The inspection team consisted of an adult social care CQC inspector. On the day of our inspection seven people used the service. We spoke with four people who use the service and three people's relatives, four care workers and the registered manager. We observed how staff supported people, and looked at documents including care plans, staff records and management reports. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask; is the service caring, responsive, safe, effective and well led?
This is a summary of what we found.
Is the service caring?
We found the service was caring. One person told us 'I like the staff, they are very nice and help me'. They told us that they enjoyed the activities and tasks they had been supported to complete, including washing, going out shopping and having a cup of tea in the community. Another person told us they had recently been supported to take a friend out for a meal. 'I love it here, I can go to the pub or have a barbeque for my birthday'.
One relative told us 'They know X well. I can tell from their voice that X is settled and calm there'. Another relative said 'There is an extremely high level of care. Staff can only be described as sheer niceness. They show X love, kindness and gentleness. I have never seen them lose their patience'.
All the care workers we spoke with told us they cared about the people they worked with. One care worker told us 'I really enjoy coming to work'.
Is the service responsive?
The service was responsive to people's needs and wishes. One person told us they had chosen the colour of the walls in their room, and these had been painted 'my favourite colour'. Another person explained how they had been supported to visit their GP, and had been visited by the district nurse to ensure a health need was supported appropriately. They understood the actions necessary to promote their healing.
People told us staff listened to their comments. They said staff understood when they wanted to go out, but listened and respected their wishes if they changed their mind. They told us staff helped them to maintain their friendships with people in another service. One care worker told us 'The residents are brilliant. They always want you to be there. They tell you and show you what they want you to do'. This meant staff understood people's wishes, and responded appropriately to support these.
A relative told us their loved one appeared happier and more content since living at Beech Gardens. They explained how the staff had taken actions to promote the person's wellbeing, and provided reassurance to help them to manage their anxieties.
We found the service met the requirements of the Deprivation of Liberty Safeguards. The manager was reviewing whether any applications needed to be made in response to the recent supreme court judgement in relation to Deprivation of Liberty Safeguards.
Is the service safe?
We found the service was safe. One person told us 'Everything is as it should be'. We saw people had attended training about safeguarding, and understood the actions to take to report any concerns about their safety or care. People told us they had undertaken fire drills to ensure they understood the actions to take in the event of fire. This meant people understood the actions to take in the event of potential harm.
The provider identified risks and hazards, and had taken appropriate actions to reduce the impact of these. We saw risks had been identified in relation to each person's activities, hobbies and behaviour. Records documented how risks had been discussed with people, and measures taken to reduce identified risks in agreement with each individual. This meant people and others had been protected from potential harm.
The service had been well maintained. The maintenance team and care workers ensured checks and servicing had been completed in accordance with the provider's and manufacturers' guidance. This showed us the provider understood appropriate actions to follow to protect people and others from an unsafe environment.
Is the service effective?
We found the service had effective processes in place to ensure people received quality care. One person told us 'There is nothing that isn't good about my home'. A relative told us 'They [staff] take good care of X. They know how to handle things". They told us staff understood their loved one, and knew how to support them.
We observed and saw evidence to demonstrate that staff ensured people received the care and support they wanted. People's needs had been assessed, and were regularly reviewed, to ensure they received the care they required. Feedback had been sought from people and their relatives to ensure staff effectively implemented changes requested when it was appropriate to do so.
Staff attended training to ensure they learnt and maintained the skills required to support people. We saw this training had been refreshed and assessed to ensure staff implemented training effectively.
Is the service well led?
One person told us 'X [the registered manager] is a nice man'. We observed people living at Beech Gardens smiled when they saw the manager, knew them by name and approached them for support. This indicated to us that they liked and trusted the manager. Staff told us they felt supported, and commented that the manager had an 'Open door policy'. This meant that staff knew they could ask for assistance and guidance when this was required.
We saw records demonstrated that staff had been supported through supervisions and appraisal to identify topics where they required additional support, training or development. Staff told us supervisions provided an opportunity for two way discussions. Mandatory training had been kept updated. This meant staff had been supported to learn, and ensured that people were supported by people with the skills to safely do so.