Beech Lawn Nursing and Residential Home

Updated 26 January 2023

The inspection

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

Inspection team

The inspection team consisted of one inspector.

Service and service type

Beech Lawn Nursing and Residential Home is a 'care home'. People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at on this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We also reviewed information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. This information helps support our inspections. We used all of this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with the registered manager, deputy manager and clinical lead. We spoke with 5 staff members. 4 people living at the service. We received feedback from 3 professionals following the site inspection.

We reviewed a range of records. This included 4 people’s care records. We checked 3 people’s medicines records and looked at arrangements for administering, storing and managing medicines. We looked at records in relation to staff training and supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.

Updated 26 January 2023

About the service

Beech Lawn Nursing and Residential Home is a residential care home providing personal and nursing care to up to 44 people. The service provides support to predominately older people and people living with dementia. We began the inspection on 13 December 2022. At the time of our inspection there were 43 people using the service. The service was experiencing an outbreak of Covid-19; therefore, we terminated the inspection on that date. We returned to complete the inspection on 4 January 2023. At that time there were 36 people using the service.

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

On the inspector’s arrival to the location on the first day of inspection the service had declared an outbreak of Covid-19. The service had been closed due to the need to protect people. The registered manager and quality assurance and training lead were not working in the service due to being affected by Covid-19. The clinical lead was on duty and supporting staff and residents affected. They were also informing all necessary health and social care agencies as required. We made the decision to minimise the impact of an inspection at this time and returned on 4 January 2023 to complete this.

Prior to the inspection we had received concerns that infection control measures were not effective at the start of the Covid-19 infection. Concerns were raised that a staff member had worked while testing positive to Covid-19. We found there had been a sudden and detrimental impact on staffing levels for the previous days prior to the inspection due to the impact of Covid-19 infections affecting staff. The registered manager confirmed they had been made aware of a staff member who had tested positive for Covid-19 while on shift and completed that shift as they were not symptomatic. Some staff were not wearing protective masks as was the guidance at that time. We raised this with the registered manager who took immediate action to ensure all staff used the necessary protective equipment as was required at that time when in an outbreak. We have made a recommendation in respect of this in the report.

There had been some staffing issues due to the impact of the recent Covid-19 outbreak. The registered manager had been supported by the commissioners due to the outbreak to seek additional staff and put a contingency plan in place. On the second day of inspection we found staffing levels had improved. Overseas staff had recently been employed and were going through their induction programme. Staff told us staffing had been an issue but had now improved. We found there were enough staff on duty to meet people's individual needs.

Staff were caring and treated people with kindness, respect and were mindful of people’s dignity. Comments included, “The staff are very patient and are keen to help me with things” and “I think they [staff] are very patient. It was difficult before Christmas. I think a lot of staff were poorly, but it’s got much better. I don’t usually have to wait long before somebody comes along to help”.

Incidents and accidents were managed safely. The managers took necessary actions to keep people safe and minimise the risk of reoccurrence. Steps were taken to learn lessons if things went wrong.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. A health professional told us the registered manager and clinical staff worked closely with them to ensure any placements at the service were suitable so that peoples individual needs could be met.

The provider had systems in place to protect people from the risk of abuse and people told us they felt safe. Risk assessments were completed to help identify and minimise risks people faced. Staff had been recruited safely.

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.

Staff knew how to keep people safe from harm. Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines.

Staff told us that they had received training. The deputy-manager maintained oversight of training to ensure staff had the necessary training, knowledge and skills to provide consistent care.

Staff told us they were supported by the management team. One staff member new to the service, told us they felt valued and felt supported during their induction period.

The premises were clean and well maintained. The service had effective systems to monitor equipment and utilities. There were certificates in place to support this. Systems were in place to support people in the event of an emergency.

The registered manager provided clear direction and good leadership. Feedback about the service was consistently positive. In general comments about support was positive. Some people told us there had been a lot of changes in the staff team. Communication with other agencies had not always been positive. However, all stakeholders told us this had improved and there was now a static staff team who communicated well.

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

Rating at last inspection and update

The last rating for this service was good published (19 July 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and infection control measures. A decision was made for us to inspect and examine those risks.

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.

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

Notice of inspection

This inspection was unannounced.

Follow up

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