected and where people had capacity they were supported to make decisions. Where people were unable to consent to living at the home and were under constant supervision appropriate referrals had been made to the Deprivation of Liberty Safeguards supervisory authority. People were able to make choices about their everyday lives and these were supported by staff.

There were enough staff to ensure that people’s needs were met in a timely manner. In addition staff received training and support from managers which meant that the care provided was safe and effective. Recruitment processes ensured that staff were safe to work with people living at the home. Staff had received training in keeping people safe from abuse and knew how to raise concerns.

Staff were kind, caring and compassionate and supported people’s dignity and independence.

There was a weekly programme of activities and people were able to choose what activities they wanted to undertake. The activities supported people’s health and well-being and people were also supported to access the community.

People’s ability to maintain a healthy weight was monitored along with their ability to eat safely. Where any concerns were identified action was taken to keep people safe. Where need advice was sought form other health care professionals to ensure that the care provided met people’s needs. Medicines were safely managed and systems ensured that they were always available to people when needed,

The provider took account of the views of people living at the home and their family members to monitor the quality of care provided and to identify areas for improvement. The provider and registered manager also had a set of audits in place which monitored the quality of care and identified risks to people. When any areas of concern were identified the provider took action to rectify the issue.

We inspected the home on 19 April 2016. The inspection was unannounced. There were 35 people living in the home at the time of our inspection.

The home had a registered manager (the ‘manager’) in post. A manager is a person who has registered with CQC to manage the service. Like registered providers (the ‘provider’) 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.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection the provider had submitted DoLS applications for 22 people living in the home and was waiting for these to be assessed by the local authority.

During our inspection we found a breach of the Care Quality Commission (Registration) Regulations 2009. This was because the provider had failed to notify us of significant incidents relating to the service. You can see what action we told the provider to take on this issue at the back of the full version of this report.

We also found other areas in which where improvement was needed to ensure people were provided with safe, effective care that met their needs.

The provider’s audit and quality monitoring systems were not consistently effective and some people were not protected properly from the risk of falling.

In other areas the provider was meeting people’s needs effectively.

Staff had a good understanding of how to support people living with dementia and had time to meet people’s care and support needs without rushing.

There was a calm, relaxed atmosphere in the home and care and support were provided in a warm and patient way that took account of each person’s personal needs and preferences. People and their relatives were involved in the preparation and review of their personal care plan.

A specialist activities coordinator organised a varied programme of activities and events and staff supported people to maintain personal interests and remain active.

Medicines were well-managed and people had prompt access to any specialist healthcare support they needed. Food and drink were provided to a good standard.

The provider had sound recruitment procedures in place and formal complaints were well-managed. The manager met regularly with people and their relatives to discuss any concerns and suggestions.