Beaconville Nursing Home

The registered manager has made significant progress since the previous assessment, where they had been in breach of regulations relating to safe care and treatment, consent to care and treatment, good governance, staffing, and fit and proper persons (recruitment). The registered manager has taken effective action to address previously identified shortfalls, and clear improvements were evident during this assessment. For example, staff now benefit from strengthened guidance on supporting people with SALT (Speech and Language Therapy) needs and catheter care. The registered manager is also now consistently submitting statutory notifications to the Care Quality Commission as required. Systems and processes are operating effectively, and as a result, the provider is no longer in breach of these regulations.

Leadership was visible and approachable, and there was a culture of openness and learning. Audits and improvement plans were in place, and staff and relatives felt able to raise concerns. However, governance systems were not consistently effective, as some safety actions remained outstanding.

The environment needed further improvement, for example there was an overdue Legionella risk assessment and some areas in the building needed decorating. Medicines were managed well overall, but ensuring medicines cupboards were secure was not always consistent.

People told us they generally felt safe and supported, and staff were observed to be caring and respectful. Staff understood safeguarding processes which were acted upon, and notifications were submitted to CQC when required. Staffing levels were mostly appropriate, with good training compliance and contingency plans in place.

Care planning was detailed and person-centred, and staff worked collaboratively with professionals to meet people’s health and social care needs. People were supported to maintain their health and wellbeing, although monitoring of outcomes and consent documentation was not always completed. For more information, see specific quality statement, in the effective section, relating to monitoring and improving outcomes and consent to care and treatment.

Overall, the service demonstrated a caring approach and commitment to improvement, but consistency in governance and proactive safety measures required further development.