Beechill Nursing Home

There are 23 single rooms and four double rooms across two floors. Each floor has shared bathrooms and toilet facilities.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports the Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

The home could not evidence the safe recruitment of staff. References were not in place and there was no evidence of these being requested or chased up. A generic risk assessment was used where there were no references, but this did not evidence additional support for the new staff to ensure they were suitable for working with vulnerable adults.

Assessments of people's capacity to make their own decisions were completed when they moved into Beechill. Applications for a Deprivation of Liberty Safeguards were made where applicable. However, people's capacity to make decisions was not regularly reviewed. This meant people were not always supported to have maximum choice and control of their lives. We have made a recommendation for formal capacity assessments to be regularly reviewed.

From our observations, and feedback from people and relatives, staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported support this practice.

There were enough staff to meet people's needs. People and relatives were complimentary about the staff and said communication with the home was good. Staff received the training they needed for their roles.

Staff felt well supported by the management team. A new activities coordinator had been appointed and was starting to develop a range of activities within the home and out in the local community.

Risk assessments and care plans were in place and were regularly reviewed. Staff knew people and their needs well. People received their medicines as prescribed. Some guidance for when 'as required' medicines should be administered needed to be more personalised. The home was clean throughout and PPE was used appropriately.

People were supported to maintain their health and nutritional intake. Referrals to medical professionals were made appropriately. Where appropriate, people were supported to manage their drug or alcohol misuse.

An electronic quality assurance system was now in place. Audits were regularly completed, and actions identified. Action following the local authority pilot visits had been completed or were in progress. We have made a recommendation for the staff file audit to be reviewed.