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Inspection carried out on 8 March 2019

During a routine inspection

About the service: Chorleywood Beaumont is a nursing home that was providing personal and nursing care to 49 people aged 65 and over at the time of the inspection. There is a specialist unit called ‘memory lane’ which provides care to people living with dementia. Some people were living with complex healthcare needs.

People’s experience of using this service:

Staff knew how to recognise and respond to abuse.

Potential risks to people had been identified and recorded and there was clear guidance in place to help manage the risks.

Regular checks were carried out on the environment and equipment to ensure it was safe and fit for use. The service was clean and there were systems and processes in place to prevent the spread of infection.

There was enough staff to keep people safe. Staff were checked to ensure they were safe to work with people, before they started working at the service.

Medicines were managed safely.

People and their relatives said that staff were kind and caring. Staff knew people well and their likes and dislikes. People were treated with dignity and respect. People received compassionate support at the end of their lives.

People were encouraged to be as independent as possible. Staff encouraged people to do as much as they could for themselves.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Detailed assessments were completed before people moved into the service. People's care plans were updated regularly when their needs changed. People took part in a variety of activities within the service.

Staff told us they felt supported by the registered manager and received the regular supervision and appropriate training to complete their roles effectively.

People told us that they thought the registered manager was approachable and people knew how to complain if necessary.

The registered manager, senior staff and representatives of the provider carried out regular checks and audits to ensure people received consistent, high quality care. There were regular meetings of staff, people and their relatives to gather their views.

Rating at last inspection: At the last inspection the service was rated Good. (Report published 7 July 2016)

Why we inspected: This was a planned inspection based on the previous rating of the service.

Follow up:

We will continue to monitor the service and will re-inspect in line with our return schedule.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 29 March 2016

During a routine inspection

This inspection took place on 29 March 2016 and was unannounced. The home provides accommodation and personal care for up to 55 older people, some of whom may be living with dementia. On the day of the inspection, there were 53 people living in the home.

The service has a registered manager. 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 safe and there were systems in place to safeguard people from the possible risk of harm. There were risk assessments that gave guidance to staff on how risks to people could be minimised. Risks to each person had been assessed and managed appropriately.

The service followed safe recruitment procedures and there were sufficient numbers of suitable staff to keep people safe and meet their needs. There were safe systems for the management of people’s medicines and they received their medicines regularly and on time.

People were supported by staff who were trained, skilled and knowledgeable on how to meet their individual needs. Staff received supervision and support, and were competent in their roles.

Staff were aware of how to support people who lacked the mental capacity to make decisions for themselves and had received training in Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards. People’s nutritional needs were met and they were supported to have enough to eat and drink. They were also supported to access other health and social care services when required.

People were treated with respect and their privacy and dignity was promoted. People were involved in decisions about their care and support they received.

People had their care needs assessed, reviewed and delivered in a way that mattered to them. They were supported to pursue their social interests and hobbies and to participate in activities provided at the home. There was an effective complaints procedure in place.

There were systems in place to seek the views of people, their relatives and other stakeholders. Regular checks and audits relating to the quality of service delivery were carried out. There were effective systems in place to monitor the quality of the service.

Inspection carried out on 27 September 2013

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

Following our previous inspection on 25 January 2013, it was found that the provider was not compliant with regulation 15 of the Health and Social Care Act 2008(Regulated Activities) Regulation 2010. On our follow- up inspection we found that the home was now complaint with that regulation.

The home had recently converted a bedroom into an additional lounge; this provided sufficient communal seating for people who were living with dementia. People we spoke with said that they liked the new lounge.

We saw evidence that the home supported staff by having regular team meetings during which staff were given the opportunity to discuss any concerns they may have. Supervisions and appraisals were undertaken by the home but the records did not always show that staff were given an opportunity to voice their opinions during supervision and the appraisal system did not document why staff ‘self-grading’s’ were changed. Staff had received mandatory training which supported them to support people who used the service.

Inspection carried out on 25 January 2013

During a routine inspection

The people who lived in the home told us that they were very happy with their care. They told us that the staff were very kind and caring and that 'the staff treat us kindly', 'they are considerate', 'I am very well looked after and comfortable'. We were told that some of the food was variable and we found that some of the food served on the day may not have been suited to people who had swallowing difficulties. We told the manager of the home about the food and we were assured it would be addressed straight away. We were told that the staff were respectful to the people and that the people felt respected as adults who had lived a full life.

The people told us about their house meetings with the manager and how they decided on the social events in the home. During our visit we observed people being taken to the cinema. On their return we overheard a lively discussion on the film they had seen and we were told that they had a ‘lovely time’.

Although we found the premises clean and fresh with an appropriate amount of communal space for most of the people. However, people living in the ‘Memory Lane’ part of the home were subjected to cramped communal areas that did not meet their needs. The home had improved since our last visit in March 2012. During this visit we found that the home was not meeting the needs of all the people appropriately.

People’s health and welfare had been monitored and we saw that people’s independence and dignity had been promoted

Inspection carried out on 15 March 2012

During a routine inspection

The people who use the service told us that they have no complaints. They said that the staff were lovely and would do anything for them. One person was planning a special birthday and told us that the staff made a ‘fuss’ of them which they enjoyed. They told us that they felt safe in the home and that the staff were trained to care for them.

They told us that they were involved in the running of the home by attending meetings with the manager. They told us that the manager listened to them and planned social activities that met their wishes.

Inspection carried out on 23 December 2010

During an inspection in response to concerns

When we spoke to people who use this service, we received differing views about the standard of the food provided. Some people said that it is variable;’ up and down' as one person put it. One person thought that the choice offered was repetitive and those who had lived in the service for longest all thought the standard was not as good now as it used to be. On the other hand, even those who had some reservations about the food said that it could be very good at times and of those spoken to, several were looking forward to their Christmas meal, which had been outstanding last year. At least one person was very complimentary about the quality of the food and one relative of a person who had lived in the home for over a year indicated that they had thought the food was excellent.

All of those spoken too confirmed that they had a number of choices for each meal and most felt that they could ask for alternatives which would be readily provided. We were told that there is usually a choice of venues for meals, including more than one dining room on most occasions and also the opportunity to take meals in their own rooms if they preferred.

All residents that were spoken to during the visit about things like heating, hot water and cleanliness, told us that these were very satisfactory and had no complaints.

The views of those people we spoke to about staffing levels were varied. Concerns included views that staffing levels had been cut back, that call bells were sometimes not answered quickly enough and that there were not enough staff. Whilst others felt that response times were reasonable given the number of people staff had to help. All of those spoken to were complimentary about the standard of personal care they were given and one relative paid tribute to the level of individual care and understanding their relative had received during their time in the home. One recurring theme from all those spoken to was that the recent series of management changes had not been helpful and that the home would benefit significantly from the appointment of a suitable person into the manager post, who could bring some stability and consistency to the home..

Reports under our old system of regulation (including those from before CQC was created)