Beechfield Lodge is based in Salford, South Manchester and is a care home, which can accommodate up to 60 people. All the rooms are for single occupation, 45 are self-contained flats with a small kitchenette, lounge and bedroom areas and a bathroom. The other 15 rooms are single bedrooms with the majority having en-suite facilities of a toilet and sink.

At the last inspection in July 2014 the service was rated Good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports’ link for Beechfield Lodge on our website at www.cqc.org.uk.

At this unannounced inspection on the 29 September 2017 we found the service remained Good. The service met all relevant fundamental standards.

The service had a registered manager. 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 were protected from abuse and all told us they felt safe. Staff were knowledgeable about how to recognise signs of potential abuse and were aware of the reporting procedures. Assessments identified risks to people and management plans to reduce the risks were in place.

Risks had been identified and management systems were in place to monitor risk and reduce incidents ensuring peoples safety. There were also detailed assessments to follow in case of an emergency.

At the time of the inspection there were sufficient staff on duty to meet people’s needs. However the dependency tool lacked detail to determine people’s dependency.

People and their relatives we spoke with told us they though there were sufficient staff on duty. Recruitments procedures ensured the right staff were employed to meet people’s needs safely.

Systems were in place to ensure management of medicines was safe. Staff received training and competency assessments to administer medications safely. The provider completed regular audits of the system to ensure standards were maintained. Although the audits did not cover topical medications and these systems could be improved.

We observed staff took account of people’s individual needs and preferences while supporting them. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Staff were aware of peoples nutritional needs and people were supported to maintain a balanced diet. People were supported to maintain good health and had access to health care services.

People were treated with respect. People we spoke with and their relatives told us staff were kind, considerate and caring. Staff we spoke with able to tell us how they respected people’s preferences and ensured their privacy and dignity was maintained.

People told us they could take part in activities of their own choice and that there were also organised group activities taking place during our inspection.

There was a system in place to tell people how to raise concerns and how these would be managed. People told us they would feel comfortable raising any concerns with the management team.

Systems were in place to monitor and improve the quality of the service provided. Areas for improvements had been identified and action plans were in place these were followed by staff. The provider also had a quality team who monitored the service to ensure continued improvements.

Staff were clear about their roles and responsibilities and had access to policies and procedures to inform and guide them.

Further information is in the detailed findings below.

We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. 

Beechfield Lodge is a residential care home based in Salford, South Manchester. The home provides residential care for up to 59 people and is owned by Anchor Housing. Some people who lived at the home suffered from dementia.  All the rooms are for single occupation with the majority having en-suite facilities of a toilet and sink. There are some larger en suite rooms with showers and kitchenettes. On the day of our inspection there were 48 people living at Beechfield Lodge.

The home was divided into three areas known internally as The Lowry, Buile Hill and The Keys.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People received the information they needed to help them to make decisions and choices about their care. People’s views and wishes were incorporated into their plans of care. Care plans showed they had been discussed with the person or their representatives, with individual quotes from people who used the service captured during the care plan review process.

People’s privacy and dignity was respected however we saw two instances where it was not. Examples of this were when one person was seated outside the toilet whilst it was used by somebody else and the staff member walked away and did not return for some time leaving another member of staff to assist this person. On another occasion a toilet door was left open whilst one person was assisted to the toilet.

We spoke with one person in their bedroom who was enjoying watching the television. We observed there was a strong, overpowering smell of urine with a wet patch on the floor next to a urine bottle which appeared to have been spilt. The manager told us this was often done intentionally by this person however there was no mention of this in the care plan or risk assessment as to how it was being managed. Observation checks had also been undertaken by staff but with no mention of this incident in the notes.

We observed the lunch periods in Lowry and Buile Hill and observed good interactions between staff and people who used the service. We saw evidence staff understood people’s care requirements with sufficient numbers of staff available to assist people with their nutrition and hydration.

People who were able to express their views verbally felt they received effective care and support to meet their needs. The care plans we looked at showed people who lived at the home, or their representatives, were involved in the assessment of their needs and planning of their care.

The home was responsive to people’s individual and changing needs. The registered manager told us additional staffing had been provided since April 2014, with an additional member of staff added to both the day and night shift. The register manager told us; “This has made a huge difference”.

The registered manager demonstrated a good knowledge of the people who lived at the home. Throughout the day we saw both the registered and deputy manager talking with people who lived at the home and staff. Everyone looked very comfortable and relaxed with the managers.

We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards with systems in place to protect people’s rights under the Mental Capacity Act 2005.  The MCA and DoLS provide legal safeguards for people who may be unable to make decisions about their care. There were six people living at Beechfield Lodge who were subject to DoLS. We saw robust documentation to show the necessary referrals and correspondence had been made with the local authority.

We carried out this inspection in response to concerns we had received regarding the standards of care at Beechfield lodge.

We spoke with three night staff who told us there were two people who liked to get up early and this was documented in their care plan. The night staff we spoke with told us they would only assist a person to get up early if they were asked to do so by the person.

We spoke with a visiting district nurse who told us staff contacted them in a timely manner if they were concerned that a person was at risk of developing a pressure ulcer. Comments included: “They are very good at following instructions.” “People are well cared for.” “When staff are concerned they fax over a referral for a visit.”

We spoke with staff who told us they felt there were enough staff on duty to meet people's care needs. Comments included: “It would always be nice to have more staff but I think we are fine.” “Sometimes a shortfall with sickness when we can’t get cover but it is not often.”

During the inspection, we spoke with four visitors and one person who was using the services. They told us they were happy with the care being provided and felt that people were well looked after.

One visitor said “The care is very good and there seems to be plenty of activities at the home”. The person who was using the services told us they regularly took part in activities, when possible but preferred to stay in their room.

We found that people had their preferences recorded and were offered choices. The provider acted in accordance with people's wishes and people who use the service received care in a way that met their needs and preferences.

The people we spoke with told us they felt the home was clean and safe. One visitor told us “The room and the home is very clean, I always recommend this to other people”.

The people told us the staff were cheerful, happy and positive. They also told us they had no concerns about the services they received and were confident they could speak to the staff if they had any concerns. The person who was using the service told they felt sometimes the staff were rushed and looked hurried, especially at night.

People were cared for by staff that had been through the appropriate recruitment checks.

There was an effective complaints system available, in case anyone wished to raise a complaint.

During our inspection there was a positive atmosphere within the home. We observed staff interacting with people, calmly and in a timely manner, both in communal areas and in people’s rooms.

We observed people engaged in activities including armchair exercise, tai-chi and a music quiz.

People living in the home told us: ”I’m what you would call spoilt rotten.” “I get lovely meals.” “I just like it all here, everyone’s always cheerful.”

Care plans contained a number of agreements to gather consent to care and treatment, which were signed by the individual or relatives. These included agreement to medication and night checks.

We observed equipment in use by individuals and staff throughout the day. People were using walking frames independently and, where people did require support, we observed staff communicating with people, explaining what equipment they were using and worked with people at their own pace.

We looked at the staffing rotas for January 2013 and found that the staffing levels reflected the details provided by the manager. There were enough qualified, skilled and experienced staff to meet people’s needs.

A relative told us during our inspection that: “When you are here as much as we are, you see things even when staff don’t know you are there. They are nice with everyone, the way they talk to people. And just the simplest things like knocking on doors, it makes a difference.”

People who use services were very complimentary about the home.Everyone we spoke to said they were happy living at the home and that they were well looked after. No one had any complaints about any aspect of their care. Comments included 'It’s lovely here, no one bothers you – I get the care I need.' 'I love it. When I first came, I wanted to go home but not now. They let us help.' 'I like it here. There are lots of activities and the choice is yours.' 'The staff are grand, there isn’t one who does not do her work, they are all so friendly.'