This inspection took place on 20 February 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

Beaconsfield Court 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.

Beaconsfield Court accommodates up to 32 older people providing personal care in one adapted building across three floors. On the day of our inspection, there were 30 people using the service. Some of the people were living with a dementia type illness.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 last carried out a focussed inspection at Beaconsfield Court on 22 November 2016 and rated the service as Good. At this inspection the service met all regulations and continued to be rated Good.

Staff and management team understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding adults. People we spoke with told us they felt safe at the service.

Accidents and incidents were appropriately recorded and investigated, and risk assessments were in place for people who used the service that described potential risks and the safeguards in place to mitigate these risks.

Medicines were managed safely. Trained staff administered people’s medicines. Records accurately accounted for the medicines people had been given.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff.

Staff were suitably trained and training was arranged for any due refresher training. Staff received regular supervisions and an annual appraisal.

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.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Beaconsfield Court . Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People’s needs had been assessed and personalised care plans developed. Care plans were evaluated to check they reflected people’s needs. People had the opportunity to be involved in the review.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs. The newly opened coffee shop area with tables and chairs where people and visitors could sit with hot drinks enabled a lovely environment for people to maintain relationships with those close to them. The service maintained good links with the local community.

People who used the service and family members were aware of how to make a complaint and we saw any complaint or issue was dealt with promptly by the management team.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager and were comfortable raising any concerns. People who used the servic

This inspection visit was carried out in order to follow up a breach of Regulation 18 of the Health and Social Care Act in relation to Staffing. At our last visit to Beaconsfield Court on 7 October 2015, we issued a requirement notice. Following the visit on 7 October 2015, the registered provider sent us an action plan detailing how and when they would take action in order to meet this requirement notice.

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. There was a registered manger for the service who was on annual leave at the time of our inspection. We undertook the inspection with the deputy manager of the service.

At our last visit to the service in October 2015, we found there were not sufficient staff to meet the needs of people using the service. The registered provider submitted an action plan to CQC stating when and how they intended to take action to meet the regulation. This included a review of staffing levels by the Assistant Operations Director and the Managing Director, a review of dependency levels of people who used the service and early morning visits to the service to review staffing levels. The registered provide told us they were going to provide additional staffing between 8am and 2pm.

At this visit we saw the registered provider had implemented this increased staffing and there were now five care staff on a morning shift along with a senior care worker for 29 people. We witnessed staff were able to spend time talking with people and undertaking one to one activities. Staff told us there was less pressure and the increased staffing levels had made a positive difference to the quality of the service.

We reviewed records that showed the registered provider had committed to maintain the staffing levels and regularly reviewed the dependency needs of people using the service. We saw this requirement was now met.

The inspection took place on 7 October 2015. The inspection was unannounced. This meant the provider or staff did not know about our inspection visit.

Beaconsfield Court is a residential care home for up to 32 people based in Barnard Castle. The home provides care to older people and people with dementia. It is situated on the main street of Barnard Castle, close to local amenities and transport links. On the day of our inspection there were 29 people using the service.

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.

We spoke with care staff who told us they felt supported and that both the registered manager and deputy manager were always available and approachable. Throughout the day we saw that people who used the service and staff were comfortable and relaxed with the registered manager and each other. Although the atmosphere was busy we saw that staff interacted with each other and the people who used the service in a very friendly, positive and respectful manner.

From looking at people’s care plans we saw they were written in an easy to read and person centred way and made good use of pictures, personal history and used simple language to describe individual’s care, treatment and support needs. These were regularly reviewed and updated.

Individual care plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: their GP or Chiropodist.

Our observations during the inspection showed us that people were not always supported by sufficient numbers of staff. We found the number of available staff available didn’t always suit the layout of the building and people’s needs. We saw staff were responsive to people’s needs and wishes, but that there were insufficient numbers of staff deployed to meet people’s needs. We spoke to staff, family members and the people who use the service who shared this concern.

Staff were supported to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended both face to face training and online learning opportunities. They told us they had regular supervisions with the registered manager, where they had the opportunity to discuss their care practice and identify further training needs. We also viewed records that showed us there were robust recruitment processes in place.

We looked at how the service administered medicines and how they did this safely. We looked at how the records were kept and spoke to the registered manager about how staff were trained to administer medicines and we found the process to be safe.

During the inspection we witnessed the staff rapport with the people who used the service and the positive interactions that took place. Staff were caring, positive, encouraging and attentive when communicating and supporting people.

We observed people were encouraged to participate in activities that were personalised and meaningful to them. For example, we saw staff spending time engaging with people on a one to one basis on an activity and we saw evidence that others were being supported to go out and be active in their local community and trips further afield.

We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a selection of choices of drinks and snacks. The daily menu that we saw also offered choice.

We found the building and outside garden area that met the needs of the people who used the service and there were plans to improve this further.

We saw a complaints procedure that was in place and this provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services if they needed it.

We found an effective quality assurance survey took place regularly and we looked at the results. The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service; their representatives were regularly asked for their views at meetings and the registered manager’s drop in surgeries.

We spoke with seven people living at the home. Everyone was positive about the staff and the care they provided. One person receiving care told us; “The care I get here is fantastic the staff are always there when you call and nothing is too much trouble for them”.

We saw staff interacting with people in a friendly and caring manner and observed staff upholding people’s privacy and dignity by ensuring they knocked on doors and explaining to people what was happening next. There was also lots of laughter and friendly chat between members of staff and residents and their visitors.

We saw that people’s views were taken into account in the planning and delivery of their care and that people were kept informed about developments in the service.

There was a system in place for the acting manager to check the quality of the service being provided and this was shared with staff and people using the service.

All of the people that we spoke with said they were happy at Beaconsfield Court. One person said "It's great, it's the tops." People also said they were involved in their care, with their preferences being sought and taken into consideration.

People told us that they were happy with the care and treatment they were receiving. One person said "We get looked after very well" and another said "They look after you pretty well here."

People said they were happy with the staff at Beaconsfield Court and the care that they provided. One person said "The staff are very good, lovely people" and another person told us "The staff look after me well at all times." They also said the staff knew them well and how best to support them.

All the people that we spoke with told us they felt safe at Beaconsfield Court. People were also clear about how and who to report any concerns about their safety to.

People said they were aware of the complaints system. They also said they would be happy to raise any concerns they had with the staff and would be confident these would be listened to and acted upon. All of the residents that we spoke with said they hadn't had any reason to complain.