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Care Services

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Beechcroft, Prenton.

Beechcroft in Prenton is a Nursing home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs and treatment of disease, disorder or injury. The last inspection date here was 23rd November 2019

Beechcroft is managed by Flightcare Limited who are also responsible for 6 other locations

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Inadequate
Effective: Inadequate
Caring: Requires Improvement
Responsive: Inadequate
Well-Led: Inadequate
Overall: Inadequate

Further Details:

Important Dates:

    Last Inspection 2019-11-23
    Last Published 2019-05-03

Local Authority:

    Wirral

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

19th March 2019 - During a routine inspection pdf icon

About the service: Beechcroft is a care home that provides accommodation for up to 43 people who need help with their personal care or nursing care. At the time of the inspection 40 people lived in the home. There are three communal lounges for people to share and a pleasant back garden for people to enjoy.

People’s experience of using this service: The overall rating for this service is ‘inadequate’ so therefore the service is in special measures by CQC.

There were no adequate or effective systems and processes in place to monitor the quality and safety of the service. This resulted in people being exposed to ongoing risks with regards to their care.

The provider’s fire safety arrangements were unsafe. There was no evidence that staff had practiced how to evacuate people from the home in an emergency for a significant period of time. People who lived in the home did not have adequate personal emergency evacuation plans in place and there was a lack of evacuation equipment in place to assist an evacuation.

People’s needs and risks were not properly supported or managed and people’s support was inconsistent and in some instances unsafe. Some people sustained accidental injuries during the delivery of support due to poor moving and handling practice. Some people had fallen due to being left unsupervised or unsecure in a wheelchair or recliner chair. This did not show that people were well treated or looked after.

People who required support at their end of their lives did not have support plans in place to advise staff how to provide appropriate and responsive support to meet their needs.

Some people had unexplained injuries. Some had been reported to the local authority but some had not. A significant number of these unexplained injuries had not been reported to CQC as required. Some people sustained similar injuries for a significant period of time but no consideration had been given to whether this indicated potential abuse.

The number of staff on duty was insufficient to meet people’s needs. People’s call bells rang for significant periods of time before being answered. When call bells rang staff did not always respond with any sense of urgency. Some people told us they waited a long time for help. One person said that they could wait for hours during the night for someone to help them.

Where the manager had concerns about staff conduct they had not always ensured that appropriate action was taken when they left the provider’s employment. This meant they had failed to demonstrate a duty of care.

During our inspection, we observed that staff interacted with people in a kind and caring way. They were respectful towards people and patient.

People had access to a range of activities either group based or one to one in support of their social and recreational needs.

Rating at last inspection: At the last inspection in 2017 the service was rated good. After this inspection, the registered manager in post left the home.

Why we inspected: This was an urgent and responsive inspection planned in response to information of concern reported to CQC via the ‘Share your experience’ link on CQC’s website.

Enforcement : Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up: The home has been placed in special measures. 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 proced

22nd February 2017 - During a routine inspection pdf icon

The inspection took place on 22 February 2017 and was unannounced. Beechcroft provides support for people with both nursing and personal care needs. It is a 43 bedded home with 35 single and four shared bedrooms.

As a condition of the provider's registration with the Care Quality Commission, the home is required to have a registered manager. A registered manager is a person who has registered with the CQC 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 home had a registered manager who had worked there for over 20 years.

We looked at care plans and found that they were person centred, detailed and clearly reflected people’s needs. Staff had a good knowledge of the life histories and care needs of the people that they supported. We saw that there were activities available and most people said that they enjoyed them.

The home employed adequate staff in order to meet the needs of the people who lived there. The staff employed were supported by the management team to do their jobs well. They had access to regular training, support and supervision.

The premises were cleaned and well maintained. We saw that the equipment was regularly checked to ensure that it was safe for use. We also saw that the service ensured that the maintenance of the home did not disrupt the care that was being provided.

The manager and staff had a good understanding of the Mental Capacity Act and saw that it was safely applied to ensure that people were cared for lawfully.

The staff were kind and caring and we saw many examples of how they respected the privacy and dignity of the people who lived in the home. People spoke very highly of the staff and the manager and the care that they received.

The home was well led and the manager and deputy manager worked hard to maintain systems and processes to ensure that people received good care in a warm and safe environment.

We saw that risk assessments were in place and were updated regularly to keep people safe. Medicines were managed well for everyone who lived in the home. The deputy manager monitored the systems and processes well and made sure that standards were maintained.

End of Life care was an area where the service particularly focussed and this had been recognised with the service holding the Gold Standard Framework (GSF) Beacon status for End of Life Care. The service had been awarded Beacon status for a second time in March 2015 and this is valid until March 2018. It was clear that this award and the values of the GSF were very important for all of the staff.

14th January 2016 - During an inspection to make sure that the improvements required had been made pdf icon

We carried out an unannounced comprehensive inspection of this service on 1 and 2 July 2015. During this visit a breach of legal requirements was found. We found the provider was failing to provide safe care and treatment, failing to ensure people’s legal consent was obtained and lacked suitable management systems at the home to ensure the service was well led. We issued the provider with requirement actions.

Requirement actions require the provider to make the necessary improvements to ensure legal requirements are met within a timescale they agree is achievable with The Commission. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach and agreed appropriate timescales with The Commission.

We undertook a focused inspection on the 14 January 2016. During this visit we followed up the breaches identified at the July inspection. We found the provider had taken appropriate action to meet all of their legal requirements.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘ Beechcroft’ on our website at www.cqc.org.uk’

Beechcroft provides support for people with both nursing and personal care needs. It is a 43 bedded home with 35 single and four shared bedrooms. There were 35 individual bedrooms and four shared bedrooms in the home. There were communal toilets and communal bathrooms with specialised bathing facilities for people to use on each floor. At the time of our visit, there were 34 people who lived at the home.

A registered manager was in post at the time of our visit. 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 and associated Regulations about how the service is run.

At our last inspection in July 2015, we found people’s care plans did not cover all of people’s needs and risks and failed to provide adequate or clear information to enable staff to deliver safe and appropriate care. The storage of some medicines was unsecure and the way in which medication was administered was not safe. There was a range of quality assurance audits in place but they did not effectively identify and mitigate all of the risks to people’s health, safety and welfare. They did not ensure that staff followed policies and procedures and failed to identify gaps in the employment checks made when staff were recruited.

During this visit, we looked at the care files belonging to three people who lived at the home. We found that care files had been re-organised so that they were easier for follow. People’s needs were clearly documented, properly risk assessed and staff had appropriate guidance on how to care for people safely.

We found that where people’s capacity to make a specific decision was in doubt, the manager had followed the Mental Capacity Act 2005 legislation in order to assess their capacity and ensure people’s legal consent was obtained.

The audits at the home had been reviewed to ensure they were suitable for use. Changes had been made to care plan audits, accident and incident audits were now in place and improvements had been made to staff recruitment. All of the policies and procedures at the home had been reviewed to ensure they were up to date and staff had signed to verify that they read and understood them. These changes had a positive impact on how the service was led.

At this inspection we found the service to be safe, effective and well led.

3rd April 2013 - During a routine inspection pdf icon

People living at the home had declining ill health. Some people had limited mental capacity to consent or make informed decisions about their care.

We saw records that showed the home supported each person’s ability to consent or make decisions. Where a person lacked the capacity to consent we saw evidence of relative involvement in decision making.

We talked with one person who lived at the home and two relatives. They told us they were happy at the home and that the care was good. They said:

“Wonderful [I’m very happy here]”

“Mum is well looked after“

“Very happy with the care”

We observed people were well cared for and treated with dignity and respect. People’s needs were assessed and reviewed. We found care records contained relevant information in relation to personal details, individual needs and preferences. Care plans and risk assessments were in place, individualised and up to date.

We reviewed three staff records. We found the provider had undertaken appropriate checks to ensure people had the necessary skills and suitability to work with vulnerable people. Staff demonstrated an awareness and understanding of how to protect people from abuse and report any concerns.

We reviewed the provider’s complaints policy and three complaints. We saw evidence that complaints were logged, investigated and responded to appropriately in accordance with the complaints policy.

27th June 2012 - During a routine inspection pdf icon

We spoke with four residents and their relatives. All of the residents we spoke with were happy with the home and did not have any concerns or issues about the care received. They told us staff always treated them kindly and respectfully. One resident said “Staff are very caring.”

One relative told us they had been involved in the care planning process and had been given annual satisfaction surveys to complete.

Residents we spoke with told us the food was good and that they were given a choice in what they wanted to eat.

Three residents told us they were happy with how their medicines were given to them and that they were always given on time.

1st January 1970 - During a routine inspection pdf icon

Beechcroft provides support for people with both nursing and personal care needs. It is a 43 bedded home with 37 single and three shared bedrooms. There were communal toilets and communal bathrooms with specialised bathing facilities for people to use on each floor. At the time of our visit, there were 42 people who lived at the home.

The registered manager of the home at the time of our inspection was on annual leave and did not participate in the inspection. 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’. Due to the manager’s absence, the deputy manager of the home took responsibility for our visit.

During this inspection, we found breaches of Regulations 11, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.

We looked at eight care plans and found they did not cover all of people’s needs and risks. Some risk assessments and care plans failed to provide adequate or clear information to enable staff to ensure they delivered safe and appropriate care. Some care plans had not been updated appropriately when people’s needs had changed and some risk management actions were not followed. For example, two people’s risk management plans for pressure area care specified that they were to be re-position every two hours but repositioning charts failed to evidence that this was being appropriately undertaken. We also found however that some of the nutritional guidance for staff to follow in relation to people’s care was not consistently monitored or adhered to in order to ensure people’s nutritional needs and risks were managed.

Where people’s care plans indicated they had mental health conditions which may have impacted on their ability to consent to decisions about their care, their capacity had not been assessed in accordance with the Mental Capacity Act 2005 unless the person was subject to a Deprivation of Liberty Safeguard. Consent forms in people’s files had often been signed by relatives and there was little evidence the person themselves had participated in or agreed with consent given.

Where a mental capacity assessment had been undertaken as part of DOLs, the assessment process was very good. We spoke to the deputy manager about this, who told us they had just started a new mental capacity assessment process.

People had a choice at mealtimes and were given a suitable range of nutritious food and drink. People we spoke with were happy with the food and choices on offer. We saw that the home catered for special diets such soft diets or diabetic needs and alternatives to any of the mealtime options were always provided. People identified at risk of malnutrition received dietary supplements to promote their nutritional intake and were involved with professional dietary services where this was appropriate.

We observed a medication round and saw that the way in which medication was administered was unsafe. Staff did not follow the provider’s medication policy in the administration of medication which placed people at risk. Some medicines were stored un-securely in communal areas and people’s bedrooms which placed them at risk of unauthorised use. Staff we spoke with, during our visit, who were responsible for administering medication, did not demonstrate they were knowledgeable about safe administration practices or were competent to do so. Medication training for some staff was over two years old and the majority had not had their competency checked since they commenced in employment.

A health professional we spoke with during our visit said they thought staff at the home cared for people well. We observed staff supporting people at the home and saw that they were warm, patient and caring in all interactions with people. Staff supported people sensitively with gentle prompting and encouragement and people were relaxed and comfortable in the company of staff. From our observations it was clear that staff knew people well and genuinely cared for them. People looked well cared for and both people who lived at the home and their relatives were positive about the staff at the home and the care they received.

Staff when recruited had suitable employment and criminal convictions checks to ensure they were suitable to work with vulnerable people but some staff had not had their personal identify or right to work in the UK checked. The provider told us they had recently put systems in place to resolve this. Recruitment risk assessments had not always been completed prior to recruitment and required improvement.

The number of staff on duty was sufficient to meet people’s needs. We observed staff to be kind and respectful and the activities co-ordinator offered a range of activities to occupy and interest people.

Staff we spoke with said they felt confident and supported in their job roles. Records showed staff had received an annual appraisal and regular supervision. Training records showed the majority of staff had completed adequate training although there were some gaps in the training of some staff members with regards to safeguarding, mental capacity and medication. We found when speaking to staff that these training gaps impacted on the staff’s knowledge in these areas.

The home was clean and well maintained with good infection control standards. The home had achieved a five star rating (very good) from Environmental Health in relation to its catering facilities and standards.

The culture of the home was positive and inclusive and visitors were made welcome by all the staff team. Good teamwork was evident throughout the home in meeting people’s needs and all staff we spoke with told us they had a good relationship and confidence in the management team. This demonstrated that the manager and provider had fostered good staff leadership and morale.

There were audits in place to check the quality of the service where audits had identified improvements were required these had been undertaken. Some of the audits in place however were ineffective. For example, care plan audits had not identified the lack of clear and coherent care planning information in people’s files; accident and incident audits were limited and did not provide sufficient information to enable the staff team to learn from and prevent similar accidents or incidents re-occurring and the lack of staff and management adherence to company policies had not been picked up and addressed. This indicated that the service’s management and leadership required improvement.

People were able to express their feedback through a satisfaction questionnaire which was sent out each year to gain people’s views on the quality of the service. The surveys returned so far indicated people who lived at the home and their relatives were very satisfied with their care.

At the end of our visit, we provided discussed some of the issues we had found with the deputy manager and provider. We found that they were receptive and open to our feedback and demonstrated a positive commitment to continuous improvement.

 

 

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