Beech House

Beech House is a residential care home providing accommodation and personal care for up to six people. The home supports people who live with a visual impairment and other complex support needs. At the time of inspection six people were living at Beech House

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the management team at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

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

Improvements had been made since the last inspection in February 2019 where Beech House was rated as inadequate. Systems had been put in place to keep people safe. However, we need assurances the improvements made so far, will be sustained and will remain embedded.

Fire safety arrangements were in place and staff knew how to keep people safe in the event of an emergency. There were enough staff to support people safely. Care plans and risk assessments had been reviewed and updated. People received their medicines as expected. Staff had a good knowledge of safeguarding processes.

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.

People were treated with kindness and compassion. People’s privacy and dignity was maintained. People were involved in their care planning.

Information was available to people in audio formats. Peoples care plans contained information about how they liked to be supported. People were supported to maintain relationships and be involved in the community.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

The service applied the principles and values of Registering the Right Support and other best practice guidance. The outcomes for people using the service reflected the principles and values of Registering the Right Support and focused on them having as many opportunities as possible. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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 11 July 2019) and there were multiple 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 8 May 2019. During this inspection the provider demonstrated that improvements have 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 was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Beech House is a care home that provides accommodation for up to six people who need help with their personal care. The home supports people who live with a visual impairment and other complex support needs. At the time of the inspection 6 people lived in the home. The home is a two storey building. There are two bedrooms on the ground floor and four bedrooms on the first floor. Each bedroom has its own en-suite facilities. There is a communal lounge and dining room for people to share.

People’s experience of using this service:

The overall rating for this service is ‘inadequate’ so therefore the service is in special measures.

The systems and processes in place to monitor the quality and safety of the service failed to identify and drive up improvements in the service. This has resulted in people being exposed to ongoing risks.

The provider’s fire safety arrangements were unsafe as they did not ensure people were evacuated in the event of a fire. There was also a lack of emergency evacuation equipment to help people with mobility difficulties evacuate the building.

Where people’s capacity to consent to decisions about their care was in question, the provider had not always followed the Mental Capacity Act 2005 to ensure that any decisions made on people’s behalf were legally consented to and in the people’s best interests.

Where people had health conditions, their care plans did not always contain sufficient information about these conditions and the support they required. Care plans were not always consistently updated when people’s needs changed and some of the language used to describe people’s needs was at times inappropriate.

Regular meetings took place with people’s relatives to involve them in the running of the service and seek their feedback. The opinions and views of the people who lived at the home were however not sought in any meaningful way.

We saw that staff members treated people kindly and with respect. They were aware of people’s needs and preferences and the things that were important to them.

People received the medicines they needed to keep them safe and well. Staff had received training on how to administer medication safely and their competency to do so was checked.

People had enough to eat and drink and the relatives we spoke with told us that their loved ones were happy with life at the home.

People’s needs were met by a range of health and social care professionals.

The premises were clean and well maintained. There were regular health and safety checks to ensure that the premises and the moving and handling equipment in place was safe to use.

Staff told us they felt supported by the manager and records showed staff received supervision in their job role. Staff received training and the most of the training was up to date.

The atmosphere at the home was warm and inclusive. The culture of the staff team was open and transparent.

You can see what action we told the provider to take at the back of the full version of the report.

Rating at last inspection and why we inspected: This was the first inspection of the service since it registered as a regulated provider with CQC.

Follow up: Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.