Beeston View is a purpose built care home for people with dementia, run by Barchester Healthcare Homes Limited. The care home is on the same site as Iddenshall Hall. The grounds and gardens are accessible to people who use the service. Bedroom accommodation consists of 48 single rooms all which have en-suite shower facilities.

At the last inspection in July 2014, the service was rated as Good. At this inspection we found the service remained Good. Our last visit had identified improvement needed in the provision of activities and our question about the service being responsive had reflected this. Despite this, the rating for the service had been assessed as good overall. This visit found that a robust programme of activities were in place of people who used the service.

The registered provider had systems in place to ensure the safety of the people who used the service. This included arrangements for identifying, reporting and taking action on any allegations of abuse. This was reinforced through training for staff, staff knowledge and reporting processes. People’s safety was further enhanced through assessments for individuals identifying risks they faced from the environment or from risks associated with their own health and social needs. The registered provider ensured that a system for the safe management of medication was in place and that the premises were well maintained and hygienic.

The registered provider took the requirement of the Mental Capacity Act 2005 (MCA) and associated safeguards into account. This meant they were working within the law to support and assist people who may lack capacity to make their own decisions. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People who used the service were supported by a staff team who had received the training and had the knowledge to best support them. The nutritional needs of people were met. Consideration was made to the dietary needs of people, their personal preferences and ensuring that those who were at risk of choking could eat safely.

Staff interactions were friendly, caring and supportive. People were supported in a patient manner with people supported in a respectful manner. Staff ensured that people were treated as individuals and had their privacy and dignity take into account through care practice. People were given information about their care and the support they could be provided with.

Care plans provided staff with the information they need to successfully support people in all aspects of their daily lives. Care plans were reviewed and updated when required. A robust activities programme was in place and activity co-ordinators employed to provide carried and regular activities. Records maintained in respect of activities complimented care plans maintained by the service so that a whole picture of people’s progress could be achieved.

Information was in place in respect of how people could make a complaint. Complaints records were maintained and concerns responded to in a timely manner.

The registered manager used a variety of methods to assess and monitor the quality of the Beeston View. These included regular audits of the service and staff and resident meetings to seek the views of people about the quality of care being provided. The registered manager had provided feedback to people about the rating that we had applied at our last visit. The registered manager always notified us of significant incidents within the service as required.

Further information is in the detailed findings below

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

We carried out this inspection on 21 July 2014 and this was an unannounced inspection. 

The previous inspection was carried out on 1 May 2013.  All areas reviewed met the current regulations.

Beeston View is a purpose built care home for people living with dementia, run by Barchester Healthcare Homes Limited. The care home is on the same site as Iddenshall Hall, which is a care home that is owned by the same company. The grounds and gardens are accessible to people who use the service. Bedroom accommodation consists of 48 single rooms all which have en-suite shower facilities. At the time of this inspection there were 43 people living at Beeston View. 

The registered manager has been registered with the commission since July 2014.  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.

People told us that they were happy living at the home and they felt that the staff understood their care needs. People commented “The staff are kind”, “I like it here”, “Mum is safe here” and “This is the best place I have been in.”  However, relatives also raised concerns with regard to people being dressed in night clothes in the early evening; not being dressed in their own clothes; and some personal care needs not being fully met.

We found that people, where possible were involved in decisions about their care and support. Staff made appropriate referrals to other professionals and community services, such as the GP, where it had been identified that there were changes in someone’s health needs. We saw the staff we observed were kind and thoughtful towards them and treated them with respect.

We found the home was clean, hygienic and well maintained.

Records showed that CQC had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.

We looked at the care records of five people who lived at the home. We found there was detailed information about the support people required and that it was written in a way that recognised people’s needs. This meant that the person was put at the centre of what was being described. We saw that all records were well recorded and up to date.

We found the home had systems in place to ensure that people were protected from the risk of potential harm or abuse.  We saw the home had policies and procedures in place to guide staff in relation to the Mental Capacity Act 2005 and deprivation of liberty safeguards (DoLS), safeguarding and staff recruitment. This meant that staff had documents available to them to help them understand the risk of potential harm or abuse of people who lived at Beeston View.

We found that good recruitment practices were in place and that pre-employment checks were completed prior to a new member of staff working at the service. This meant that the people who lived at Beeston View could be confident that they were protected from staff who were known to be unsuitable.

We found on the day of the inspection that there was a lack of activities accessible for people. We found that there were no planned activities on the day of our visit. Relatives told us that they hadn’t seen activities taking place and one relative told us their relative had not been involved in any activities. Relatives and staff were concerned about the staffing levels particularly on the upstairs unit. During our observations, we saw that sufficient staff were on duty. Following the inspection the registered manager confirmed that sufficient staff were always on duty to meet the needs of the people who lived at Beeston View. 

We looked at the care records of four people who lived at Beeston View and the files of four staff members. The inspector spoke to three people who lived at Beeston View, three staff, the deputy and registered manager. The expert by experience spoke to three people who lived there, four staff and seven visitors. Observations during the lunchtime were undertaken.

Comments from people who lived at Beeston View included, “I was asked whether or not I would be happy to have a male carer - I said not at my age", "They are very friendly and helpful - you can always get what you want if you ask and don’t have to wait long", "They are busy but have time talk to you and have a joke - I feel very safe here and have no complaints at all” and “I've found staff okay and seems enough to me. They have time for you. Can go to any one of the staff if I have a problem and they wll see to it.”

Comments from visitors included, “Mum was involved in Dad’s care plan. Any problems and she speaks to the senior carer or unit manager and they are soon sorted. All the family feel dad is safe and well cared for”, “Staff try so hard - they’re patient and caring – that’s at all levels and are so helpful and friendly - nothing is too much trouble."

Comments from staff included ”At the moment there is enough staff to meet resident’s needs because we are a few residents down but some days we are rushed if someone phones in sick or if we have residents who are ill. Mealtimes can be rather hectic”

We made observations of the support provided to the people who used the service during a meal time. We observed that staff were patient, friendly and caring in their interactions. They were attentive and sensitive to people’s needs.

We spoke to two people who used the service who said they were well looked after and happy with the service they received. Some comments made were:-

“It’s wonderful here. The staff are lovely and so supportive. I think my care and health needs are very well met.”

“I choose my food and clothes. I go to bed when I like. I’m well cared for. You can always find a member of staff.”

We spoke to three relatives who said that they were overall happy with the care and support provided.

Records showed that people had been assessed before they began to use the service and they had a care plan in place detailing the support they needed.

There were practices in place to ensure that the recruitment of staff appropriately supported the people who used the service.

The home was clean and there were procedures and training in place to promote hygiene and prevent infection.

There were systems in place to obtain the views of the people who used the service and their relatives about how the service operated. The home operated an effective system for the management of complaints.

We asked Cheshire West and Chester Council for information about how the service operated. No information of concern was reported.

We spoke to people who use the service and they said:

“The staff are very nice.”

“I like living here.”

“The food is very good.”

We spoke with relatives of the people who use the service and they commented:

“My relative has been here three and a half years. The family chose the home. We have no concerns about the care given. The staff approach is very good and we like the way staff seem to know mother well. The food is good and we visit regularly.”

“My relative has been here two years. The family choose the home, we looked at various homes in the area and chose this one as it was the best organised and best staffed. Also we had a recommendation from a friend about the home.”

“Very pleased with the care given and we are always made to feel welcome. We have no concerns or complaints. Meals are very good with choices available. When my relative returned from hospital the staff were very upset about the way he came home, and they have helped him recover well. The staff do a wonderful job.”

“My relative has lived here for three and a half years. One of the family chose the home, with a recommendation that this was a good home. The care is good and we are delighted with the home. The staff are very welcoming and the people are well cared for. There is no unpleasant smell in the home. I see the unit manager often and she is very good and will deal with any issues raised. She also keeps in contact by phone with us.”

We spoke with staff and they commented:

“I enjoy my job and I am fairly new in my role.”

“I have worked here for 3 years. I enjoy my job and the staff are friendly. The place has a homely atmosphere. The home is quite good to keep clean and enough products are available to keep it fresh and clean.”

“The staff team is good. I like working here. The training is good and I like the e-learning.”

“I have worked here for a long time. The staff are lovely and we have a good range of training. I enjoy my job and get good support from the management team.”

We also spoke with other professionals, they commented:

“I am happy with the home. The staff are very good and enthusiastic.”

“Staff are kind and they know the residents well. Staff respond well to information and support given to them. Get good support from the management team.”