Beckfield House Residential Home

Beckfield House Residential Home is a care home in the village of Heighington. It is registered to provide accommodation and personal care to 27 older people, some of whom may be living with dementia. At the time of our inspection, 21 people lived at the service.

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

People’s medicines were administered as prescribed. However, the provider’s medication policies and procedures were not always followed. Care plans did not always guide staff how to manage risks associated with people’s healthcare needs. Though staff were knowledgeable about the risks and the support people needed. Some areas of the service and equipment could not be appropriately cleaned due to being worn. We have made a recommendation about monitoring equipment. Quality assurance systems had not identified or resolved shortfalls in a timely manner.

People were happy with the care provided as staff were caring and respectful. People said, “I like it. It's friendly, cosy, like a home from home really. [Staff] are all very pleasant.” Staff respected people as individuals and supported people to maintain their independence. People told us staff maintained their privacy and dignity.

There was enough staff to meet people’s needs. Recruitment, induction and ongoing training processes helped ensure only suitable staff were employed and that they had the required skills and knowledge. Staff were supported by the management team and received supervision, appraisals and attended team meetings.

People were offered a variety of meals and staff worked to ensure people had options they liked. People were supported to access healthcare services and staff followed professional advice. People’s rooms were personalised, and signs were used to help people find their way around. Activities were available for people and visitors were welcome at any time.

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.

Relatives and staff were happy with the management of the service; they could approach them at any time, felt supported and were confident any issues would be quickly addressed. People, their relatives and staff were involved in the development of the service.

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 this service was good (published 22 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the management of medicines and the monitoring and addressing quality shortfalls at this inspection. 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 for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The registered provider also operates a day care support service in the same building as the care home although this type of service is not regulated by the Care Quality Commission (CQC).

We inspected the home on 14 February 2017. The inspection was unannounced. There were 25 people living in the home on the day of our inspection.

The home had a registered manager in post. A registered 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 seven people living in the home and was waiting for these to be assessed by the local authority. Staff understood the principles of the MCA and demonstrated their awareness of the need to obtain consent before providing care or support to people. Any decisions that staff had made as being in people’s best interests were made in accordance with the provisions of the MCA.

On this inspection, we identified the need for further improvement in the provision of activities and other forms of stimulation available to people living in the home. We also asked the provider to ensure that people and their relatives had an opportunity to be involved in reviews of their individual care plan. In all other areas however, we found people were provided with safe, effective care that met their individual needs and preferences.

The registered manager and her team had worked hard to address the areas for improvement identified at our last inspection. The registered manager had a positive and forward-looking approach and was committed to the continuous improvement of the home in the future.

People’s medicines were managed safely and staff worked closely with local healthcare services to ensure people had access to any specialist support they required. People’s individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm. A range of auditing and monitoring systems was in place to monitor the quality and safety of service provision.

There were sufficient staff to meet people’s care needs and staff worked together in a well-coordinated and mutually supportive way. The provider supported staff to undertake their core training requirements and encouraged them to study for advanced qualifications. Staff were provided with close supervision and regular team meetings were used effectively to facilitate good communication. The registered manager maintained a high profile within the home and provided strong, supportive leadership to her team.

There was a warm, relaxed atmosphere in the home and staff supported people in a kind and caring way. Staff knew and respected people as individuals and provided responsive, person-centred care. People were provided with food and drink that met their individual needs and preferences.

At this visit we found the stairs and landing carpets had been completely replaced with a new carpet which had been fitted professionally. The flooring outside the kitchen and in the hall area had been replaced with a non-slip floor covering.

We looked at the medication records for nine of the 24 people living at Beckfield House. These records were in good order and demonstrated people were given their medicines as prescribed.

We spoke with a District Nurse who visited the home during our inspection. They told us, 'We get good co-operation from the care staff here. Tissue viability is well managed and we receive prompts from the care staff if necessary.'

On the day we visited we saw some floor coverings in a poor state of repair which increased people's risk of trips and falls.

We found there were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

We found records relevant to the management of the service were accurate and fit for purpose.

We saw staff had time to interact with people and were attentive to people's needs. Their interaction with people was friendly, respectful and professional.

We saw the cook provided a choice of hot and cold foods at each mealtime.

We looked at how the premises had been maintained. One person told us, 'Overall the building is well maintained and decorated well.'

We reviewed the level of support given to staff. We found the home had a training plan in place and all mandatory training had been provided regularly.