This inspection took place on 5 and 12 October 2018. The first day was unannounced. Beachlands 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. Beachlands is registered to provide care and accommodation to 29 people. There were 27 people living in the service when we visited. People cared for were mainly older people who were living with a range of care needs, including arthritis, diabetes and heart conditions. Some people were also living with dementia. Some people needed support with their personal care, eating, drinking or mobility.

Accommodation was provided mainly on the ground floor, with a few rooms on the first floor. The service is situated in a quiet residential street in the East Sussex town of Seaford.

The last inspection of Beachlands was on 19 and 20 February 2018. At that inspection, the service was rated as Inadequate and the service was placed in special measures. This was because some people’s risk had not been appropriately assessed and the provider had not assessed if there were enough staff deployed to meet people’s needs. The provider had also not ensured the requirements of the Mental Capacity Act 2005 (MCA) were being followed and some people did not receive the support they needed where they had additional healthcare or nutritional needs. Also, staff had not been trained in relevant areas and people’s privacy, dignity and independence were not always supported. Some people's care plans did not clearly set out how they needed to be cared for, some staff did not follow people's care plans and although there were recreational activities provided, these were not accessible to all of the people. We also found systems for monitoring quality and safety were not effective and some records were not accurately completed.

After the last inspection, we followed our enforcement procedure to ensure the provider made the required improvements. We undertook this unannounced comprehensive inspection to check on the improvements made by the provider. We found the provider had been successful in making some improvements and the key question Caring is now rated as Good. The provider had also met regulations in relation to people’s safety and meeting the requirements of the MCA. The provider is no longer in special measures. However, the provider still needed to undertake further work to ensure people’s care plans set out how they needed to be cared for and they were followed by staff. Further improvements were needed to ensure the safety and quality of the service. This means, although improvements have been made, the service remains in breach of two Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service is now rated as Requires Improvement.

The service had 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. The provider for the service also owns another service as a separate legal entity. That service is also rated as Requires Improvement.

As at the last inspection, the provider had not ensured all people had person-centred care plans to outline how their individual needs were to be met and these were followed by staff. This included care plans for people who were living with dementia and people who chose not to leave their own rooms.

As at the last inspection, the provider’s audit systems did not to identify a range of areas to ensure safety and quality of care for people. This was because the provider’s audits did not cover all areas of care delivery, including the accu

This inspection took place on 19 and 20 February 2018. The first day was unannounced. At the last inspection of Beachlands Residential Care Home (Beachlands) in December 2016 and January 2017, the overall rating was requires improvement. At that inspection, we found breaches in Regulations 9, 11 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because care plans were not reflective of people’s individual health and social needs and there were not enough meaningful activities for people to participate in. Mental capacity assessments for people who had limited capacity were not always followed or reflective of individual needs. Systems for monitoring quality were not always effective.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key questions effective, responsive and well led to at least good. We undertook this unannounced comprehensive inspection to look at all aspects of the service and to check that the provider had followed their action plan. This inspection showed improvements had not been made and the service remained in breach of Regulations 9, 11 and 17. Additionally this inspection found the service was in breach of Regulation 12. The overall rating for Beachlands has been rated as Inadequate.

Beachlands 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. Beachlands provides accommodation and care for up to 29 people. There were 26 people living at the service when we inspected. People cared for were mainly older people who were living with a range of care needs, including arthritis, diabetes and heart conditions. Some people needed support with their personal care and mobility. Some of the people were also living with dementia.

Accommodation was provided mainly on the ground floor, with a few rooms on the first floor. The service was situated in a quiet residential street in the East Sussex town of Seaford.

The service had 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. The provider for the service is Beachlands Care Limited and Beachlands is their only registered premises.

As at the last inspection, the provider did not to identify a range of areas to ensure safety and quality of care for people. The provider told us that, due to difficulties with the recruitment of permanent staff, the service had been using agency care workers to provide much of the care to people for an extended period of time. Agency care workers were not given the information they needed to enable them to care for people safely. The provider had not identified that agency care workers were not always being supervised in their roles to ensure they provided people with safe and quality care. The provider had not ensured that their audits covered all areas of care delivery or ensured that all other audits were completed to the same standard. This included medicines audits and the accurate and full completion of people’s records.

As at the last inspection, the provider had not ensured all people had assessments and care plans to outline how their needs were to be met. This included assessments and care plans relating to people’s mobility, communication needs, continence care and for people who were living with dementia. Some activities provision had been started since the last inspection but these did not take place every day and they were aimed at people who were able to come to the main lounge. Peop

This inspection took place on 8 and 15 December 2016 and was unannounced. A third day of inspection took place on the 20 January 2017 and was announced. Beachlands Residential Care Home provides care and support for up to 29 people with care and support needs related to age, who may also have a diagnosis of dementia. There were 21 people living in the home at the time of our inspection.

The home had 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.

Care plans did not all reflect people’s assessed level of care needs as they changed. The lack of meaningful activities for people, specifically those who lived with dementia, at this time impacted on people’s well-being.

The registered manager demonstrated empathy for the people who used the service and worked hard to deliver good care. However, the quality assurance systems did not show how they reflected on their practice and drove continuous improvement.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The provider, registered manager and staff did not all have a good understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Where people’s health needs had changed, such as not eating and drinking, care plans did not always reflect the changes and demonstrate the actions staff had taken to ensure their health. Information was not always readily available on people’s life history and there was no evidence that people were involved in their care plan.

Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. During the inspection process, immediate improvements had been made to the medicine documentation by securing the assistance from the dispensing pharmacist.

Risks associated with the environment and equipment had been identified on the first day of the inspection and these were immediately managed to mitigate the risk of harm to people.

Accidents and incidents were recorded appropriately and steps taken by the home to minimise the risk of similar events happening in the future. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place. Staff retention was good and most staff we spoke with had worked at Beachlands for many years.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, such as diabetes and dementia. Staff had received both one to one and group supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place.

People were encouraged and supported to eat and drink well. One person said, “I like the food, its nice food.” There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.

People we spoke with were complimentary about the caring nature of some of the staff. People told us care staff were kind and compassionate.

We found a number of breaches of the

During our inspection we spoke with five people who used the service. We also spoke with four members of staff including the manager, the lead carer and two care workers. We also spoke with one of the directors. We looked at care documentation, records, audits and minutes of meetings.

People who used the service told us that they liked living at the home, they were happy with the care and treatment they received and the service met their needs. They told us that staff were “kind and caring” and there was always someone around to provide help and support. One person who used the service told us, "I'm very happy here and have no complaints".

We saw that individual care plans provided structure and guidance for care workers, to ensure that the assessed current and on-going support needs of people using the service could be met consistently and safely.

People who used the service confirmed that they felt safe in the home.

Satisfactory recruitment procedures were in place.

People were protected against the risks associated with medication because the provider had appropriate arrangements in place to manage medicines.

The service had effective systems in place to deal with people's comments and complaints.

We found that care workers had developed awareness and a sound understanding of each individual's care and support needs. This was evident from direct observation of individuals being supported in a professional, sensitive and respectful manner.

We observed staff caring for people who use the service and saw evidence of staff regularly checking the preferences of people who use the service. People spoken with were complimentary about the approach of the staff who supported them and told us that the staff treated them with respect. One person said, "We respect each other."

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We tracked the care records of four people who used the service which showed that people were provided with the care and support that they required and met their assessed needs.

We spoke with two staff members who confirmed that they were provided with safeguarding training and they were aware of their responsibilities regarding reporting and recording allegations of abuse.

We observed the care and support provided to people and we saw that the staff interacted with people in a caring, respectful and professional manner. Staff responded to requests for assistance promptly. We examined the homes training records. The records showed that the staff team received regular training in the mandatory areas.

We saw evidence of audit checks by senior members of staff of care planning. People who used the service spoke positively about the approach of the manager when concerns had arisen. One person told us, "I didn't like a certain meal. I told the manager and she made sure it was changed for me straight away."

People told us that they were happy living in Beachlands Residential Care Home and were pleased with the care they received. Comments included “I have been here four years…its beautiful here” and “I am very happy here, its suits me”. People told us that they were visited by professionals such as GPs and District Nurses when needed.

People spoke very highly of the staff and described them as “Exceptionally good” “Friendly” and “Very nice”. One person told us that “Nothing is too much trouble for the staff here”.

The people who used this service all said there was a good choice of food and plenty to eat. One person described the food as “Exceptional” another person said “You are always offered an alternative if you don’t like what’s on the menu or are on a special diet”.

People told us that they were able to choose what they wanted to do in the home. People told us that they got up and went to bed when they wanted to.

Everyone we spoke with praised the variety and frequency of activities. Comments included “We do things like bingo and quizzes with the staff or I often read my book and watch TV” and “We are always given a choice ….we are asked if we want to join in”.

The people we spoke with told us that the home was kept “Very clean and tidy” and that the laundry service was “Very good”.