Archived: The Beacon Intermediate Care Unit

The Beacon Intermediate Care Unit is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Beacon Intermediate Care Unit is registered to accommodate 27 people in one adapted building. At the time of the inspection 20 people were using the service. The service provides short term reablement to maximise the independence of people and enable them to return to living in their own home in the community. The service comprises care, therapy (occupational therapy and physiotherapy) and social work intervention all based in the same building. The service also provides a range of facilities and equipment to support people’s reablement needs.

The service had a new 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.

We found improvements had been made to the medicines management systems to ensure they were safe. Staff administration and recording practices had improved through additional training, assessment, supervision, participation in work-shops and regular meetings.

Quality assurance systems had been reviewed and maintained since the last inspection and we saw action had been taken when issues had been identified. The provider had worked hard at implementing positive changes and was committed to ensuring improvements were sustained and developed further, to ensure people received high quality care. Staff described the culture of the organisation as open and management as supportive and approachable.

A robust recruitment process was in place, which ensured staff had the necessary values, skills, experience and were suitable to work with people who used the service. Staff received the training and support they needed to carry out their roles and meet people’s needs. The provider monitored staffing levels regularly, to ensure staffing levels were sufficient and staff deployment was effective.

Staff had received training and had procedures to guide them in safeguarding people from the risk of harm and abuse. In discussions, staff were clear about how they would escalate concerns and which agencies they would contact for advice.

People told us they felt safe. Staff had completed assessments with people to identify risk areas and the steps required to minimise risk. People received care tailored to meet their individual needs and the care recording systems were being fully transferred over to the electronic format.

The service was operating within the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

People’s health and nutritional needs were met. Records showed people had access to a range of community healthcare professionals for advice and treatment. These included dieticians when people lost weight and required additional support. The menus provided varied meals with choices and alternatives. The lunchtime experience was relaxed and had a social atmosphere with lots of chatter and interaction from staff. People told us they liked the meals provided to them.

We observed caring interactions between staff and people. Staff engaged positively with people, encouraging and supporting their independence. Staff had a good knowledge and understanding of people’s needs and worked together as a team. They were cheerful and supported the privacy and dignity of people as they went about their work.

The provider had a complaints procedure and people told us they felt able to raise concerns and these would be addressed by management.

The environment was clean, tidy and safe. Staff had access to personal, protective equipment which helped them to prevent and control the spread of infection. Improvements had been made to the facilities, with more planned through a comprehensive renewal programme.

The service has 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.

At the last inspection on 21 and 22 April 2015, the service was rated Good. At this inspection on 22 and 23 May 2017, we found some inconsistencies in the safe and well-led questions and the overall rating for the service has changed to ‘Requires Improvement.’

Medicines were not always managed in a safe and proper way; we saw there were shortfalls in the administration and recording of some people’s medicines. This was a breach in regulation. You can see what action we have asked the registered provider to take at the back of the full version of the report.

Although some staff were not happy with the staffing levels, people and relatives felt there were enough staff and this was confirmed in our observations. We saw staff were available and responded promptly to people. In recent months, staffing levels had increased on day shifts with regular support from the staff who worked at the registered provider’s community intermediate care service.

Robust recruitment procedures were in place, which helped ensure staff were suitable to work in the care service. Staff received the training and support they required to carry out their roles and meet people’s needs.

People told us they felt safe and this was echoed by relatives we met. Staff understood safeguarding procedures and how to report any concerns. There were procedures in place to manage risk effectively and we found evidence throughout the inspection that all efforts were made to support people’s safe mobility and prevent falls.

We found people’s nutritional needs were met. There were plenty of choices for meals and fluids and dietetic advice was obtained when required. The lunchtime experience was relaxed and had a social atmosphere with lots of chatter and interaction from staff. People liked the meals provided to them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives praised the staff who were described as kind, caring and considerate. People told us they were treated with respect and this was confirmed in our observations. We saw staff engaged positively with people, encouraging and supporting their independence. Staff had a good knowledge and understanding of people’s needs and worked together as a team.

People and relatives told us they felt able to raise any issues or concerns and were confident these would be dealt with appropriately. They were consulted about their care and the service through discussions, reviews and surveys.

We saw people received care tailored to meet their needs however the registered manager recognised the care plans needed more work to fully reflect the person centred care being delivered and to ensure the records were more user-friendly. We saw people had access to healthcare professionals such as GPs and district nurses. A healthcare professional who visited the home regularly told us it was, "A very good service." They said staff communicated well, reported any issues promptly and appropriately and acted on any advice they gave.

We observed the culture of the organisation was one of openness and sound values based on putting people first, working together, ensuring the care was person centred and individuals being at the centre of their own care. We found the quality monitoring system had been effective in highlighting some shortfalls in areas such as staff training, appraisal, rota management, staff absence and the environment, which had been addressed. Additional support had been provided to the registered manager. However, shortfalls in the management of medicines had not been fully identified and action had not been consistently taken in order to address these.

The registered manager told us, 'All the activities people are involved with are based around the skills that people will need when they go home.' Activities included the breakfast club, walking, gardening and cooking.

Care workers supported people to take their medicines in a variety of different ways that met the individual needs and preferences of people who used the service. Where possible, people were encouraged and helped to take responsibility for their own medicines in preparation for their return home.

The service's quality assurance officer said, 'All new and agency staff complete a health and safety induction which covers all aspects of the building.'

The council health and safety officer was visiting the home at the time of our inspection. He told us, 'I have no issues, in my opinion it's a well run professional location.'

A person who used the service told us, 'If I had any concerns I would just speak to the staff. Everyone is very approachable.' Another person said, 'I suppose I would report any problems I had to the manager but I have never had the need.'