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Inspection carried out on 12 June 2018

During a routine inspection

This inspection took place on 12 June 2018 and was announced. At the last inspection on 01 June 2017, the service was rated as requires improvement. We asked the provider to take action to make improvements regarding fire safety, storage of COSHH (Control of Substances Hazardous to Health) materials, how accidents or incidents were investigated and the risk of people, visitors and staff consuming contaminated water. This action has been completed.

The Beeches (Seven Kings) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service provides care and accommodation for up to ten people with a history of mental illness. At the time of our visit, there were eight people using the service.

There was no registered manager in place. The manager was in the process of applying to register with us. 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.

People were supported in safe way and staff had a good understanding on the actions to take to reduce risks to their well-being. The provider had safeguarding policies and procedures.

There was enough staff employed to meet people's care needs. Recruitment procedures were robust to ensure staff employed were suitable to support people.

People were supported by staff that had been trained to administer their medicines safely.

The service was clean and tidy. Staff knew how to use safe infection control practices to help people avoid infections.

Staff received training and support to ensure they had the skills to provide people's support in a safe way. New staff received induction training to provide them with the skills to care for people.

The manager and staff understood their responsibility to comply with the requirement of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People were supported to make choices and had control over their lives. Staff respected people’s privacy and dignity and people were encouraged to be independent. There were good interactions between staff and people who used the service. People and relatives said staff were kind and caring.

People were involved in planning the care and support provided by the service. They received health support from staff that knew them well and understood their individual needs. People’s dietary needs were taken into account and their nutritional needs were monitored appropriately.

Records showed people had regular access to health and social care professionals. Staff had a good understanding of people’s needs, choices and preferences, and were aware of how to meet people’s individual needs as they changed. There were suitable activities for people to join in.

The provider had a complaints procedure which people could access and made aware of. The manager ensured that any issues raised were resolved to the satisfaction of the person.

The provider sought the views of people who used the service, staff, relatives and professionals and responded to them to help improve the service. There were regular audits carried out to ensure the quality of the service provided was maintained.

Inspection carried out on 1 June 2017

During a routine inspection

This inspection took place on 1 June 2017 and was unannounced. At our last inspection in June 2015, we found the provider was meeting the regulations we inspected.

The Beeches (Seven Kings) is registered to provide care and accommodation for up to ten people with a history of mental illness. At the time of our visit, eight people were using the service including one person who was not well and was in hospital.

There was a registered manager in place. 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.

During our visit, we found the provider was failing in its duty to ensure people, staff and visitors to the service were safe as we identified a number of health and safety concerns.

Quality assurance systems were in place and audits were regularly carried out. However, improvements were needed in those areas.

The provider had a complaints procedure available for people and their relatives to use and staff were aware of the procedure. People were able to express their views to the staff or the registered manager.

People said they felt safe living at the service and around the staff. Staff were knowledgeable about the procedures to ensure that people were protected from harm and knew how to report any potential abuse.

Risk assessments were clear and staff understood individual risks to people.

There were enough staff to meet people's needs and provide them with effective care and support. The provider ensured all new staff had the relevant checks carried out before they started working at the service. Staff received regular training and supervision.

Staff respected and maintained people's privacy and promoted their independence. They supported people to take part in their chosen activities. Staff understood people's needs and preferences. There was a system in place to ensure relevant information was passed between staff.

People were provided with a varied menu and had a choice of what they would like to eat or drink.

The staff and the registered manager had a good understanding of their role to ensure people's rights were maintained. People's consent was sought before care was provided.

People received their medicines when they needed them. They were supported to access a range of health care professionals.

Care records were detailed and up to date. They were person centred and individualised. People were involved in making decisions about their care and support.

People, relatives and staff felt the service was run well. There was an open culture within the service.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

Inspection carried out on 24/06/2015

During an inspection to make sure that the improvements required had been made

This inspection took place on 24 June 2015 and was unannounced. At the last inspection on 09 April 2015 we found the service to be breaching regulations as staff were not adhering to safe administration of medicines. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Beeches (Seven Kings) on our website at www.cqc.org.uk.

The Beeches (Seven Kings) is registered to provide care and accommodation for up to ten people with a history of mental illness.

There is a registered manager in place. 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 this inspection we found the registered manager had taken sufficient action to ensure people received their medicines safely.

Inspection carried out on 09/04/2015

During a routine inspection

This inspection took place on 9 April 2015 and was unannounced. At our last inspection in August 2014 we found the provider was meeting the regulations we inspected.

The Beeches (Seven Kings) is registered to provide care and accommodation for up to ten people with a history of mental illness.

There was a registered manager in place. 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.

Staff were not adhering to safe administration of medicines and this was a breach of the regulation relating to safe care and treatment. You can see the action we have told the provider to take at the back of this report.

People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening.

We observed the way staff interacted with the people using the service and saw they treated people with respect and dignity. There were enough staff on duty to meet the needs of the people living at the home.

There was appropriate guidance for staff on how to manage these risks and keep people safe. We found people’s diverse needs had been recorded and saw that care and support was provided in accordance with people’s wishes.

People were supported to eat and drink sufficient amounts of nutritionally well-balanced food and drink that met their needs. People were able to express their views and were involved in making decisions about their care and treatment. People’s preferences and likes and dislikes were clearly identified in their care records so staff had the necessary information to care for and support them appropriately.

The staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). They were aware of how to support people who could not make decisions for themselves when required. Staff had received training to meet the needs of people using the service and were well supported by the management of the service. Appropriate checks were carried out before staff began work.

The provider carried out regular checks to assess and monitor the quality of service provided. People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

Inspection carried out on 7 August 2014

During an inspection to make sure that the improvements required had been made

A single inspector carried out this inspection. The focus of the inspection was to check if the service was administering medicines safely to people who used the service. During an inspection on 15/05/14 we sampled the medicines administration records and noted some missing signatures. There were instances where prescribed medicines had been administered but not signed for. This meant that procedures on administration of medicines were not being followed.

During this visit we found that the provider had taken appropriate action to protect people against the risks associated with the unsafe management of medicines. We looked at the records for monitoring the medicines given to people and these had been signed to indicate that people had received their medicines on time.

Inspection carried out on 15 May 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found

Is the service safe?

People told us they felt safe living at the service. We found the provider had taken steps to ensure people were protected from the risk of abuse and staff had undertaken safeguarding training.

We sampled the medication administration records and noted some missing signatures. There were instances where prescribed medication had been administered but not signed for. This meant that procedures on administration of medication were not being followed.

Is the service effective?

People told us that they felt respected and involved in their care and running of the service. We looked at a sample of care plans and found them to be well organised and reflective of the care and support that people were currently receiving. Information about the involvement of healthcare professionals in people’s care was available in their care plans so that staff had the necessary information to support people to meet their healthcare needs.

Is the service caring?

People who used the service told us they were satisfied with the care and support they received. From our own observations we saw staff treated people using the service with dignity and respect. Staff were aware of people’s preferences and routines so they could support people in their daily lives.

Is the service responsive?

Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe. People told us they did not have any complaints but would not hesitate to speak to the manger or staff if they had any concerns. Comments and complaints people made were responded to appropriately.

Is the service well-led?

People were supported in promoting their independence and community involvement. People were given opportunities to express their choices and to make decisions in their daily lives. Staff helped them in the way that they preferred and they had their wishes, privacy, dignity and independence respected.

Inspection carried out on 23 August 2013

During a routine inspection

The service was providing care to nine people with mental health needs. We spoke with four people as part of the inspection. People using the service were happy with their care. One person said, "I am comfortable here." Another person said, "the staff are friendly people."

The service assessed people's individual needs and preferences to ensure they received appropriate support. People told us they were offered choices and their wishes were respected. Staff obtained people's consent before providing care. The staff worked with other professionals to help people gain independent living skills and encouraged people to take part in activities and the local community. People told us they liked their rooms and we saw that the environment was comfortable, suitably furnished and clean.

People using the service were positive about the staff and described them as "helpful". Staff told us they had received effective induction, training and supervision to carry out their roles. The senior staff actively monitored the quality of care in the home. The manager sought feedback about the service and was responsive to suggestions for improvement.

Inspection carried out on 28 February 2013

During a routine inspection

There are eight people currently living in this home. We spoke to three of the people who were at the home the day we visited. They each said they were happy living here. One person told us ''I can choose what I want to eat and I can go out and meet my friends''. Another person told us about the holiday they are going on later in the year they said they are ''Very excited and we went to Spain last year and that was great''.

We saw that the care plans are reviewed every six months, they are personalised and each person is involved in their own care plan. There are detailed risk assessments linked to each persons care plans and their chosen activities.

Staff receive regular training and complete mandatory training when required. Regular appraisals and supervision takes place with staff and staff felt trained to deliver the care to people in this home. All staff have had safeguarding training and the staff we spoke to can detail what could be classified as abuse.

There are regular meetings and feedback opportunities with people who live here staff and health professionals. If concerns are identified these are actioned in line with company policies.

The two relatives we spoke to are very happy with the care and support offered to their relatives at this home. They have no concerns and the manager is in contact frequently , they visit regularly and staff are always there to talk to.

Inspection carried out on 15 December 2011

During a routine inspection

People using the service told us that they enjoyed living at the Beeches because they were supported to do the things that they wanted to do. One person told us, “Everything is good here, I get support from the staff who are excellent and I make the choices that I like.” This person also told us that they received good support to access healthcare services in the community to meet their needs. Another person told us, “Staff are good, they listen to you. They made me better here. I didn’t know where I was before I came here. This is a good home.” All the people we spoke with were positive about the service they received at the Beeches.

People told us that the staff treated them with respect and that they were always available to help them when they needed it.