Beamish Residential Care Home

Beamish Residential Care Home is a residential care home providing personal and nursing care to up to 21 older people, including people who may live with a dementia related condition. At the time of our inspection there were 19 people using the service, accommodated in an adapted building.

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

There were sufficient staff to support people safely. A relative told us, "Definitely the best place, pleased [Name] is there, where they can be looked after on a 24-hour basis. The bedroom door is always open and a staff member will always go and check on them, I do think [Name] is quite safe." Staff had received safeguarding training and were clear on how and when to raise their concerns. Where appropriate, actions were taken to keep people safe.

Staff followed effective processes to assess and provide the support people needed to take their medicines safely. A relative commented, "We were very strict with [Name]'s medicines and staff are too. They make sure [Name] takes their medicine correctly at the right time."

Staff contacted health professionals when people’s health needs changed. A relative told us, "Staff involve other people whether it's a referral to the Speech Therapy Team or Mental health team and they contact the GP."

People and relatives were very positive about the caring nature of staff and had good relationships with them. They trusted the staff who supported them. A relative told us, "Staff are incredibly compassionate and they are absolutely brilliant with residents. They are good at building relationships and are always friendly and always approachable, absolutely kind and patient."

Staff followed good infection control practices. A programme of refurbishment was taking place around the home.

Records provided guidance to ensure people received safe, person-centred care and support from all staff members. A professional commented, “People receive personalised care and staff members are well-aware of their needs.”

Staff spoke very positively about working at the home and the people they cared for. They said communication was effective to ensure they were kept up-to-date about any changes in people’s care and support needs.

Staff respected people's diversity as unique individuals with their own needs. The staff team knew people well and provided support discreetly and with compassion. A relative told us, "Staff are very good with [Name] and they feel comfortable. [Name] cried with happiness when they got a permanent place here."

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last

The last rating for this service was good (published 18 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beamish Residential Care Home on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation to ensure protocols are in place for the use of ‘when required’ medicines.

We have made a recommendation to review the use of the shared room in order to promote people’s rights to privacy and dignity.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• The registered manager and the provider had researched COVID19 using a variety of resources to ensure they met best practice requirements. Staff were informed about these requirements on a notice board, in meetings, during handover periods and through regular support during each shift. Staff told us they felt supported.

• Staff had thought through all aspects of people’s care in the home and taken steps to reduce the risks of COVID-19.

• Restrictions had been put in place regarding visitors to the home.

• Staff had made changes to the environment of the home to keep people safe.

• Staff had initiated regular weekly updates to the local GP surgery to promote good partnership working.

Further information is in the detailed findings below.

Beamish Residential Care Home can accommodate up to 21 older people who do not require nursing care. On the day of our visit there were 20 people using the service.

Beamish Residential Care Home was last inspected by CQC on 3 August 2015 and was rated Good overall. At this inspection the rating continued to be Good overall.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like 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.

Safeguarding procedures were in place. There had been no recent safeguarding matters formally investigated. The premises were effectively maintained and safety checks undertaken on a regular basis, including checks with regard to fire safety. Risk assessments were in place related to the environment and the delivery of care.

People’s medicines were managed safely. There were enough staff deployed to keep people safe. The provider’s recruitment processes minimised the risk of unsuitable staff being employed.

Staff received mandatory training in a number of areas, which assisted them to support people effectively, and were supported with regular supervisions and appraisals. People’s rights under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were protected.

People were supported to maintain a healthy diet and had access to health care professionals to help maintain their wellbeing and staff responded to any health concerns. There was a homely feel to the building and people’s individual rooms were decorated to their tastes.

People and their relatives spoke positively about the staff at the service, describing them as kind and caring. Staff treated people with dignity and respect. Staff knew the people they were supporting well, and throughout our inspection we saw all staff including the cook and operations director having friendly and meaningful conversations with people. People were supported to be as independent as possible and had access to advocacy services where needed.

People and their relatives told us staff at the service provided personalised care. Care plans were person centred and regularly reviewed to ensure they reflected people’s current needs and preferences. People were supported to access activities they enjoyed. Procedures were in place to investigate and respond to complaints.

People and staff spoke positively about the registered manager and operations director, saying they were accessible and included them in the running of the service. The provider carried out a number of quality assurance checks to monitor and improve standards at the service.

The provider had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.

We looked at the care records of four people, spoke with three staff members and observed how people were cared for. We found people had individual care records which contained relevant care plans and risk assessments to ensure their care was appropriately planned and delivered. We also found the service ensured that people had consented to their care and had been involved in any decisions regarding their health and well-being.

We looked at the home's policy on protecting people from abuse and staff training and supervision records and found the provider had taken appropriate steps to protect people from abuse. We also found staff working in the home were trained to a suitable standard.

The provider did have a quality and monitoring system in place that reviewed the care people received. We did suggest that some minor improvements could be made such as a yearly review of the service and a future plan on continued improvements. The deputy manager acknowledged our comments and said they would make further improvements to the system.

As part of our review on 02 February 2013 and 12 February 2013 we looked at medicines records, medicines supplies and care plans.

We spoke to two people who used the service about their medicines at this inspection. One said they were very happy for staff to look after their tablets, but wanted to keep their own ear drops so they could apply them themselves. The other person was prescribed eye drops when required and said they would like to have these drops administered more often to relieve symptoms of dry eyes.

Overall, we found people who used the service had their medicines given at the times they needed them, and in a safe way. A small number of further improvements were still necessary.

We found the provider had made improvements to the monitoring and evaluation of people's plans of care, however we identified some concerns about the management of people's medicines.

We spoke to two people who used the service about their medicines at this visit. One person said about their tablets "They (the staff) bring them up and I take them" but also that "I don't always get my inhalers unless I ask for them." The other said "The staff are marvellous and very helpful.'