Beechwood Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The premises were not well maintained and potentially put people at risk. This was in breach of Regulation 12 of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014. Risk assessments were in place which set out the risks people faced and included information about how to mitigate those risks, although there was no set frequency for the review of risk assessments. Systems were in place to protect people from the risk of abuse and staff had been trained about this. There were enough staff working at the service to support people in a safe way and robust staff recruitment practices were in place.

This service scored 31 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We spoke to people living in the home, they told us they felt happy living there. One person we spoke to said, “I like living here, it is a nice place and I feel safe .” They also said they knew who to approach if they felt worried. People’s voices were heard in different ways. One person’s relative had an established relationship with the Registered Manager. Two other residents had advocates. They told us they felt people were safe in the service and had no concerns.

Staff were able to tell us the different types of abuse and what signs people may exhibit if they were victims of abuse. They told us about the training that was provided to them by the home which they received regularly. All the staff we spoke to told us about the importance of protecting vulnerable people and were able to tell us about the people they would talk to, both inside and outside of the organisation if they were concerned.

During our assessment we saw people were supported safely. We observed people supported by staff to do the things they needed to do. We saw people being supported to prepare food in the kitchen with staff ensuring risks were managed safely. We saw people being supported to go out into the local community with sufficient staff number to be able to keep people safe.

The provider had processes in place for safeguarding people from the risk of abuse. They had a Safeguarding Adults policy which made clear their responsibility to report any allegations of abuse to the local authority, the Care Quality Commission, and where appropriate, the police. The provider also had a Whistleblowing policy. Although this included contact details of the Care Quality Commission, it also stated, “Employees should not breach the confidentiality policy and discuss their concerns outside of the project without first raising them internally.” Although this should be the usual practice, there may be occasions where it would not be appropriate to raise concerns internally in the first instance, and the policy should make this clear. Where people lacked the capacity to go outside their home on their own in a way that was safe, the provider had applied to the local authority for Deprivation of Liberty Authorisations. We saw that where the local authority had put conditions on these Authorisations the provider had taken steps to meet them.

People and relatives told us that people were supported in a safe way. A relative said, “Yes, [person] is safe.” Residents had risk assessments in place which described the support needed in order to manage risks safely. However, these were not always reviewed regularly. We spoke to the Registered Manager who told us about changes being made to ensure they were reviewed more often.

Staff were able to tell us about the types of risks within the home, many risks they told us about were using kitchen equipment and the possibilities of injury such as when people used knives and hot water. Other staff told us about risks associated with the medication people took and the side effects this might cause.

We saw staff supporting people around the home who required close monitoring. During our assessment we observed staff supporting a person on close supervision in a safe and respectful way that followed guidance from risk assessments.

Risk assessments were part of the people’s care plans. There were risk assessments written about such things as, being in the community, a variety of physical injuries and eating. However, whist these detailed the risk and actions to mitigate the risk, it was not clear how people were involved in the process of agreeing the risk.

People and relatives expressed some concerns with the physical environment. A relative told us, “I’ve been complaining about the condition of the place. Everything is perfect except for that. I brought it up with the manager and [the owner]. They have taken responsibility and said they will do it [improve the physical environment], but it’s been a while. The walls could do with painting, the communal areas need doing.” However, the same relative also told us, “[Person’s] room was done up and looks great.”

The Manager told us about systems the home had in place to check the safety of the home. They told us the checks were done on a daily, weekly and monthly basis. A staff member told us how they were nominated to carry out a number of health and safety checks, this included liaising with the fire services as well as making sure daily and weekly checks were carried out.

Prior to our assessment of the home, we were alerted to a warning notice issued to the home by the fire services. The warning notice related to the fire system and fire doors within the home. We noted the provider had addressed all areas and were awaiting a re-inspection of the property. As part of our assessment, we checked inside and outside the property. We noticed a ladder in the alley leading to the fire escape that was hanging vertically from hooks to the side of the building. This was a risk to people’s safety and impeded people using the alley in the event of a fire as it potentially blocked their escape route. The manager told us that a plan existed to move the ladder imminently to a safer location. We saw garden tools at the back of the property that were not safely stored. These included a number of sharp items such as a spade and hedge shears. We noted one person was using an emollient cream for a skin condition. This cream stated on the label that it was flammable but there was no risk assessment for this, and it was not recorded in the person’s personal emergency evacuation plan. On the first day of our visit, we saw an extractor fan within easy reach in a person’s en-suite bathroom which had a missing cover exposing wires. We pointed this out to the provider who was unaware of this. They addressed this and had a replacement cover fitted. We noted a metal carpet grip outside a person’s en-suite bathroom was not fixed down. This created a risk of injury from both the metal carpet grip and the edge of the bathroom floor tiles. We noted broken furniture in a person’s room. The provider told us about the discussions with the person’s family to replace it which was happening imminently.

We saw governance systems for the home which required staff to carry out thorough checks to make sure the environment was safe. As part of the home’s governance systems, we saw that the Manager highlighted anything that required fixing was flagged to the attention of the Director of the home. However, the home’s processes did not pick up a missing air vent cover that had exposed live wires. A staff member told us he was delegated aspects of health and safety, checking to make sure the environment was safe. When we pointed out to him that there was an exposed wire in the bathroom vent of a person’s bedroom, he told us as it was a female’s bedroom he did not carry out the checks.

People and relatives told us there were enough staff working at the service. A relative told us, “absolutely there are enough staff.”

We heard that there was a stable staff team working in the home which provided consistency. The staff told us about the training they undertook to ensure they had the skills to be able to support the people living in the home. The Manager told us if there were absences through sickness, staff would call them to arrange cover. Staff told us about their induction when commencing employment which combined reading all information about people as well as working alongside experienced staff members to get to know people in the home.

We observed during our assessment that staff knew people’s needs and how to respond to them. People using the service and an advocate were complimentary about staff. There were 2 staff on duty and we observed them to be caring for people in a timely way. We reviewed 3 staff files and found that the appropriate checks had been completed.

The provider had systems in place to ensure safe and effective staffing. Various checks were carried out on staff, including criminal record checks, employment references and proof of identification. There was a staff recruitment policy to guide practice in this area. The provider also had a staffing level policy to determine how many staff were needed. We were satisfied that there were sufficient staff working at the service to meet people’s needs.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.