The Reigate Beaumont

The Reigate Beaumont is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Reigate Beaumont is registered to provide accommodation and personal care for up to 60 people. There were 51 people living at the service at the time of our inspection.

People’s experience of using this service

There were sufficient staff at the service to support people with their needs. Staff were aware of the risks associated with people’s care and ensured that people were provided the most appropriate care. Safety checks were undertaken at the service and there were plans in place to protect people in the event of a fire. People received their medicines when needed. There were People were enabled by staff to be independent with their medicines if they chose this. People were protected from the risk of abuse as appropriate systems were in place.

People were supported to have maximum choice and control of their lives and were supported in the least restrictive way and in their best interests. Policies and systems in the service supported this practice.

Staff received appropriate training in relation to their role and were encouraged to progress. Nurses received clinical supervisions and were provided with updated clinical training. All staff were supervised in their role and staff told us that they felt supported. People told us that they were supported with all their healthcare needs, which was confirmed from records and by health care professionals.

People and relatives told us that staff were kind, caring and respectful towards them. We saw examples of this during the inspection. People were supported and encouraged to remain as independent as possible and were involved in decisions about their care.

There were sufficient activities and outings for people. People who were cared for in their rooms had one to one activities provided and were protected from the risk of social isolation. Care plans were planned around people’s health care needs and staff were provided with sufficient guidance in relation to the health care needs.

There was a comprehensive system in place to assess the quality of care provided. People and relatives knew how to complain and were confident that complaints would be listened to and addressed. People, relatives and staff thought the leadership of the service was robust and effective.

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

Rating at last inspection and update

At the last inspection the service was rated Requires Improvement (the report was published on the 3 July 2018) and there two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Reigate Beaumont on our website at www.cqc.org.uk.

The inspection took place on 20 March 2018 and was unannounced. At the time of our inspection 56 people were living in the home.

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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection.

People’s medicines were not always handled in a safe way by staff. Although we found administration of medicines was not an issue, dispensing and good medicines practices were lacking. We saw staff attending to people’s needs on the day, however we found deployment of staff was not always organised in such a way that people received a staff member’s full attention or received support when they needed it. We also found a lack of attention to detail for some people.

People were cared for by staff who were kind, caring, attentive and showed respect towards them. People could have privacy when they wished it and they were given the opportunity to contribute to their care plan. Information for people was provided in a way they would understand and where there were restrictions in place staff followed the principals of the Mental Capacity Act (2005).

People’s care plans were person centred and where a person’s needs changed staff responded to this. Staff ensured people had access to health care professionals when they needed it as well as to a range of nutritious food. Staff used national guidance to support them to provide effective care. Where people had accidents or incidents staff took appropriate action and as such reflected on incidents to aid their learning.

Risks to people had been identified and guidance was in place for staff. Before people moved into the home their needs were assessed to ensure staff could provide effective, safe and responsive care. The home was adapted to meet people’s needs and staff ensured people were not at risk of infection or abuse because they understood their responsibilities in respect of these. This was aided by the registered provider’s robust recruitment process.

Health and safety and quality assurance processes were in place to check the environment that people lived in was safe and the service people received was of a good quality. In the event of a fire there was fire information available for staff and the emergency services.

People were cared for by a consistent staff team who felt supported by the registered manager and had access to the training and supervision they required in order to carry out their role. Staff worked together as a team and the culture within the service was good. Staff met on a regular basis to discuss all aspects of the service.

People were given the opportunity to give their feedback on the care they received. Although people had access to a range of activities evidence of people who stayed in their room receiving one to one time with staff was lacking. However, people were happy with the care they received from staff and told us they were confident if they had any concerns or complaints these would be addressed.

The registered manager had developed a positive culture within the home. One that was open and transparent. They had worked well with the local authority safeguarding team to investigate any concerns and had developed relationships with other external agencies in order to improve the care people received at the service.

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

The service had a registered manager in post on the day of the inspection visit. ‘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 and associated Regulations about how the service is run.

Risks were well managed and when risks were identified assessments were in place to minimise the risk to people. These were supported by guidance in people’s care plans to help keep them safe.

There were sufficient numbers of staff who were appropriately trained to meet the needs of the people who lived at the service. Staff received regular support in the form of annual appraisals and formal supervision.

Staff recruitment procedures were robust to ensure that staff had appropriate checks undertaken before they commenced employment.

People were protected from the risk of abuse. Staff had received training in safeguarding adults and were able to evidence to us they knew the procedures to follow should they have any concerns. They told us they would report anything they were uneasy with to the nurse in charge.

Medicines were well managed and people had their medicines when they needed them. All medicines were administered and disposed of in a safe way.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the persons rights were protected.

People were encouraged and supported to be involved in their care. People’s bedrooms had been decorated to a good standard and were personalised with their own possessions. One person was able to have their dog with them.

Health care needs were being met. People had access to a range of health care professionals, such as the GP, a community psychiatric nurse, dentist and opticians. Qualified nurses managed some health needs of people.

People told us the food was very good and there was lots of choice. We saw people had access to drinks and snacks at any time during the day or night.

Staff were kind and compassionate. We saw people were treated with and respect and their privacy and dignity was respected at all times. For example staff knocked on people’s doors before they entered their room.

People had individual care plans which gave clear guidance to staff on what support people needed. They were detailed and updated regularly. Relatives told us they had been consulted regarding people’s care plans and were able to attend reviews of care.

The registered manager operated an open door policy and we saw several examples of people, relatives and staff visiting the office to discuss various subjects or just for a chat. The registered manager also ensured she visited people in their rooms if they were unable to access the open door policy.

People were aware of the complaint procedures and told us they would know how to make a complaint. A relative told us they were satisfied with the way their complaint was managed.

The registered manager had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained. The registered manager and deputy manager had systems in place to record and monitor the quality of the service provided and to make improvements where necessary. Accidents and incidents were recorded and acted upon.

People would be protected in the event of an emergency at the home. Staff were aware of the home’s contingency plan, if events occurred that stopped the service running. They explained actions that they would take in any event to keep people safe. The premises provided were safe to use for their intended purpose.

One person told us they chose the home to be near their family and another person who used the service told us that the views were so pretty it was the deciding factor in their choice.

People's needs were assessed and care and treatment was planned and delivered in line with individual care plans. People were involved in their care planning as much as possible. One person who used the service told us the care was excellent and the staff were kind and caring. A relative said the staff always have a welcome smile.

We saw the home was clean and hygienic and people told us their room and bathroom were cleaned daily. We also noted the home provided ample well furbished accommodation for people to enjoy.

People were protected by the safeguarding procedures in place and staff were knowledgeable about these procedures.

The staff told us they felt they had the appropriate training and support to enable them to undertake their roles.

We saw people had access to the home's complaints procedure and they were confident their concerns and suggestions would be listened to and acted upon.

People told us that they were consulted regarding their care and treatment and we saw evidence in individual care plans that reflected their vires.

We were told that the food was good and people attended a meeting with the chef during our visit to discuss menus.

Staff told us that they liked working in the home and that they had the support and training necessary to undertake their roles and responsibilities.

We found the health, safety and welfare of the people who used the service and the staff was observed to be promoted.

The home was managed by an experienced manager with the skills and qualifications necessary to undertake her role efficiently. people we spoke to felt well supported by the management structure in place. We were told "I can always talk to the manager about anything and it will be dealt with efficiently".

We founf systems in place that monitored quality assurance and people told us that they are consulted about how the home is managed and asked for their comments.