Beeston View

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

We reviewed 6 quality statements for this key question. There were systems to keep people safe from abuse and harm. Relatives were able to able to raise concerns and they felt they would be acted on quickly. Relatives told us that staff knew their loved ones well and would support them when they became distressed and in line with plans of care. People and relatives were involved in how the service was run. The service worked with people to understand their individual needs and requirements adapting care and support around those individual needs. We observed staff supporting people that were walking around the building and monitoring if they required support or reassurance. People were kept safe as risks to people and within the environment were assessed regularly and mitigated. People told us that the environment was well maintained. One relative told us, "The equipment is clean and from what I see looks in good condition." We observed areas that were not well maintained or monitored and this included walls damaged on ground and first floor and a gas ring left turned on with an open flame with no kitchen staff present. This was fed back to the provider whilst on site and the provider took immediate actions. On day two of the site visit there was no issues found. The provider had the appropriate checks and records for all areas of the service. This included fire safety records, gas and electrical records which were all up to date and with any recommendations actioned by the provider. People were protected from the risk of infection as staff were following safe infection prevention and control (IPC) practices. We saw that whilst on site there was shortfalls in the cleanliness of the home. This included dirty furniture in peoples bedrooms and disorganised sluice and storeroom. This was fed back to the provider and they made immediate improvements.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives we spoke to on-site told us that they feel listened to and if any issues or concerns they feel comfortable raising them. Relatives told us they felt involved and if changes were required, they would be done.

Feedback from staff supported the improvements in a positive learning culture and the introduction of robust handover processes including clinical handovers. Staff were aware of freedom to speak up champions. They mostly felt confident to raise concerns and suggestions for improvement, though one staff member felt that there was a lack of response to concerns raised. Not all staff had received training on distressed reactions, but were aware of redirection techniques. The provider provides a dementia care e-learning and support from their Divisional Dementia Care Specialist who has been supporting the home. The provider has been completing monthly home clinical governance meetings which has fed into the improvements and positive learning for the team and in relation to incidents for the service, as this is reviewed monthly with outcomes identified and actions put in place accordingly.

The provider has recently learned lessons in order to support with improvements following feedback from relatives and staff via 'Tell Barchester' and 'Your Voice surveys', the service implemented a new handover form which included more comprehensive information about the residents, ensuring they continue to provide individualised, person-centred care. The speak up process supports and encourage all staff members to speak up in a timely way to discuss any issues, risks or concerns affecting their workplace with their manager, as well as welcoming any opportunities for improvement and feedback. We observed a case study to support person centred care, through learning what works for a person to support the care they require and in a supportive way.

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.

People told us they felt safe in Beeston View and knew they could raise any concerns they may have.

Staff had received safeguarding training and annual refresher training. Staff felt confident to report a safeguarding concern and knew where to get support. Staff were aware of the importance of resident’s mental capacity. Staff were aware of the whistle blowing policy and felt confident to raise concerns.

People and their relatives felt the home was safe. We observed safe interactions between staff and people living in the home when support was being provided. We observed staff interacting with people in a kind and caring way, providing safe and appropriate support to meet people's needs, whilst managing risks and helping people to stay safe. Staff were observed to use equipment safely when supporting people to transfer and mobilise. Steps were taken to ensure the environment promoted people's safety, such as the use of window restrictors and sensor mats to safeguard people from falls, key pads were on doors to stairwells to prevent accidents, and call bells were available in people's rooms.

Systems were in place to manage DoLS but were not kept up to date. DoLS authorisations, and any conditions attached were not incorporated within people's plans of care. Conditions not always being met. On the day of assessment we found one resident's DoLS authorisation had been received the day before the on-site visit and the service were in the process of rewriting the care plan to incorporate the restrictions to enable staff to support appropriately.

People and relatives told us that they were kept informed and included in changes that have an impact on the person living at Beeston View. Relatives that we spoke to told us that they made suggestions and were involved in the care and support.

Staff demonstrated awareness of people's risks and knew where to find personalised guidance on how to support people safely. Leaders told us they encouraged positive risk taking, which was managed in a person-centred way for individuals. Preventative measures to mitigate risk were discussed with the person and their family or representatives.

We observed staff support people in a safe and meaningful way. Pressure cushions were in place for people if they needed them and we saw staff playing games alongside people and encouraging them to participate. Interaction observed was kind and caring and staff appeared to know the people well. When people needed support to mobilise staff were there to support them.

People's risks had been identified and assessed. We found notes in care plans demonstrated that staff understood the actions they needed to take to manage people's individual risks to maintain people's safety. Records demonstrated staff were following care plans, information was updated in people's care records, as necessary. Documentation was routinely reviewed and updated following a change in a person's need.

People and relatives told us on site that the environment was safe and equipment is well maintained.

Overall feedback was positive, we received one comment regarding access to appropriate equipment which was a lack of various sized gloves.

We observed that on day one of the site visit the environment was not as clean as expected. We observed dirty bedroom furniture, one tablet found on a corridor floor, sluice disorganised and unclean, the store cupboard was cluttered and PPE found on the floor. We saw walls damaged on the ground and first floor. This was all fed back to the registered manager and operations manager and actions were taken immediately to rectify the issues we saw. On day one of the visit we saw that the kitchen was not clean, this was during busy lunch meal preparation time. This was also fed back to the manager.

People's risks had been identified and assessed. We found notes in care plans demonstrated that staff understood the actions they needed to take to manage people's individual risks to maintain people's safety. Records demonstrated staff were following care plans, information was updated in people's care records, as necessary. Documentation was routinely reviewed.

People told us there were enough staff to meet their needs in a timely way, that staff knew them well and how they needed their needs to be met, and that there was good consistency with staff.  “Yes usually and good continuity. Occasionally there are agency staff but not often”. “Yes, they understand her condition, each day can be different for her due to her condition”

Staff told us that the housekeeping staff members have increased and if they lack staffing they will ensure bathrooms, bedrooms and bins are taken care of, or would split the work to ensure it is completed. The housekeeping staff receive support from the carers at the weekend. A carer also told us that staffing numbers seems to be improving and said that it could be better at the weekends but this is being addressed through new rotas. Currently there are 4 empty rooms downstairs which helps managing the workload. Most staff we spoke to felt supported in their role, but one staff member felt that pressures on management meant less access to support. Staff we spoke to felt morale was good, and there was support in teams and across departments.

We observed there to be enough staff available to support people and meet their needs in a timely way. Staff were present in communal areas and supported people with activities of their choice. There was a board displayed with photographs of each staff member to help people know who was who. Staff were heard speaking to people in caring and dignified ways.

The provider maintained a training matrix which showed high levels of completion by staff, however we were unable to determine the actual level of training, supervision or appraisals for staff at Beeston View as the matrix included staff from another of the providers services. Evidence was provided to show staff had their competency assessed each year . A 'Learning and Development' policy is in place that reflects the providers aim to ensure all staff have a robust induction and have equal access to training to ensure they develop the necessary skills for their role. Staff rota's reflected consistent numbers of staff on duty. The provider used a dependency analysis tool and these were evident within people's care files. When required, agency staff were utilised safely and individual profiles were in place to ensure each agency staff member had the necessary skills. Not all staff files reflected safe recruitment procedures as there were unexplained gaps in employment history in two of the files reviewed and one staff members interview record did not reflect appropriate questions for the role applied for.

People and relatives told us that the home was clean and relatives told us about their personal observations when visiting which were all positive.

Staff had received training on infection prevention and control and knew how to prevent and control the risk of infection on a daily basis and when there is an outbreak. Staff had access to appropriate cleaning products, and personal protective equipment, however there were issues accessing correctly sized gloves. Staff understood the process for waste management.

Cleanliness and hygiene in the environment and with the equipment observed on day one of the visit, we found some issues and these were actioned by the provider and observed on day two of our visit. People we observed that use the service were well presented and well looked after.

The service had a regular auditing processes to identify areas of improvements in respect of Infection prevention and control. The management team undertake daily walks around the service which also include observations on cleanliness. There are policies and procedures in relation to infection control, waste management, Infection outbreak management and personal protective equipment use.

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