This inspection took place on 23 and 24 August 2016 and was unannounced. There were no concerns at the last inspection of December 2013. Beech House provides accommodation and nursing care for up to 55 people. A unit in the home called the Poplars provides care for those people who have a diagnosis of dementia. At the time of our visit there were 55 people living at the service. There was a registered manager in post. 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.
We were introduced to people throughout our visits and they welcomed us. People were relaxed, comfortable and confident in their home. We received positive comments about people’s views and experiences throughout our visits. People and relatives recently wrote in the homes survey, “Please continue to maintain your impressive standards”, “This is my home and I love it”, “Keep up the good work”, and “I consider myself very fortunate to be here”. One relative wrote to the registered manager, “We would like to express our thanks and appreciation to all staff involved in the care of our mother, for their kindness, understanding and support; it was a great comfort to us both”.
Staff involved in this inspection demonstrated a genuine passion for the roles they performed and their individual responsibilities. Visions and plans for the future were understood and shared across the staff team. They embraced new initiatives with the support of the registered manager and colleagues. They continued to look at the needs of people who used the service and ways to improve these so people felt able to make positive changes.
People experienced a lifestyle that met their individual expectations, capacity and preferences. There was a strong sense of empowering people wherever possible and providing facilities where independence would be encouraged and celebrated. People’s health, well-being and safety were paramount.
The registered manager listened to people and staff to ensure there were enough staff on duty to meet people's needs. They demonstrated their responsibilities in recognising changing circumstances within the service and used a risk based approach to help ensure the staffing levels and skill mix was effective. One relative told us, “I like how there is always a staff member in sight and someone on reception, it’s reassuring”.
Staff had the knowledge and skills they needed to carry out their roles effectively. They enjoyed attending training sessions and sharing what they had learnt with colleagues. There was an emphasis on teamwork and unison amongst the staff at all levels. Following a recent review carried out in the Poplars unit by Staffordshire university, they wrote, “There was a range of training opportunities available to staff and a core of highly- committed staff members who had been with the organisation for a number of years. All of these features contribute to the sense of a robust and dynamic organisation that reliably protects the interest of the people for whom it cares”.
People were supported to enjoy a healthy, nutritious, balanced diet whilst promoting and respecting choice. The ‘residents’ annual surveys consistently reflected how much they enjoyed the quality of food, the variety and the constant access to beverages and snacks through the day.
Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that their life experiences remained meaningful. People were supported to maintain their personal interests and hobbies.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). For people who were assessed as not having capacity, records showed that their advocates or families and healthcare professionals were involved in making decisions.
People received appropriate care and support because there were effective systems in place to assess, plan, implement, monitor and evaluate people's needs. People were involved throughout these processes. This ensured their needs were clearly identified and the support they received was meaningful and personalised. One person wrote in a recent survey, “All staff are kind and caring, nothing seems to be a chore or too much trouble for them”.
Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals and where necessary care and support had been changed to accurately reflect people's needs.
People lived meaningful lives and that suited personal interests and hobbies. The service had developed a creative and active community life at the home.
People and relative feedback was a vital part of the quality assurance system either through annual surveys, ‘residents’ meetings, complaints or reviews. People, relatives and staff were listened to and action was taken to make improvements where required. The registered manager monitored and audited the quality of care provided striving to meet the ever changing needs of people living in the home.