Archived: The Beeches (Doncaster)

We found the following examples of good practice.

The provider had a process in place to enable relatives to visit their family members in a safe way and in line with government guidance. A visiting pod was available and families had enjoyed using this space. Visitors were asked to show a negative test prior to entry to the home.

Professional visitors were required to show a negative lateral flow test and evidence of COVID-19 vaccination.

Infection prevention control (IPC) signs reminded everyone at the point of entry and throughout the home about procedures for infection control.

The home was accessing regular testing, which had assisted them in identifying an outbreak of COVID-19.

Hand sanitising stations were readily accessible throughout the home and staff used these frequently.

Staff were applying and disposing of personal protective equipment (PPE) appropriately and had received training in IPC and hand washing.

The home was visibly clean and well presented. Some refurbishment of bathrooms and toilets had recently been completed.

We found the following examples of good practice.

Prominent and clear infection prevention control (IPC) signs reminded everyone at the point of entry and throughout the home about procedures for infection control.

The service worked with the local authority IPC team and other health professionals in managing the outbreak.

The home was accessing regular testing, which had assisted them in identifying an outbreak of COVID-19.

Hand sanitising stations were readily accessible throughout the home and staff used these frequently.

Staff were applying and disposing of PPE appropriately and had received training in IPC and hand washing.

The provider was in regular contact with the home to monitor and evaluate the measures that were in place.

Frequent advice, guidance and support was given to the staff and they were able to access emotional support should they need it.

The Beeches (Doncaster) is a residential care home providing personal to 31 people aged 65 and over at the time of the inspection. The service can support up to 32 people. Some people using the service were living with dementia.

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

The provider had a system in place to ensure people were safeguarded from the risk of abuse. Staff knew how recognise and report abuse. Medicines were managed in a safe way. Risks associated with people's care had been identified and appropriately managed to ensure risks were minimised.

Lessons were learned when things went wrong. The registered manager kept a record of accidents and monitored the outcome. The home was clean and fresh. However, we saw some areas of the home required attention. The registered manager told us these areas had been identified and action was ongoing. Some actions from the last fire officer visit had not been completed. The registered manager told us they would address this and email the lead inspector following our inspection.

People's needs were assessed and care and support was delivered appropriately. The home was working in line with the principles of the Mental Capacity Act. Best interest decisions had been made when required and in the least restrictive way. 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.

People received a balanced and varied diet which met their needs and suited their preferences. Staff we spoke with told us they felt supported by the registered manager and received training.

We observed staff interacting with people and found them to be caring and friendly. Privacy and dignity was maintained. There was a focus on people making choices and staff ensured preferences were adhered to. Positive feedback received from relatives and people living at the home.

Care plans we saw were person centred and were in line with people's assessed needs. Staff knew people very well. The provider employed a well-being co-ordinator who arranged activities and social stimulation. We observed people had access to varied activities. The provider had a system in place to monitor and deal with complaints. End of life care was documented in people's care plans.

The provider had a system in place to monitor the service. Several audits took place and any issues arising were addressed. Relatives and people who used the service had opportunities to feedback their experience. Staff felt listened to and included in the service.

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

Rating at last inspection

The last rating for this service was good (published 28 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This unannounced inspection took place on 28 March 2017. The home was previously inspected in March 2016, when a breach of legal requirements was identified regarding staff recruitment. Following that inspection, the provider sent us an action plan identifying what they would do to meet legal requirements in relation to the breach. This inspection was undertaken to check that they had followed their plan and now met all of the legal requirements.

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

At this inspection we found the service had made improvements and met all relevant fundamental standards. We found recruitment procedures were now robust, thereby ensuring essential checks were completed prior to staff commencing employment. We also found the process for inducting new staff to the service had improved.

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.

Throughout the inspection we received positive feedback from people using the service and the visitors we spoke with. We observed that people were treated with respect, kindness and understanding. We saw staff took account of people’s individual needs and preferences, while supporting them in a dignified way.

People told us they felt safe living at the home. Assessments identified potential risks to people, and management plans were in place to reduce these risks. Staff were knowledgeable about how to recognise signs of potential abuse and aware of the reporting procedures.

We found there was sufficient staff with the right skills and competencies to meet the assessed needs of people living in the home. Overall staff had received training to meet people’s assessed needs, with further training being arranged.

Systems were in place to make sure people received their medications safely, which included key staff receiving medication training.

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 had a varied diet which they said they enjoyed. We saw people could access a range of health care professionals including their GP, district nurses and dieticians.

People had access to activities which provided regular in-house stimulation, as well as trips out into the community. People told us they enjoyed the activities they took part in.

People using the service, relatives and staff were happy with the way the service was run. They spoke positively about the registered manager, who they said was helpful, supportive and a good communicator. There were systems in place for monitoring the quality of the service provided and highlighting areas for improvement. We found the registered manager and staff team listened to and learnt from the feedback of others, to make changes and improve the service.

Further information is in the detailed findings below

The Beeches is situated in the village of Armthorpe on the outskirts of Doncaster. It is a purpose built home providing care for up to 32 older people, including people living with dementia. The home has bedrooms on the first and ground level of the building. None of the bedrooms have en-suite facilities. There is parking and a secure garden at the rear of the building. At the time of our inspection there were 30 people living at the home.

The service had a registered manager in post at the time of our inspection. 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.

The home had a friendly atmosphere which people described as welcoming. Throughout our inspection we saw staff supporting people in an inclusive, caring, responsive and friendly manner. They encouraged people to be as independent as possible, while taking into consideration their abilities and any risks associated with their care. The people we spoke with made positive comments about how staff delivered care and said they were happy with the way the home was managed.

People told us they felt the home was a safe place to live. We saw there were systems and processes in place to protect people from the risk of harm. Staff were knowledgeable about safeguarding people from abuse, and were able to explain the procedures to follow should there be any concerns of this kind. Assessments identified any potential risks to people, such as risk of falling, and care files contained management plans to reduce these risks.

Medicines were stored safely and procedures were in place to ensure they were administered correctly. We saw people received their medications from staff who had been trained to carry out this role.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. However, this had not always been consistently followed. For example, we found one staff member did not have a second reference on file. We also found little evidence to show they had received a structured induction when they started to work at the home. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Staff had access to a varied training programme and support to help them meet the needs of the people who used the service.

People were provided with a choice of healthy food and drink ensuring their nutritional needs were met. We saw specialist diets were provided if needed and the people we spoke with said they were happy with the meals available.

People’s needs had been assessed before they moved into the home to make sure their needs could be met. People living at the home, as well as their relatives, had been involved in planning care. Care files reflected people’s needs and preferences in satisfactory detail, but some lacked details about people’s abilities to do things themselves. Care plans and risk assessments had been reviewed on a regular basis to assess if the planned care was working, or if changes needed to be made.

People had access to a varied activities programme which provided regular in-house and community activities. People told us they enjoyed the activities they took part in, but could choose not to participate if they preferred.

The company’s complaints policy was available to people using or visiting the service. People told us they had no complaints, but would feel comfortable speaking to staff if they had any concerns.

There was a system in place to enable people to share their opinion of the service provided and the general facilities available. We also saw a structured audit system had been used to check if company policies had been followed and the premises were safe and well maintained. Where improvements were needed action plans had been put in place to address shortfalls.

At this inspection we looked at three people's care plans and found clear evidence to confirm people's needs were assessed and care and treatment was delivered in line with their individual care plan.

We spoke with two relatives who told us they were very satisfied with the care provided at the home. One relative said, 'Mum has been here for over two years and the staff look after her very well.' Another relative said, 'Staff always keep me informed if my relative is unwell, they (the staff) are kind and caring.'

People we spoke with said, 'I like living here, staff are very nice, they look after us and make sure we are safe.'

People experienced care, treatment and support that mostly met their needs and protected their rights. One person we spoke with said, 'The staff knows my likes and dislikes.' Relatives said they were mostly happy with the care people received. One relative told us their parent had lived at the home for over two years and they were very satisfied with the care.

There were effective systems in place to reduce the risk and spread of infection. This included staff receiving training in this subject and the provision of protective equipment. Relatives we spoke with told us they always found the home to be clean and fresh.

People received the care and treatment from suitably qualified, skilled and experienced staff. Appropriate checks had been undertaken before staff began work.

The people who lived in the home were kept safe because the provider had taken steps to maintain the building and we saw that regular health and safety checks had been carried out.

People were protected from the risks of unsafe or inappropriate care and treatment because their records had been reviewed and updated regularly. People who used the service was familiar with how to raise concerns.